Category: Crime Victim

Children’s Medicaid Reimbursement

Posted by Jeff on
Wrongful Death

As personal injury lawyers, our primary duty to our clients is to maximize each client’s net recovery. So, while it’s great to get a significant settlement on behalf of a child, such a settlement is much smaller when a large portion must be repaid to a health insurance company or Medicaid. At Gomez & Golomb, we work hard dealing with and extinguishing any Children’s Medicaid Reimbursement claims not allowed under Georgia law.

An example is when a minor is injured. PeachCare/Medicaid often pays the medical bills and claims a lien against future settlements in these situations. After careful review, we interpret Georgia and federal law to hold that PeachCare has no right to reimbursement for any settlement with a minor. We, therefore, fight these reimbursement claims tooth and nail.

In Georgia, an injured child only has a claim for pain and suffering. Southern Guaranty Ins. Co. v. Sinclair, 228 Ga. App. 386 (1997) discusses this concept. In that case, the Court held that a minor has no claim for medical expenses because that obligation rests with the child’s parents. This reasoning makes sense because until a minor child reaches the age of 18, they cannot be bound under contract. Therefore, in a Children’s Medicaid Reimbursement situation, a child cannot be liable for medical expenses nor claim reimbursement of medical expenses.

The United States Supreme Court held that Medicaid/PeachCare can only reach settlement monies paid to reimburse medical bills following an injury. Thus, PeachCare/Medicaid can claim a lien against that part of an injured person’s recovery only for money received for medical expenses. Arkansas Dept. of Health and Human Services v. Ahlborn, 547 U.S. 268; 126 S. Ct. 1752 (2006).

Reading Sinclair and Ahlborn together, Medicaid/PeachCare cannot claim a lien against a minor child’s settlement proceeds. To shield a settlement from Peachcare/Medicaid, we structure the settlement between the wrongdoing party and the minor child. The settlement clarifies it only covers pain and suffering.

If you have a question about these issues, please call Gomez & Golomb LLC at 404-382-9994. 

Wrongful Death in Georgia – Who Makes the Claim

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If your loved one has recently passed, we offer our sincere condolences. Losing a loved one is tragic, but at some point, the living must go on living. This means educating yourself regarding your family’s legal rights in order to make a full recovery on behalf of your loved one.

If your loved one’s death was caused by the negligence of another, who is entitled to make a claim? A claim may include include funeral expenses, medical expenses, pain and suffering before your loved one’s death, and the value of your loved one’s life that has been cut short?

To understand who can make a claim, we must first understand that Georgia law allows two different claims following a wrongful death: one is just referred to as a “wrongful death claim”, and the other is referred to as an “estate claim” or “survival claim”. The same person can bring both claims, but this isn’t necessarily the case.

Wrongful Death Claim

Under Georgia law, this claim belongs to the loved one’s spouse and children. See OCGA § 51-4-2. If the loved one had no spouse or children during their life, the loved one’s parents are entitled to make the claim. See OCGA § 19-7-1. Finally, if no spouse, children, or parents are alive, the court can appoint an administrator or executor to make the claim. See OCGA § 51-4-5. Relatives such as a sibling, uncle, aunt, or grandparent have no right to prosecute the wrongful death case.

We will discuss this in further detail in another blog. However, generally, a wrongful death claim includes recovery for the value of your loved one’s life had he or she not died prematurely.

Estate/Survival Claim

The administrator of your loved one’s estate is the party entitled to make claims for funeral, medical, and other necessary expenses and any claim for pain and suffering before death. OCGA § 51-4-5.

If you have any questions about who can make a wrongful death claim on behalf of your loved one, please call us. We have provided a very general overview, but many details and complications come up when applying these rules in real life.

Were you injured or a crime victim on someone else’s property?

Posted by Jeff on
an example of an invitee

If you slip and fall or a rape victim on someone else’s property, the reason why you are on the property matters. Whether you can recover for your injuries often turns on your relationship with the property owner. The law has fancy words to describe the different types of relationships, which we cover below.

The first type of relationship, that of a trespasser, is easy to understand. A trespasser is someone who goes onto someone else’s property without invitation or permission. An example is if someone breaks into your house. If the trespasser gets hurt, you are responsible only if you intentionally tried to hurt the trespasser. This becomes relevant in a landlord-tenant situation. If a lease does not identify a tenant, arguably the tenant is a trespasser and will have a tough claim against the landlord. However, this can be overcome if the landlord knew the tenant was living on the property but took no action.

