O.C.G.A. §34-9-261 and 262 – TTD and TPD Max Rates
The changes with the most immediate consequences have been the increase of weekly income benefits. For all injuries on or after July 1, 2023, the maximum temporary total disability (TTD) rate is $800.00, the maximum temporary partial disability (TPD) rate is $533.00; and the maximum death benefit to a surviving spouse serving as sole beneficiary is $320,000.00.
O.C.G.A. §34-9-13 – Death Benefits for Unmarried Dependents
The General Assembly expanded and clarified eligibility for death benefits for unmarried dependents. While there is still no presumption of dependency for unmarried dependents, those who lived with a deceased employee “continuously and openly in a relationship similar or akin to marriage” for a period of three or more months can qualify for death benefits if evidence at the time of the accident shows that the deceased employee provided “support of economic value” to the dependent. The forms of support can include but are not limited to “monetary support, sustenance, or housing.” However, where the deceased employee’s payments were made to a claimant dependent exclusively for board and lodging, that claimant dependent will not qualify.
Rule 203(e) – Medical Mileage Increased to 45 Cents Per Mile
Mileage reimbursement rates for claimant traveling from their home to obtain medical services increased from 40 cents per mile to 45 cents per mile. Note that this increased rate is payable to all claimants for medical-related travel regardless of their date of accident.
Rule 200.2 – Medical Records to All Parties
In non-catastrophic claims where employer/insurers voluntarily use medical case managers, the rule now specifies that these managers must provide copies of all medical records, medical reports, office notes, test results, and all other written documents received from the claimant’s treating physicians to all parties and their attorneys.
Rule 203(c)(9) – Additional Fees for Peer Review
Employers, insurers, and physicians have long been able to file a request for peer review with a peer review organization in the event of a dispute over charges not contained in the fee schedule, charges allegedly not paid pursuant to the fee schedule, and/or where charges are disputed as not being the usual, customary and reasonable charges prevailing in the state. Going forward, anytime an authorized peer review organization determines that an additional fee is due to the medical provider, the employer/insurer must not only pay the medical provider the additional fee, but also the fee for peer review initially paid by the medical provider.
Please feel free to call or email if you have any questions.
Chad McDonald, Esq.
Senior Associate Attorney