COVID-19 Resource Center

07/01/2021

Georgia Office Scores a Workers’ Compensation Victory at the Court of Appeals

Managing partner Benjamin Leonard and senior associate Matthew Pittman of the firm’s Atlanta office obtained a favorable ruling at the Court of Appeals in a Workers’ Compensation claim involving death benefits.

The underlying claim involved a surviving claimant/spouse whose husband, and employee driver of the employer, died in August 2012 in a compensable accident while driving for the employer.  The decedent employee and his surviving claimant/spouse, who had no minor children and no other potential dependents, filed a claim for benefits.  The claimant/spouse filed a claim for dependency benefits and was paid the same pursuant to OCGA § 34-9-13(c).  The claimant/spouse was paid the full amount of the statutory limit on weekly benefits to a sole surviving spouse with no other dependents at the time of death for the date of accident (per OCGA § 34-9-265(d)for that date of accident the limit was $150,000.00).

Upon the limit having been paid, the claimant/spouse filed a claim for additional benefits, contending the deceased’s mother (who passed away in 2017 during the pendency of this claim) was a partial dependent, thus the cap on benefits under OCGA § 34-9-265(d) did not apply.  An evidentiary hearing was held and the Administrative Law Judge found the decedent’s mother had not filed a claim for benefits prior to passing away in 2017, thus she had not qualified as a dependent during her lifetime.  The claimant/spouse appealed to the Appellate Division, which affirmed the ALJ, and thereafter appealed to the Superior Court, which also affirmed.  Thereafter the claimant/spouse filed an appeal with the Court of Appeals, arguing the limit on her benefits under OCGA § 34-9-265 (d) did not apply because she was not the sole surviving dependent at the time of the employee’s death.

The Court of Appeals affirmed the lower courts and rejected the claimant/spouse’s argument.  The Court reasoned that the language of the death benefits statute under OCGA 34-9-13 (b)(1) was clear on its face that if an employee dies and leaves a person wholly dependent upon him or her, any partially dependent individuals would not be eligible for benefits.  The Court further examined the language of OCGA § 34-9-265 (b)(2), which it interpreted as making wholly partially dependent individuals mutually exclusive; if a wholly dependent individual existed at the time of the death, no partial dependents would be eligible for benefits.

In determining each dependent class to be mutually exclusive, the Court determined the deceased’s mother was not ever eligible to receive benefits during her lifetime.  Thus, as such, and coupled with the fact she passed away before filing a claim for such benefits, the limitation on benefits for the claimant/spouse was correctly applied under OCGA § 34-9-265(d).  The finding of a posthumous claim of partial dependency made no difference in the application of the limitation on benefits to the claimant/spouse due to the reasoning of the Court.