Category: Slip and Fall

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. 

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.

Slip and Falls in Georgia: Building Code Violations

Posted by Jeff on

Slip and falls at commercial properties often involves allegations that a property was “out of code.” The purpose of Georgia’s building codes is to protect public health, safety, and general welfare regarding construction and occupancy of buildings and structures. In other words, Georgia courts and the Georgia legislature have concluded it’s in everyone’s best interest for buildings and structures to be built with at least a minimum level of safety in mind.

In Georgia, O.C.G.A. § 8-2-20(9)(B) is the statute that covers mandatory and permissive state codes. Each of these separate codes typically consist of a base code (e.g., The International Building Code as published by the International Code Council) and a set of Georgia amendments to the base code. The mandatory codes are applicable to all construction whether or not they are locally enforced and the permissive codes are only applicable if a local government chooses to adopt and enforce one or more of these codes.

Georgia courts have ruled that violation of a building code is negligence per se, and evidence of non-conformity with building code standards may be proof of a landowner’s superior knowledge of a defect. In Georgia, someone who falls generally cannot recover unless the landowner knew of or should have known of the danger.

This all sounds good, but dow does it work in real life? When a client comes to us who was injured due to a fall at a commercial property–and it appears there may be a building code violation–we hire an engineering expert to go out to the property to view/measure the condition of the building and render an opinion. Often times our expert will look at such things as the riser heights of stairs and height of railings. If the expert finds a building code violation, this significantly strengthens a claim against the landowner. A building code violation shows objectively that the premise was unsafe, and makes it difficult for the landowner to claim lack of knowledge.

If you’ve been injured in a fall, please call us at 404-392-9994 to discuss your options.

Slip and Fall in a Parking Lot

Posted by Jeff on

Who is responsible when you’re injured in a shopping center parking lot. Is it the store you were shopping in? Is it the owner of the shopping center? Or, is it both? These were the issues decided in a recent Georgia appellate case. See Boyd v. Big Lots Stores, Inc., 18A1140 (July 31, 2018).

In what is likely one of his last opinions, Judge Andrews, writing for the court, predictably sides against the injury party. Judge Andrews is retiring from the bench, and for attorneys who represent injured parties, it can’t come soon enough. While Judge Andrews authors intelligent, articulate opinions, he typically sides with businesses and insurance companies.

With regard to parking lot injuries, the general rule is that a business must keep its premises and approaches safe for its customers. This includes protecting its customers from known dangerous conditions in the parking lot. In the Big Lots case, the customer was injured 45-feet away way from the store entrance. The Court of Appeals explained that an “approach” to a premises refers to property that is within the last few steps taken by the customer, as opposed to mere pedestrians. More specifically, an approach “is that property directly contiguous, adjacent to, and touching those entryways to [the] premises under the control of an owner or occupier of land, through which the owner or occupier, by express or implied invitation, has induced or led others to come upon his premises for any lawful purpose, and through which such owner or occupier could foresee a reasonable invitee would find it necessary or convenient to traverse while entering or exiting in the course of the business for which the invitation was extended.”

In Big Lots, the customer exited the store, walked across a sidewalk, and continued away from the store into the parking lot. The Court decided she was no longer within the store’s “approach” when she slipped and fell because the area was not adjacent to or touching the entry/exit of the store.

Although Big Lots got out of the case, all was not lost for the injured party as she still has a claim against the owner of the shopping center for her injuries.