St. Paul Fire & Marine Insurance v. Norman

325 S.E.2d 810, 173 Ga. App. 198, 1984 Ga. App. LEXIS 2756
CourtCourt of Appeals of Georgia
DecidedDecember 4, 1984
Docket68888
StatusPublished
Cited by10 cases

This text of 325 S.E.2d 810 (St. Paul Fire & Marine Insurance v. Norman) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St. Paul Fire & Marine Insurance v. Norman, 325 S.E.2d 810, 173 Ga. App. 198, 1984 Ga. App. LEXIS 2756 (Ga. Ct. App. 1984).

Opinions

Beasley, Judge.

This is an appeal by the employer and its carrier from a superior court order which set aside a Workers’ Compensation Board conclusion that the employee’s injury was a “change in condition” and not a “new accident.” Appellants contend that the court erred in this regard and also that it erred in determining that the claim was not barred by the statute of limitations, in refusing to give credit for sal[199]*199ary paid in lieu of workers’ compensation, and in awarding compensation for medical benefits directly to the claimant-employee rather than to the providers of the medical services.

The claimant, appellee Norman, was an employee in the office of Dr. Sapp on May 24, 1974, when she injured her knee at work. As a result of this injury, Dr. Sapp performed surgery on claimant’s knee. Bituminous Casualty Corporation, which at that time provided workers’ compensation coverage for Dr. Sapp, paid her medical expenses and the employer paid her salary in lieu of compensation during the time she was unable to work due to her injury. No disability payments were made, either for temporary total disability or for permanent partial disability. Claimant returned to work after about two months.

As a result of the wear and tear of ordinary life and the activity connected with performing the claimant’s normal duties, the condition of her right knee grew gradually worse. She developed bone spurs as a direct result of the 1974 injury and surgery, necessitating a second operation on January 16, 1981. This surgery was also performed by Dr. Sapp, who had since incorporated his practice with two other doctors as Tifton Orthopedic Clinic, P. C. Complications following the surgery required numerous surgical procedures, and the last record treatment was on May 25, 1981. Claimant was disabled from January 15, 1981, until she returned to work for the Clinic on April 6, 1981. Associated medical expenses totaled $19,989.53 for the January 16 surgery plus $2,828 for the follow-up procedures.

Bituminous, which by this time had been supplanted by St. Paul Fire & Marine Company as the Clinic’s workers’ compensation insurance carrier, declined to provide any coverage, contending that the claim was barred by the one-year statute of limitations. Norman then filed her claim with a group insurance carrier, which paid all medical expenses except for $633 of the hospital bill. No further effort was made to pursue a workers’ compensation proceeding until April 1982.

The administrative law judge and the State Board of Workers’ Compensation ruled that the January 1981 disability was a “change in condition” entitling claimant to an award against the employer and 1974 carrier (Bituminous) for medical expenses only. They ruled that any economic benefits normally associated therewith were barred by the statute of limitations of Ga. Code Ann. § 114-709.

Appeal was taken to the superior court, which set aside the award and ruled that the claimant’s 1981 injury was a “new injury” and not a “change in condition.” The court ordered the Clinic and the 1981 carrier, St. Paul, to pay claimant (1) temporary total disability benefits for the period of January 15, 1981, to April 6, 1981 (refusing to give credit for the salary paid the claimant by her employer during that time), (2) $19,989.53 for accrued medial expenses, (3) medical [200]*200expenses to be incurred in the future, and (4) other benefits and attorney fees to be determined by the Board. The court further recommitted the case to the Board for determination of permanent partial disability benefits.

The Clinic and St. Paul obtained leave to appeal to this court through the discretionary appeal procedure. Held:

1. The first complaint is that the superior court erred in its determination that Norman suffered a “new accident” rather than a “change in condition” on January 15, 1981. We disagree.

At the outset, appellants contend that the new Ga. Code Ann. § 114-709 [OCGA § 34-9-104] enacted in 1978, controls the 1982 claim because only a procedural matter is at issue. At the time of the 1974 accident, the “change of condition” provision was limited to those cases where there had been an award of workers’ compensation or Board-approved settlement. By the 1978 amendment, the statute was changed to encompass “change of condition” where the original physical condition was established “by award or otherwise.” Ga. L. 1978, pp. 2220, 2233.

The amended statute applied only prospectively as to substantive rights; it applied retroactively as to procedural matters regardless of the date of the accident: “In respect to the provisions of Code Sections 114-404, 114-405, and 114-406, as herein amended, and insofar as any provision of the Workers’ Compensation Act creates a substantive right, it shall apply to any accident or injury occurring on or after July 1, 1978. In all other respects, including all procedural matters, it shall apply to any action taken on or after July 1, 1978, without regard to the date of accident or injury.” Ga. L. 1978, pp. 2220, 2236.

Appellants attempt to distinguish the case of Hart v. Owens-Illinois, 250 Ga. 397 (297 SE2d 462) (1982), which held that OCGA § 34-9-104 is substantive and thus not to be applied retroactively, by asserting that Hart held that only Section (b) (3), the statute of limitations portion, is substantive. They contend that Section (a) of the statute, defining “change in condition,” is procedural.

However, the situation here is analogous to Hart, wherein it was concluded that a new claim was created which had not existed prior to the amendment. Similarly, with the 1978 amendment to the definition of “change of condition,” a new claim was fashioned. By the amendment, the law allowed, for the first time, a claim where the condition had been established “otherwise” than by Board award or Board approved settlement. The employee did not have such a claim in 1974. The 1978 act did not create one for her with respect to the accident which had occurred four years earlier and the time for making a claim based on it had long expired. The inchoate cause of action, which never ripened, was extinguished by the running of the statute of limitations. Although the procedure for handling the claim [201]*201if still in process would have been that in the 1978 act since the manner for dealing with claims was explicitly to apply retroactively, a claim itself had never been perfected by the obtaining of an award or Board-approved settlement. Section (a) created a substantive right where none existed before, and so the pre-1978 law controls.

The court below properly set aside the Board’s finding of a “change in condition” because former Ga. Code Ann. § 114-709 has two prerequisites for a “change in condition”: (1) Board notification that final payment of a claim had been made pursuant to a Board order; and (2) an authorized review of an award or settlement made between the parties and approved by the Board.

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St. Paul Fire & Marine Insurance v. Norman
325 S.E.2d 810 (Court of Appeals of Georgia, 1984)

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Bluebook (online)
325 S.E.2d 810, 173 Ga. App. 198, 1984 Ga. App. LEXIS 2756, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-paul-fire-marine-insurance-v-norman-gactapp-1984.