Please ensure Javascript is enabled for purposes of website accessibility

Workers’ Compensation – Prior Back Injury – Application Falsehood – 20-Year Gap 

By: S.C. Lawyers Weekly staff//October 27, 2022

Workers’ Compensation – Prior Back Injury – Application Falsehood – 20-Year Gap 

By: S.C. Lawyers Weekly staff//October 27, 2022

Although the respondent-employer showed that the claimant-employee falsely said on his post-hire medical questionnaire that he had never sought medical attention for a prior back injury or back pain, and although the employer showed that it relied on this falsehood, the employer failed to show a causal connection between the claimant’s 1997 back injury and his 2017 back injury, especially since – in the interim – the claimant worked for Westinghouse for 16 years. 

We reverse the Workers’ Compensation Commission’s denial of the claim. Remanded. 

The record contains no medical evidence that the claimant’s 1997 back injury somehow contributed to his June 24, 2017, injury or that he was predisposed to back injury. Because the medical testimony is the only competent evidence in the record relating to a causal connection, or lack thereof, between the claimant’s false representation of the 1997 back injury and the 2017 injury, the Commission erred in finding the employer proved its fraud in the application defense. 

The Commission’s order does not contain sufficient findings of fact and conclusions of law relating to Capers v. Flautt, 305 S.C. 254, 407 S.E.2d 660 (Ct. App. 1991). The order merely states that “moreover, the claim would be barred under Capers v. Flautt.” The Commission did not apply the law to its findings or indicate which findings were applicable to Capers. 

S.C. Code Ann. § 42-9-60 provides in part, “No compensation shall be payable if the injury . . . was occasioned . . . by the wil[l]ful intention of the employee to injure . . . himself. . . .” 

The record contains no evidence that the claimant deliberately intended to injure himself as described in this section. The Commission erred in finding his claim was barred by § 42-9-60. 

The Commission found that the claimant did not injure his back in an accident arising out of his employment with respondent. The Commission specifically grounded its findings on the claimant’s lack of credibility and his “vague” and “rambling” responses. 

The claimant’s credibility as to his prior workers’ compensation claim and prior back injury in 1997 is not a reasonable and meaningful basis for the Commission’s determination that he did not suffer an accidental injury arising out of his employment in 2017. Rather, the medical evidence pertaining to his 2017 injury, which consists of an MRI and the expert medical opinion of a neurosurgeon, is not contradicted and constitutes substantial evidence that supports a reversal of the Commission’s order. 

Reversed and remanded. 

Brailey v. Michelin North America, Inc. (Lawyers Weekly No. 011-022-22, 11 pp.) (Bruce Williams, C.J.) Appealed from the Workers’ Compensation Commission. Stephen Benjamin Samuels for appellant; Grady Larry Beard and Jasmine Denise Smith for respondents. S.C. App. 

Business Law

See all Business Law News

Commentary

See all Commentary

Polls

How Is My Site?

View Results

Loading ... Loading ...