O.C.G.A. § 34-9-206 (2019)
Reimbursement for costs of medical treatment
(a) Any party to a claim under this chapter, a group insurance company, or other health care provider who covers the costs of medical treatment for a person who subsequently files a claim under this chapter may give notice in writing to the board at any time during the pendency of the claim that such provider is or should be a party at interest as a result of payments made in the employee’s behalf for medical treatment. (b) In cases where a group insurance company or other health care provider covers the costs of medical treatment for a person who subsequently files a claim and is entitled to benefits under this chapter, the board shall be authorized to order the employer or workers’ compensation insurance carrier to repay the group insurance company or other health care provider the funds it has expended for the claimant’s medical treatment, provided that such employer or its workers’ compensation insurance carrier is liable under this chapter for such medical treatment and provided, further, that such other provider has become or should be a party at interest pursuant to the provisions of subsection (a) of this Code section. The employer or its workers’ compensation insurance carrier deemed liable for such medical treatment shall not be obligated to pay such sums directly to the employee unless, and only to the extent that, it is proven that the employee has paid for such medical treatment himself.
History
(Code 1981, § 34-9-206, enacted by Ga. L. 1985, p. 727, § 6; Ga. L. 1990, p. 1409, § 9.)
Annotations
Code Commission notes. - Pursuant to Code Section 28-9-5, in 1986, in subsec-
tion (b) commas were inserted preceding and following ‘‘further’’.
JUDICIAL DECISIONS Requirement of section. - Only requirement of O.C.G.A. § 34-9-206 is that the provider must have covered the costs of medical treatment. Tolleson Lumber Co. v. Kirk, 200 Ga. App. 689, 409 S.E.2d 260 (1991). No liability when statute of limitations runs. - When a claimant was injured in 1985, but did not file a claim for Workers’ Compensation benefits until July 1987, the claim was barred by the statute of limitations contained in O.C.G.A. § 34-9-82(a), and neither the employer nor its compensation carrier was liable. Thus, neither the employer nor its compensation carrier was liable to the group health provider for medical expenses incurred by the claimant from 1985 to July 1987 for treatment of the 1985 work-related injury. State Wholesalers, Inc. v. Parks, 194 Ga. App. 900, 392 S.E.2d 64 (1990). Personal injury protection carrier as party at interest. - Under O.C.G.A. § 34-9-206, a motor vehicle personal injury protection carrier which covered certain medical expenses of the claimant can be a party at interest to a workers’ com-
pensation claim. Tolleson Lumber Co. v. Kirk, 200 Ga. App. 689, 409 S.E.2d 260 (1991). Intervention not required. - Workers’ compensation insurers/payors did not have a ‘‘property right’’ under the Workers’ Compensation Act that required medical care providers to intervene in an injured employee’s workers’ compensation claim, rather than proceed in the superior court, in order to protect the payors’ potential windfall. Aetna Workers’ Comp Access, LLC v. Coliseum Med. Ctr., 322 Ga. App. 641, 746 S.E.2d 148 (2013). Claimant’s right to direct payment affected by time of injury. - The 1990 amendment allowing a workers’ compensation insurer to gain the windfall that results when a third-party provider does not seek payment constituted a substantive change not applicable to a 1988 injury, and, thus, a claimant covered under the prior law was entitled to be paid directly for the amount of the claimant’s medical expenses which were paid by a third party provider which had not sought reimbursement. Carroll v. Diamond Rug & Carpet Mills, Inc., 224 Ga. App. 361, 480 S.E.2d 374 (1997).