SUNBELT PLASTIC EXTRUSIONS, INC. v. JULIE PAGUIA

Court of Appeals of Georgia·Decided August 26, 2021·No. A21A0867·Published

Opinion

FIFTH DIVISION

RICKMAN, C. J.,

McFADDEN, P. J., and SENIOR APPELLATE JUDGE PHIPPS

NOTICE: Motions for reconsideration must be physically received in our clerk’s office within ten days of the date of decision to be deemed timely filed.

https://www.gaappeals.us/rules

DEADLINES ARE NO LONGER TOLLED IN THIS COURT. ALL FILINGS MUST BE SUBMITTED WITHIN THE TIMES SET BY OUR COURT RULES.

August 19, 2021

In the Court of Appeals of Georgia A21A0867. SUNBELT PLASTIC EXTRUSIONS, INC. et al. v.

PAGUIA.

MCFADDEN, Presiding Judge.

The primary issue in this workers’ compensation case is whether Sunbelt Plastic Extrusions, Inc. and its insurer (collectively, “Sunbelt”) proved their statute- of-limitation defense to Julie Paguia’s claim for a designation that her work-related injury is catastrophic. An administrative law judge with the State Board of Workers’ Compensation and the appellate division of the board ruled that it did not. The superior court affirmed. We granted Sunbelt’s application for discretionary appeal and now hold that some evidence supports the board’s factual finding. We also find that evidence supports the designation of Paguia’s work-related injury as catastrophic. So we affirm.

1. Facts and procedural posture.

When we review an award of the State Board of Workers’ Compensation, we construe the evidence

in a light most favorable to the party prevailing before the board; every presumption in favor of validity of the award should be indulged in by the reviewing court; neither the superior court nor this court has any authority to substitute itself as a factfinding body in lieu of the board;

and weight and credit to be given witness testimony and conflicts in evidence are for the board’s exclusive determination.

Publishers Circulation Fulfillment v. Bailey, 215 Ga. App. 136, 137 (449 SE2d 645) (1994) (citation omitted).

So viewed, the evidence shows that on March 31, 2009, Paguia injured her left hand in the course and scope of her employment with Sunbelt and sought workers’ compensation benefits. She was entitled to 400 weeks of temporary total disability benefits, through November 29, 2016, and Sunbelt began paying those benefits.

On November 20, 2018, Paguia filed a form with the State Board of Workers’

Compensation requesting that her injury be deemed catastrophic, a designation that would entitle her to continued payments. See OCGA § 34-9-261. Sunbelt countered that Paguia’s request was barred by the two-year statute of limitation contained in

OCGA § 34-9-104 (b). The administrative law judge conducted a hearing, rejected Sunbelt’s statute-of-limitation defense, and found that Paguia’s injury is catastrophic. The appellate division adopted the administrative law judge’s findings of fact, conclusions of law, and award, and made additional findings of fact and conclusions of law on the statute-of-limitation issue. The superior court affirmed and we granted Sunbelt’s application for discretionary appeal.

2. Statute-of-limitation defense.

Sunbelt argues that the administrative law judge and the appellate division erred by rejecting its statute-of-limitation defense. We disagree.

OCGA § 34-9-104 (b) allows a claimant to seek additional workers’

compensation benefits because of a change in condition (which Paguia sought here, see Williams v. Conagra Poultry of Athens, 295 Ga. App. 744, 746 (673 SE2d 105) (2009)), provided that “not more than two years have elapsed since the date the last payment of income benefits . . . was actually made[.]” “Thus, once an employer ends the payment of [temporary total disability] benefits to an employee, that employee must file a claim for any additional . . . benefits within two years of that cessation date; otherwise, the claim is time barred.” Roseburg Forest Products Co. v. Barnes, 299 Ga. 167, 169 (1) (787 SE2d 232) (2016).

We have deferred to the appellate division’s determination that a payment is “actually made” under OCGA § 34-9-104 (b) when it is mailed to the recipient. Lane v. Williams Plant Svcs., 330 Ga. App. 416, 419-420 (1) (a) (766 SE2d 482) (2014) (whole court) (“We need not decide whether the so-called mailbox rule . . . should be applied to the limitation period in OCGA § 34-9-104 (b), because the Appellate Division’s determination that a payment is ‘actually made’ when it is mailed to the recipient is reasonable and entitled to deference.”) (footnote omitted). See also Rawleigh Medical Co. v. Burney, 25 Ga. App. 20 (a) (102 SE 358) (1920) (the term “mailed” means “the deposit of the letter in a United States post office or United States postal mail box, or in the custody of a United States mail collector”). See generally United Grocery Outlet v. Bennett, 292 Ga. App. 363, 364 (665 SE2d 27) (2008) (discussing the evolution of the statute-of-limitation-triggering language in OCGA § 34-9-104 (b)).

a. Findings of fact.

