State News : South Carolina

Brooks v. Benore Logistics System, Inc., 442 S.C. 462, 900 S.E.2d 436 (2024).

In Brooks v. Benore Logistics System, Inc., the South Carolina Supreme Court reversed a 2022 ruling of the Court of Appeals and re-affirmed an already long-standing test for repetitive trauma claims. 442 S.C. 462, 900 S.E.2d 436 (2024). In Brooks, Respondent Claimant alleged a work-related repetitive trauma injury to his back. Appellant Employer denied Claimant’s claim. The Single Commissioner found the Claimant suffered a compensable repetitive trauma claim, but the Appellate Panel reversed. In reversing, the Appellate Panel held that in order to prove a compensable repetitive trauma injury under Section 42-1-172, a claimant must satisfy a two-prong test: (1) That the claimant’s job was “repetitive” in nature as defined by Section 42-1-160(F); and (2) That medical evidence supports a causal link between the repetitive work and the alleged injury.  The Court of Appeals reversed the Appellant Panel’s decision, holding that the Workers’ Compensation Commission did not have the authority to determine whether a claimant’s job was repetitive in nature. Specifically, the Court of Appeals explained that the two-part test announced by the Appellate Panel was unfaithful to the plain language of Section 42-1-172 in that it set an “extra hurdle” for claimants.

In reversing the Court of Appeals decision, the Supreme Court held that the Court of Appeals “erred in rejecting the appellate panel’s conclusion that Section 42-1-172 requires a two-prong analysis, specifically, (1) whether a claimant’s job activities are repetitive, as that term is defined in Section 42-1-160(F); and (2) whether the claimant establishes by medical evidence that there is a causal link between the repetitive work and the alleged injury.”  The Supreme Court explained that “it is self-evident that, to receive compensation for a repetitive trauma injury, a claimant must first prove his or her job is in fact repetitive.”  The Supreme Court acknowledged that “repetitive” is not explicitly defined in Section 42-1-172 but found direction from Section 42-1-160(F) which provides that any injury that occurs as a result of “a series of evidence in employment, of a similar or like nature, occurring regularly, continuously, or a frequent intervals in the course of such employer, over extended periods of time” is not compensable except as provided for in Section 42-1-172.  Because the General Assembly removed those types of injuries from the general “injury by accident” statute (Section 42-1-160), the Supreme Court utilized this as a definition of “repetitive” in applying the two-party analysis. Accordingly, while affirming in result, the Supreme Court reversed the Court of Appeals and re-established that compensability of an alleged repetitive trauma injury must be proven pursuant to the two-part test as outlined above.

As an additional aside, the Supreme Court affirmed the Court of Appeals’ finding that ergonomics studies may but used in meeting the first prong of the aforementioned test, but are inadmissible, unless conducted by a medical professional, as evidence for or against the second prong (causation).

Samual Paulino v. Diversified Coatings, Inc., 2024 S.C. LEXIS 100 (2024).

            In Samual Paulino v. Diversified Coatings, Inc., Samuel Paulino sustained an injury to his back while working as a custodian at Diversified Coatings, Inc. in February 2015. 2024 S.C. LEXIS 100 (2024). Despite undergoing surgery and extensive treatment, including physical therapy and pain management, Paulino continued to experience significant pain and limited mobility. His treating physicians assigned impairment ratings of 12% to his lumbar spine and 13% to his whole person, and his functional capacity evaluation indicated he could perform medium work duties with substantial limitations. At a hearing before the single commissioner, Paulino testified about his ongoing pain and inability to perform his job duties, which led the commissioner to find that he was permanently and totally disabled due to a greater than fifty percent loss of use to his spine.

The court of appeals reversed the workers' compensation commission's award, stating there was no medical evidence to support the finding of a fifty percent or greater loss of use. However, the Supreme Court of South Carolina reversed the court of appeals' decision, reinstating the commission's award. The Supreme Court found that the commission's decision was supported by substantial evidence, including medical records, functional capacity evaluation notes, and Paulino's testimony. The court emphasized that the commission's findings did not solely rely on medical impairment ratings but considered the entire record, demonstrating a comprehensive evaluation of Paulino's condition and its impact on his ability to work.

            Importantly, the Supreme Court disagreed with the employer’s argument that doctors’ medical impairment ratings are “virtually outcome determinative,” and that, in the alternative, even if ratings do not control, they are “clearly the paramount factor for the Commission’s consideration.”  In so holding, the Court reiterated its view that substantial evidence can support findings of permanent and total disability even when the claimant’s impairment rating alone would not. See, e.g., Linen, 286 S.C. at 68-70, 332 S.E.2d at 211-212 (affirming finding of fifty percent loss of use of the back based on other evidence in the record despite doctors assigning impairment ratings of 15% and 20%-30%); Lyles v. Quantum Chem. Co. (Emery), 315 S.C. 440, 445, 434 S.E.2d 292, 295 (Ct. App. 1993) (affirming finding of a fifty-eight percent disability to the back based on testimony from the claimant); Sanders v. MeadWestvaco Corp., 371 S.C. 284, 291-93, 638 S.E.2d 66, 70-71 (Ct. App. 2006) (affirming finding of forty percent disability to the back based on claimant's testimony despite a doctor assigning an impairment ratings of eighteen percent to the lumbar spine); c.f. Tiller v.  Nat'l Health Care Ctr. of Sumter, 334 S.C. 333, 340, 513 S.E.2d 843, 846 (1999) ("[M]edical testimony should not be held conclusive irrespective of other evidence."   (Quoting Ballenger v. S. Worsted Corp., 209 S.C. 463, 467, 40 S.E.2d 681, 682-83 (1946))).

