The South Carolina Supreme Court issued a workers’ compensation case ruling that it conceded was as “rare as the proverbial hens’ teeth.” It had to do with an immediate appeal of an interlocutory administrative decision. Normally, in these cases, such matters must reach a final conclusion before either side can appeal them. However in this case, which justices described as a set of “extraordinary circumstances,” the court ruled that requiring the plaintiff to wait for a final agency decision wouldn’t provide him with an adequate remedy. To explain why, we start by explaining there was never a dispute in Hilton v. Flakeboard America Limited as to the compensability of the plaintiff’s work-related injury. Both sides agreed the plaintiff sustained a compensable injury as a result of an insect or spider bite while working at a sustainable forest product manufacturer. The issue was whether the plaintiff required additional medical treatment to reach maximum medical improvement.
Maximum medical improvement is one of the thorniest issues in workers’ compensation claims. It’s the point at which the worker’s injuries have stabilized, and any further functional improvement is not likely, even with continued physical therapy or medical treatment. In other words, that’s as good as it’s going to get. From this point, the employer is going to seek a determination of the degree of permanent or partial impairment, which will set the stage for all future workers’ compensation benefits. It will define which long-term benefits the employee can expect.
In this case, the plaintiff had been receiving medical treatment for the work-related insect bite injury and claimed he had not yet reached maximum medical improvement (MMI). A single commissioner agreed with him on the merits, finding MMI wasn’t yet reached. The commissioner further opined that any misrepresentations the workers’ compensation plaintiff made during his claim were the result of a serious cognitive deficit he’d suffered as a result of a previous brain injury.
The employer appealed, raising issues of maximum medical improvement, temporary disability, the worker’s entitlement to further treatment, and the worker’s credibility. None of these involved the issue of the worker’s competency or the necessity of a guardian ad litem. There was also no claim by the employer that it had been denied the right to have the claimant examined by a doctor of its choice in an independent medical review.
The full commission conducted a hearing, although it did not actually observe the claimant. The commission issued an order that mirrored that of the single commissioner, but it raised several of its own “issues on appeal.” Among those were the plaintiff’s competency. The commission, apparently based on comments regarding the plaintiff’s cognitive deficits, ordered the plaintiff sent to a neurologist of the employer’s choice for evaluation as to the causation and extent of his problems, as well as a determination of whether he was competent to testify in these proceedings or whether he needed a guardian ad litem. Neither of these issues had been raised by the defendant, or the plaintiff for that matter.
The plaintiff appealed, but the state appellate court ruled the order was not immediately appealable because it wasn’t a final order. The state supreme court granted certiorari and, despite conceding this was an interlocutory appeal, vacated the commission’s findings and remanded to the commission to resolve only those issues raised by the employer’s appeal. The court reasoned the commission had overstepped its role in raising its own issues on appeal, particularly considering it had not even observed the plaintiff in testimony. The defendant hadn’t asked for an independent medical exam, nor did it question the mental competency of the plaintiff.
The commission is ordered to only decide those issues the employer had raised on appeal from the single commissioner’s decision.
Contact the Carolina workers’ compensation lawyers at the Lee Law Offices by calling 800-887-1965.
Hilton v. Flakeboard America Limited, Oct. 12, 2016, South Carolina Supreme Court
More Blog Entries:
Mordhorst v. Dakota Truck Underwriters – Bad Faith in Workers’ Compensation Insurance, Oct. 13, 2016, Rock Hill Workers’ Compensation Lawyer Blog