Georgia Court Rules in Favor of Injured Worker Despite Prior Medical Misrepresentation (Insurance Business)

Georgia Court Rules in Favor of Injured Worker Despite Prior Medical Misrepresentation

Tuesday, March 4th, 2025 Legislation & Regulation Litigation Risk Management Workers' Compensation

A Georgia Court of Appeals ruling has reinforced employee rights in workers’ compensation cases, setting a precedent that employers must act promptly upon discovering misrepresented medical histories. The case involved Sharon McKay, an employee at Inalfa Roof Systems, who sustained two workplace injuries in 2021. Though she initially concealed a severe prior injury, her employer learned of it before her second workplace accident. When Inalfa attempted to deny her claim based on the Rycroft defense, the court ruled that the company had effectively waived this argument by continuing to employ her.

The Rycroft defense, established in Georgia law, allows employers to deny workers’ compensation if an employee knowingly provides false medical history, the employer relies on that information when hiring, and the misrepresentation directly affects a later injury claim. Inalfa successfully used this defense against McKay’s first injury claim, but the court determined it could not be applied to her second injury, which occurred after the company was already aware of her medical history.

The decision underscores the importance of employer accountability in handling discovered misrepresentations. Legal experts suggest this ruling may limit the future use of the Rycroft defense, ensuring that workers who sustain injuries on the job receive fair compensation when their employer knowingly retains them despite prior misrepresentations. Employers in Georgia will need to carefully evaluate how they handle undisclosed medical histories to avoid waiving their rights to deny future claims.


External References & Further Reading
https://www.insurancebusinessmag.com/us/news/legal-insights/employee-with-prior-hidden-injury-history-wins-workers-compensation-case-in-georgia-527033.aspx
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