The South Carolina Court of Appeals found that the state’s Workers’ Compensation Commission erred in its decision that a worker’s claim was limited to her back injury and didn’t cover other related medical issues.
After developing blood clots in her lungs which prevented her from working, the worker filed a claim for injuries to her back and legs. However, the commission agreed with the employer that liability should only be for the back injury, which the appeals court said was clearly an error based on the evidence.
Injury, treatment lead to depression
In Pate v. College of Charleston, the worker was injured severely enough that she required surgery in May 2012. The surgeon assigned a 40% impairment rating to her spine and a 36% impairment rating to the whole person.
Long-term treatment following the surgery involved various joint, trigger point and epidural injections and a variety of pain medications. The surgeon testified in court that he’d increased the worker’s impairment rating by 10% to account for chronic pain caused by the injury.
After returning to work, the worker remained on pain medication and still required injections every two months. In August 2014, the worker was referred to a clinical psychologist for evaluation and treatment for severe depression. She was placed on an antidepressant and nerve pain medication.
Employer can’t accommodate restrictions
In September 2014, the worker was hospitalized with blood clots in her lungs, which resulted in increased pain medication and prevented her from receiving injection therapy for several months. The blood clots also prevented her from working.
By December 2014, the worker was approved to return to work, and the employer placed her on leave without pay after finding it couldn’t accommodate her significant restrictions.
Blood clots blamed for other conditions
The worker filed a workers’ compensation claim for injuries to her back, legs and psyche, but the employer admitted liability only for the back injury, claiming the rest was due to the blood clots in her lungs.
A commissioner with the South Carolina Workers’ Compensation Commission awarded benefits for the back only and didn’t award any future medical treatment.
An appellate panel affirmed the commission’s decision in part, reversed the finding regarding the blood clots and remanded it back to the commission to determine the worker’s degree of disability and to award causally related medical treatment.
On remand, the commissioner found the worker’s injury affected her back only, assigned her a 40% permanent partial disability and found she was entitled to future medical treatment relating to the back. The worker returned to the appellate panel, the panel affirmed the commissioner’s decision and the worker filed an appeal with the South Carolina Court of Appeals.
Ample evidence injury affected other body parts
The court found there was ample evidence the worker’s back injury affected other parts of her body, meaning the commission committed a legal error in limiting the claim to only her back injury without providing any reason why.
And while the worker claimed she was permanently and totally disabled, the court said, “We do not think we can say the 40% loss of use finding is clearly erroneous,” since the commission hadn’t done a “substantive weighing” of the worker’s claim under the general disability regime.
Because of this, the appeals court reversed the decision and remanded it to the commission to evaluate the worker’s claim for a general disability award.