Thomas Contreras v. St. John’s Fire District Commission, 442 S.C. 596, 900 S.E.2d 463 (Ct. App. 2024).

              In Thomas Contreras v. St. John’s Fire District Commission, Thomas Contreras, a firefighter, sought workers' compensation for injuries sustained to his right shoulder, arm, and clavicle. 442 S.C. 596, 900 S.E.2d 463 (Ct. App. 2024). The South Carolina Workers' Compensation Commission initially awarded permanent partial disability (PPD) compensation solely for his right shoulder, based on medical evidence and evaluations. Contreras contested this decision, arguing that his injuries extended to his arm and clavicle, which would entitle him to broader disability benefits under South Carolina law. The Appellate Panel, tasked by the court to provide specific findings on each affected body part, initially upheld the single commissioner’s decision but faced subsequent appeals challenging the weight given to medical forms and the extent of Contreras's injuries.

Contreras contended that his right arm and clavicle were also impaired, presenting medical evidence and expert opinions supporting additional disabilities beyond the scheduled injury to his shoulder. Despite his arguments, the Appellate Panel affirmed its original decision, emphasizing that the medical records and evaluations did not sufficiently establish impairments to the arm and clavicle beyond the shoulder. The court upheld the Appellate Panel’s decision, citing substantial evidence supporting the limitation of compensation to the scheduled injury of the right shoulder under South Carolina's workers' compensation laws. This case underscores the importance of detailed medical evidence and the Appellate Panel's authority in determining the extent of disabilities in workers' compensation cases.

Ana Galvan v. Griffin Stafford North Charleston, 2024 S.C. App. Unpub. LEXIS 15

Claimant presented a supplemental report from an unauthorized doctor after the statutory period allowed for the submission of APAs. The Hearing Commissioner allowed the report to be introduced after deciding to hold the record open. Defendants argued that such submission was contrary to the statutory requirements for APA submissions. The Court of Appeals held that Regulation 67-612(E) grants the Commission discretion to hold the record open, and that “it is an abuse of discretion for a commissioner to reject evidence when its admission does not cause prejudice.”  See Morgan v. JPS Automotives, 321 S.C. 201, 203-04, 467 S.E.2d 457, 459 (Ct. App. 1996). The Court of Appeals held no such prejudice existed as the Hearing Commissioner offered Defendants the opportunity to depose the doctor and Defendants declined.

Michael Crowley v. Darlington County, 2024 S.C. App. Unpub. LEXIS 223

            Deputy Michael Crowley sustained two admitted injuries to his right knee and back while employed with Darlington County in 2017 and 2018. In Jan. 2021, Defendants filed a Form 21, which included a report from Dr. James Bethae date December 17, 2020. Claimant’s Counsel objected to the submission of this report pursuant to S.C. Code Ann. Section 42-15-95(c) because Defendants had failed to notify Claimant’s Counsel of their October 27, 2020, pre-IME letter to Dr. Bethae and accompanying medical records. Defendants argued that Section 42-15-95 did not apply in this instance as no doctor-patient relationship had been established between Dr. Bethae and the claimant at the time of the October 27, 2020, IME letter given Dr. Bethae had not examined or treated the claimant. The Hearing Commissioner admitted the report and the claimant appealed.

Section 42-15-95 provides the following:

(B) A health care provider who provides examination or treatment for any injury, disease, or condition for which compensation is sought . . . may discuss or communicate an employee's medical history, diagnosis, causation, course of treatment, prognosis, work restrictions, and impairments with the insurance carrier, employer, their respective attorneys or certified rehabilitation professionals, or the commission without the employee's consent. The employee must be:

(1) notified by the employer, carrier, or its representative requesting the discussion or communication with the health care provider in a timely fashion, in writing or orally, of the discussion or communication and may attend and participate. This notification must occur prior to the actual discussion or communication if the health care provider knows the discussion or communication will occur in the near future;

(2) advised by the employer, carrier, or its representative requesting the discussion or communication with the health care provider of the nature of the discussion or communication prior to the discussion or communication; and

(3) provided with a copy of the written questions at the same time the questions are                                                                                                   submitted to the health care provider. The employee also must be provided with a copy of the response by the health care provider.

Section 42-15-95(C) provides that “[a]ny discussions, communications, medical reports, or opinions obtained in violation of this section must be excluded from any proceedings under the provisions of this title.”

            The Court ultimately found that Defendants had violated Section 42-15-95 because “the purpose of the statute is for providers to exchange information with employers rather than an employer to provide a claimant’s medical records to a provider not known to the claimant, as occurred here.”  However, the Court also determined that the admission of Dr. Bethae’s report was harmless error.

The issue here is the interpretation of the words “not known to the claimant.”  If the Court is simply referring to situations, as was the case here, where a letter and medical records are sent to an IME provider pending an evaluation and without a claimant’s knowledge, that is a simple fix: include the claimant on all IME provider letters. If, however, the Court is referring to the IME providers as a whole as being unknown to the claimant because they have provided no treatment for the claimant, then that is a much more complex issue. Under this interpretation, Claimant Attorney’s may seek to argue that since all IME providers (in general) have not previously provided medical treatment and are therefore unknown to the claimant, the provision of any letters and/or medical records to these providers prior to an evaluation violates Section 42-15-95. This interpretation would greatly limit Defendants’ ability to outline the scope of an evaluation and to provide valuable background information with regard to causation, pre-existing conditions, and the like.