South Carolina courts have long recognized that an employee’s pre-existing health conditions do not prevent that worker from having a compensable work injury – so long as the injury happened in the course of and arose out of the worker’s employment. So workers can’t be denied compensation for a work injury claim simply because he or she was more susceptible to injury than a person who was otherwise healthy.
Further, pre-existing injuries that are aggravated by a work injury claim may be compensable. However, there has to be proof of aggravation.
This issue was raised in the recent case of Gill v. City of Charleston, which involved a firefighter injury in West Virginia.
The case involved injuries to the employee’s back. Claimant first suffered a back injury when he was 18 in 1985. He awkwardly lifted the door handle of a vehicle and sustained an injury. Seven years later, he suffered another back injury after an 80-foot fall while rock-climbing. In that fall, he fractured his pelvis, sacrum, pedicle, left leg and suffered injuries to his organs.
He eventually did recover, though he received ongoing chiropractic care for years. In spite of these injuries, passed the physical fitness examination necessary to become a firefighter and was hired by defendant in 2002. He continued receiving treatment even after he was hired.
In 2003, he suffered a work injury while playing basketball for physical training required by work. However, he never filed a workers’ compensation claim for that injury.
Then in 2012, he suffered yet another back injury. This time, he was at work and his back was injured as he tried to lift a practice dummy used in training.
He received treatment and a month later, was diagnosed with a back sprain that was work-related. Plaintiff received temporary partial disability benefits. Within three months, an independent medical examiner determined he’d reached maximum medical improvement with a full recovery and no lasting impairment. As a result, his claim for permanent partial disability benefits was denied.
The next month, the clinic where he was receiving chiropractic treatments sought authorization for injections to treat claimant’s back injury. However, this request was denied based on the independent medical examiner’s report. Claimant objected to this ruling.
Another independent medical examiner examined claimant and opined he’d recovered completely from the work injury and that it did not aggravated his pre-existing conditions.
The clinic again sought compensation for injections based on four different diagnoses, and that claim was approved by the Office of Judges. Defendant city appealed, and the board reversed. Then claimant appealed, asking the West Virginia Supreme Court to reinstate the original ruling of the OOJ.
However, the state supreme court instead affirmed. The court noted the four diagnoses for which plaintiff sought treatment were used before he suffered his February 2012 work injury. Beyond that, there was no causal connection established between those codes and the work injury.
Part of the problem here was the only basis claimant had to support the assertion that these diagnoses were work-related was a single report from a doctor who treated him right after the injury. Plaintiff presented no other evidence in his request that indicated the need for ongoing treatment was causally related to the work injury, as opposed to his pre-existing condition.
If you have been injured at work, contact the Lee Law Offices at 800-887-1965.
Gill v. City of Charleston, Feb. 10, 2016, West Virginia Supreme Court
More Blog Entries:
Falin v. The Roberts Co. Field Services, Inc. – Defining “Suitable Employment” for TPD, Feb. 9, 2016, Spartanburg Work Injury Lawyer Blog