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Oconee Area Home Care Services10/12/2005
BLACKBURN, P. J., MILLER and BERNES, JJ.
In this workers' compensation action, S.E.U.S. Captive Insurance Company appeals the superior court's reversal of the Workers' Compensation Board's decision that James Burton's debilitating injury at work occurred on July 16, 2003 and not on August 26, 2003. The superior court held that the evidence showed that the injury occurred on August 26 and that therefore S.E.U.S., whose coverage of this employer began August 1, 2003 (and not Healthcare Mutual Captive Insurance Company, whose coverage of this employer ceased August 1, 2003), was liable for Burton's disability payments. We hold that because some evidence supported the Board's factfinding that the injury occurred on July 16, the trial court erred in reversing the Board's decision, and we accordingly reverse the trial court's decision.
The undisputed evidence showed that James Burton injured his back at work when lifting a patient on July 16, 2003. He did not return to work until August 4, by which time his treating physician had certified that he was able to return to work. On August 26, Burton ceased working for his employer due to back pain. He sought workers' compensation benefits.
At the hearing, no party disputed that Burton was entitled to workers' compensation benefits. Rather, because the employer had changed insurance carriers on August 1, the primary issue was whether the benefits to be paid to Burton from August 26 forward were to come from the pre-August 1 carrier (Healthcare Mutual) or from the post-August 1 carrier (S.E.U.S.). This determination hinged on whether his disability arose out of his July 16 accident (with a change in condition on August 26) or out of a new accident that allegedly occurred on August 26. The ALJ hearing the matter decided that the disability arose out of the July 16 accident and ordered Healthcare Mutual to fund the workers' compensation benefits.
Healthcare Mutual appealed the ALJ's decision to the Board, which, after a review of the evidence, adopted and affirmed the ALJ's decision. Healthcare Mutual appealed the Board's decision to the superior court, which reversed the Board's decision, finding that "the evidence shows Claimant sustained a new injury on August 26, 2003" and ordering that S.E.U.S. fund the income benefits. Following the discretionary appeal procedure, S.E.U.S. appeals the superior court's judgment.
The key issue is whether Burton's disability resulted from a change in condition or from a new accident. Central State Hosp. v. James explains this distinction. When a claimant sustains an injury, is awarded compensation, returns to his normal and ordinary job duties, but then "as a result of the wear and tear of ordinary life and the activity connected with performing his normal duties and not because of a specific job-related incident," his condition gradually deteriorates to where he cannot continue to perform his ordinary work, such facts constitute a change in condition and not a new accident. Id. at 310 (1) (c). See Cypress Cos. v. Brown. On the other hand, when a claimant sustains a second accident as the result of a specific job-related incident, which aggravates a pre-existing condition arising from a prior accident, then the second accident is a new injury if it at least partially precipitated the claimant's disability. Central State Hosp., supra at 309 (1) (b).
"Whether an employee's inability to continue working has been caused by a new accident or a change in condition is a question of fact for the administrative law judge." (Punctuation omitted.) Columbus Intermediate Care Home v. Johnston. "When the record contains any evidence to support that factual finding, reviewing cour
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