The next step up is a licensee. This is a person invited onto the property as a social guest but who does not provide a benefit to the owner. A licensee is on the property only for his own convenience. O.C.G.A. § 51-3-2. So, if you invite a friend to your house, your friend is an invitee. If a licensee is injured, the property owner must exercise reasonable care to prevent injury.

Finally, there is what is known as an invitee. An invitee is a person who is invited and provides benefit to the owner. An example is if you go to Publix to buy groceries. You have been invited by the Publix onto the property and are benefiting Publix by buying groceries. With regard to an invitee, a property owner must exercise ordinary care to keep the property safe. This is a higher standard than a licensee. And requires the owner to inspect its property to make sure it is safe for its customers.

If you are injured or are a crime victim on someone else’s property, please call us. Our number is (404) 382-9991.

Georgia Crime Victims Assistance

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If you are a crime victim, in addition to suing the person who committed the crime, Georgia offers up to $25,000 in crime victim assistance. This compensation program covers such things as medical bills, funeral expenses, mental health counseling, and loss of income or support. This is a significant program. For example, in 2018, Georgia awarded almost $20 million to 14,246 crime victims in Georgia’s 159 counties.

The Georgia legislature explained the basis for program:

. . . many innocent persons suffer personal physical injury, serious mental or emotional trauma, severe financial hardship, or death as a result of criminal acts or attempted criminal acts. The General Assembly finds and determines that there is a need for assistance for such victims of crimes. Accordingly, it is the General Assembly’s intent that under certain circumstances, aid, care, and assistance be provided by the state for such victims of crimes. O.C.G.A. § 17-15-1.

To get compensation, you must file an application with the Georgia Crime Victims Compensation Program. To qualify, you must be physically injured or witness a violent crime OR suffer serious mental trauma as a result of being threatened or present during a violent crime OR trying to help a crime victim OR you are a parent of someone killed or injured as a result of violent crime OR depended on someone for financial support who was killed during a violent crime OR having been paying bills related to the crime.

The most common crimes eligible for compensation are child molestation, rape, domestic violence, homicide, hit-and-run, serious injury by vehicle, DUI crashes, assault/battery, and robbery.

Please be aware that you must meet some initial guidelines: you must have reported the crime within 72 hours and must file an applications with the Georgia Crime Victims Compensation Program within three years of the crime. These are the general rules but there are exceptions for minors and unusual circumstances.

If you qualify, you will be entitled to recover to $25,000 per victim per incident. The $25,000 includes medical expenses up to $15,000, funeral expenses up to $6,000, counseling expenses up to $3,000, lost wages expenses up to $10,000, and loss of support expenses up to $10,000.

If you are the victim of a crime, please contact Gomez & Golomb 404-382-9994. We offer a free consultation to review and explain your options to get compensated for your injuries.

Rape Victim Attorneys

Posted by Jeff on

“You save yourself or you remain unsaved.”― Alice Sebold

Unfortunately, rape is all too prevalent in our society. On average, there are there are 433,648 victims (age 12 or older) of rape and sexual assault each year in the United States. That means, every 73 seconds, an American woman is sexually assaulted.

If God forbid, you are a victim of rape and reading this, please (1) contact the police, (2) go to the emergency room, and (3) strongly consider contacting RAINN (Rape, Abuse & Incest National Network), which is the nation’s largest anti-sexual violence organization. RAINN created and operates the National Sexual Assault Hotline. 800.656.HOPE (4673).

Following a rape, victims face financial difficulties caused by medical bills, including emergency and follow-up care. Even worse, the trauma of and following the rape causes victims to experience depression, low-self-esteem, and struggles with family and at work.

Should you contact a lawyer? For many victims, contacting a lawyer and holding the responsible parties to account is part of the recovery process. A rape victim potentially has claims against attacker or rapist and against any business, school, or organization who made the rape possible. For example, if you live in an apartment complex, which failed to secure the property, you are entitled to recover from the owner and management of the apartment complex. Or, if at work, your employer failed to screen a co-worker who had a criminal history, you would have a claim against your employer.

If you have been a rape victim in Georgia, we are deeply sorry. Please call us at 404-382-9994 to discuss your legal options to hold those responsible accountable.