It is not disputed that Paguia filed her form requesting a designation that her injury was catastrophic on November 20, 2018. The issue is whether Sunbelt proved that it mailed the last payment of income benefits to Paguia more than two years before that date. Lane, 330 Ga. App. at 420 (1) (a).

At the hearing before the administrative law judge, Sunbelt presented the testimony of the insurer’s workers’ compensation claims adjuster assigned to Paguia’s claim. The claims adjuster testified that she completed a claims payment authorization form that instructed her administrative assistant to issue a check for Paguia’s last two weeks of temporary total disability benefits. She testified that generally, once she completes such a form, she “send[s] it to [her] administrative assistant, and the administrative assistant creates[s] a check in the computer system and a check is printed in [their] office.” She added that “the post office comes every day and picks the checks up and they’re sent out,” sometime between 3:30 and 4:30.

The claims adjuster testified that she is not the person who creates or mails the checks and that she did not know when her administrative assistant created the check to Paguia or when the administrative assistant placed it in the location from which the person from the post office picked it up. But, she testified, her opinion was that the check was mailed on November 15, 2016, the date printed on Paguia’s check.

From this evidence, the appellate division found that the insurer’s routine practice was for the adjuster to complete a claims payment authorization form, which is conveyed to an administrative assistant who then creates a check in the computer system. It found that the check is printed in the insurer’s office and then someone

from the post office picks up the check for mailing. The appellate division found that the claims adjuster completed the claims payment authorization form for Paguia on November 14, 2016, a check was printed, and it was picked up for mailing. But the appellate division found that Sunbelt presented no evidence about the time that elapsed between the various steps. Although Sunbelt contended that the check was mailed the day after the adjuster completed the claims payment authorization form, the appellate division found that Sunbelt presented no evidence that a one-day interval between the completion of the form and the mailing of the check is part of the insurer’s routine practice; no evidence of the length of time between the administrative assistant’s receipt of the claims payment authorization form and the creation of the check in the computer system; and no evidence of the length of time between the creation of the check and the printing of the check. Thus, the appellate division concluded, there was insufficient evidence to determine when the check was mailed, other than some time after November 14, and Sunbelt did not carry its burden of proving its statute-of-limitation defense. See Hulbert v. Domino’s Pizza, 239 Ga. App. 370, 374 (2) (521 SE2d 43) (1999) (employer has the burden of proof when raising an affirmative defense).

Free access — add to your briefcase to read the full text and ask questions with AI

SUNBELT PLASTIC EXTRUSIONS, INC. v. JULIE PAGUIA, (Ga. Ct. App. 2021).

SUNBELT PLASTIC EXTRUSIONS, INC. v. JULIE PAGUIA (SUNBELT PLASTIC EXTRUSIONS, INC. v. JULIE PAGUIA) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

United Grocery Outlet v. Bennett
665 S.E.2d 27 (Court of Appeals of Georgia, 2008)
Pike v. GREYHOUND BUS LINES, INC.
232 S.E.2d 143 (Court of Appeals of Georgia, 1977)
Williams v. Conagra Poultry of Athens, Inc.
673 S.E.2d 105 (Court of Appeals of Georgia, 2009)
Crenshaw v. Crenshaw
471 S.E.2d 845 (Supreme Court of Georgia, 1996)
LANE v. WILLIAMS PLANT SERVICES Et Al.
766 S.E.2d 482 (Court of Appeals of Georgia, 2014)
MOORE v. McKINNEY
783 S.E.2d 373 (Court of Appeals of Georgia, 2016)
BELL v. GILDER TIMBER COMPANY Et Al.
785 S.E.2d 682 (Court of Appeals of Georgia, 2016)
Roseburg Forest Products Company v. Barnes
787 S.E.2d 232 (Supreme Court of Georgia, 2016)
Callaway v. Quinn.
819 S.E.2d 493 (Court of Appeals of Georgia, 2018)
Rawleigh Medical Co. v. Burney
102 S.E. 358 (Court of Appeals of Georgia, 1920)
Publishers Circulation Fulfillment, Inc. v. Bailey
449 S.E.2d 645 (Court of Appeals of Georgia, 1994)
Patterson v. Kevon, LLC
818 S.E.2d 575 (Supreme Court of Georgia, 2018)
Hulbert v. Domino's Pizza, Inc.
521 S.E.2d 43 (Court of Appeals of Georgia, 1999)