There have been three significant decisions handed down by the South Carolina Court of Appeals and Supreme Court. The following is a summary of these three new cases:
George Dodge v. Bruccoli, Clark, Layman, and Companion Property & Casualty Insurance Co., _____ S.C. _____, ______ S.E.2d _____, Davis Advance Sheet No. 7, Opinion No. 2942 (Ct. App. 2/16/99)
The claimant, a computer programmer, reinjured his back at work while recovering from a back surgery from a prior incident which was not work related. The claimant then had two additional surgeries on his back and was referred to a pain management program. On September 8, 1992, Dr. Redmond found that the claimant had reached maximum medical improvement and assigned a 30% impairment rating to the lumbar spine. However, the claimant continued to use three Tylenol with Codeine per day so he could work. Dr. Redmond testified in his deposition that the claimant would probably need treatment and maintenance medication for the rest of his life or his period of disability would increase.
Although the claimant reached maximum medical improvement, Section 42-15-60 of the South Carolina Code allows medical, surgical, hospital, and other treatment which are reasonably required for such additional time as any judgment of the Commission will tend to lessen the period of disability. Section 42-15-60 clearly allows the Commission to award medical benefits beyond ten weeks from the date of the injury if the Commission determines such medical treatment would tend to lessen the period of disability. The court went on to hold that the employer is liable for medical treatment which would tend to lessen the time in which the injury renders an employee incapable to earn the wages which the employee was receiving at the time of injury in the same or other employment.
Ultimately, the court held that a finding that the claimant reached maximum medical improvement had no bearing on the determination of whether the employer was liable for medical treatment beyond the ten week time period. Maximum medical improvement is a distinctly different concept from disability. The fact that a claimant has reached maximum medical improvement does not preclude a finding that the claimant still may require additional medical care or treatment. Although this medical care or treatment may not reduce the claimant's degree of physical impairment, it may tend to lessen the period of disability. This could be for an indefinite period of time.
This case holds that although a claimant may reach maximum medical improvement, the employer may still be required to furnish additional medical care and treatment to lessen the claimant's period of disability. Therefore, a doctor's determination that the claimant has reached maximum medical improvement may not automatically cut off their rights to any further medical care in the future, especially when the medical care and treatment helps the claimant return to work.
Charles W. Reese v. CCI Construction Company and Gulf Insurance Company, _____ S.C. _____, _____ S.E.2d _____, Davis Advance Sheet No. 8, Opinion No. 2948 (Ct. App. 2/22/99)
The claimant worked as a carpenter and construction worker for more than twenty years. On his third day of work at CCI, the claimant was drilling a "double plate" when a power drill he was using became caught in a piece of wood and twisted his right wrist. Three days later, Dr. Patel diagnosed the claimant with aseptic necrosis which is a degeneration of the lunate bone of the wrist caused by a lack of blood supply. In his deposition, Dr. Patel testified that this condition sometimes occurs among people who work with very heavy vibratory tools. He stated that the repetitive action of swinging a hammer would most likely aggravate an underlying condition.
The Court of Appeals held that in the case of an occupational disease, liability is most frequently assigned to the carrier who is on the risk when disease resulted in disability, if the employment at the time of the disability was of a kind contributing to the disease. Although the Single Commissioner found the claimant's condition was not caused, aggravated, or contributed to by his work at CCI, the record clearly showed that the claimant was engaged in the same type of work with CCI as that which he had performed during his twenty years as a carpenter. Thus, the Court of Appeals found that the claimant's employment at CCI was of a kind contributing to the disease.
Although Dr. Patel opined that the claimant's three days of work at CCI did not contribute to the underlying condition of aseptic necrosis, the question should have been whether the employment at CCI was the same kind as that which caused his condition and thus, was of a kind contributing to the disease of aseptic necrosis. Ultimately, the Court of Appeals found this case compensable because the claimant was engaged in the same type of work which he had performed during his twenty years as a carpenter. Although his work at CCI did not cause, aggravate, or contribute to his condition, the Court of Appeals still held that CCI was still liable because they were on the risk when the disease resulted in the disability.
Elizabeth H. Tiller v. National Health Care Center of Sumter, ___S.C. ___, ___ S.E.2d ___, Davis Advance Sheet No. 10, Opinion No. 24915 (S.C. 3/8/99)
The claimant worked as a registered nurse and injured her back while pushing a medication cart that unexpectedly jammed. The claimant's x-rays showed a severely deteriorated L5-S1 disc and a narrowing and spur formation at L3-L4. The Single Commissioner found that the jamming of the medicine cart wheels aggravated the claimant's preexisting degenerative disc at L5-S1 and her discitis at L3-L4. The issue surrounding this case on appeal was the standard of proof regarding the sufficiency of medical evidence in a medically complex Workers' Compensation case. The defendants argued that the claimant failed to establish by medical testimony to a reasonable degree of medical certainty that the discitis was present prior to her accident.
The Supreme Court held that the Workers' Compensation Commission is given discretion to weigh and consider all the evidence, both lay and expert, when deciding whether causation has been established. "Thus, while medical testimony is entitled to great respect, the fact finder may disregard it if there is other competent evidence in the record".
If a medical expert is unwilling to state with certainty that a connection exists between the accident and the injury, the "expression of a cautious opinion" may support an award if there are facts outside the medical testimony that also supports an award. The Supreme Court ultimately concluded that, in deciding whether substantial evidence supports the finding of causation, the court is to consider both the lay and expert evidence. Therefore, even though the claimant did not have a doctor that was able to determine if causal connection exists to a reasonable degree of medical certainty, the South Carolina Workers' Compensation Commission can still award benefits based on the lay evidence provided.
This is a brief summary of the workers' compensation cases prepared by the attorneys at Gibbes, Gallivan, White & Boyd, P.A. If you have specific questions regarding these cases or other workers' compensation cases, please call one of the following Workers' Compensation Team Members:
- H. Mills Gallivan
- Deborah C. Brown
- Calvin C. Harmon
- Jeffrey D. Ezell
- Michelle D. O'Connor
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