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Smith v. Mr. Sweeper Stores1/30/2001
71-079
In this workers' compensation appeal, the sole question is whether Betty L. Smith or her employer/insurer bore the burden of proof of establishing that Smith's claim for continued medical treatment (after years of the employer paying for medical treatment for a work-related aggravation of a pre-existing injury) was directly related to her work- related injury. After review, the superior court affirmed the appellate division of the State Board of Workers' Compensation which found that Smith, not her employer, had that burden. We agree.
On August 2, 1990, while on company business for her employer (Mr. Sweeper Stores, Inc.), Smith was involved in an automobile accident. She sought and obtained medical benefits only. About seven years later, her employer, its insurer (State Auto Insurance Company), and the servicing agent refused to pay for continuing treatment for Smith's headaches and hypertension on the basis that such treatment was not related to the August 2, 1990 automobile accident and duly notified her doctors. Notice was sent to Smith, Dr. Warren Davis, Dr. Gary Myerson, and to the Board that the right to compensation was being disputed for these reasons: "1. Blood pressure medication is not related to 8-2-90 accident. 2. Current medical treatment and prescriptions are due to pre-existing conditions and are not related to the specific 8-2- 90 auto accident."
Smith disagreed with this action and filed a request for an administrative hearing on the matter of payment. Pursuant to Smith's request, an administrative law judge ("ALJ") conducted a hearing to resolve whether Smith was still entitled to medical services. The parties stipulated that no temporary total disability benefits had ever been paid in the case. The employer/insurer (collectively "employer") agreed that the August 1990 automobile accident had aggravated Smith's pre-existing problems with headaches and hypertension. But the employer contended that the aggravation had resolved so that it had no liability for Smith's current treatment. Smith countered that since it was the employer who was asserting that her medical problems had subsided, it was the burden of Mr. Sweeper to prove she had undergone a change in condition.
Rejecting Smith's argument, the ALJ noted that it was Smith who had the burden of proving her injury was compensable. After considering the testimony and examining Smith's medical records, the ALJ found:
Even if the August 2, 1990, injury aggravated the employee's high blood pressure and migraine headaches, I find that any aggravation has resolved and that stress from various sources is the cause of the employee's hypertension and migraine headaches.
Having determined that Smith failed to sustain her burden of proof, the ALJ denied Smith's claim for continued medical treatment. After observing that the employee bore the burden of proof "to show the relatedness of her hypertension and headaches," the appellate division adopted the award as its own. The superior court affirmed, and Smith was granted permission to pursue this discretionary appeal.
1. Smith contends that the superior court committed legal error in affirming an award that incorrectly assigned the burden of proof to her rather than to her employer. Relying upon OCGA ยง 34-9-105 (c) (5), she claims that the award must be set aside because it is contrary to law. While conceding that she had the initial burden of proving that her injury was compensable, Smith contends that the burden shifted to her employer to show that continued treatment was not related to the original accident. Smith argues that since an employer has the burden of proof in claims relating to an interven
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