Carter v. Verizon Wireless – Ongoing Coverage for Worker’s Knee Injury at Issue

A Greenville worker sustained a work-related injury to her knee back in 2006. At the time, her employer didn’t challenge her claim for worker’s compensation coverage, finding there was little dispute that the injury was proximately caused by her work.
However, the case recently came before the South Carolina Court of Appeals after the employer challenged ongoing coverage of the injury, arguing the worker’s worsening condition and ongoing medical needs were the result of intervening causes.

Greenville workers’ compensation attorneys note the court’s decision in Carter v. Verizon Wireless, which party affirmed and partly reversed earlier findings. The case is important because those who sustain work-related injuries may not always be in top physical shape, but that doesn’t mean that they aren’t entitled to ongoing benefits when the underlying condition worsens.

According to court records in the case, the claimant’s work-related injury occurred in late 2006, and surgery was performed about six months later. By the following year, her doctor/surgeon assigned her with an 18 percent impairment rating.

Several months after that, while her workers’ compensation hearing was still pending, she fractured her ankle outside of work and had to return to her doctor for care. That incident resulted in her becoming wheelchair-bound for eight months while it healed. She was just beginning to walk on it again when the hearing was held.

The state workers’ compensation commission awarded 25 percent permanent partial disability to the worker as it related to her lower left extremity. While the commissioner noted her pre-existing advanced degenerative joint disease, the commissioner indicated she was nonetheless entitled to coverage of any causally-related future medical expenses that would tend to lessen her disability.

Later that year, the worker reported increased pain and swelling in her left knee, the site of the original work injury. The doctor upped her impairment rating from 18 percent to 42 percent, and she subsequently filed a form requesting coverage of medical treatment due to a change in condition.

At a deposition, the doctor testified that the patient had been a candidate for knee replacement surgery since her work accident, but that at age 49, she had declined, opting for less invasive alternatives. He indicated that the deterioration of her knee condition from the time of the injury to the time she sought care, was the result of a natural progression of her joint disease, which was perhaps accelerated by an exercise routine that she had incorporated in the months prior. However, while exercise may have accelerated the condition, the doctor indicated the end result would likely have been the same.

The claimant denied she’d ever injured herself working out, and had chosen water aerobics specifically in order to reduce the pressure on her knee.

The commissioner denied her request for further coverage, citing the 2009 fracture of her right ankle and the exercise routine as cause to deny. The plaintiff appealed to the appellate panel, which upheld the decision, but that ruling was later reversed in its entirety by the circuit court.

Subsequently, the employer appealed to the South Carolina Court of Appeals. Ultimately, this court reversed in part and affirmed in part. The court reversed the element of the earlier decision that indicated there had been a compensable change in condition. Specifically, the court indicated that the change in her condition was the result of the natural progression of her joint disease – not her original injury, and per the 1987 ruling in Brown v. R.L. Jordan Oil Co., that meant she wasn’t entitled to compensation for it.

However, the court found that she was entitled to some compensation for future medical treatment – specifically, pain medications and potentially a future knee surgery. This is because she was considered a candidate for knee replacement surgery at the time of her initial injury. That she had chosen to put it off didn’t mean that she forfeited the right to have it covered later.

If you have been injured at work, contact the Lee Law Offices at 800-887-1965.

Additional Resources:
Carter v. Verizon Wireless, April 16, 2014, South Carolina Court of Appeals

More Blog Entries
Report: Employer Warned of “Extreme Risk” Prior to Worker’s Death, May 29, 2014, Greenville Workers’ Compensation Lawyer Blog

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