Workers’ Compensation – Causation – Prior Back Injury – Fraud in the Application Defense 

While working for Richtex Brick in 1997, Claimant suffered a back injury which resolved. When he applied to work for respondent Michelin North America in 2017, Claimant did not list Richtex Brick as a previous employer, and on a medical form he answered “no” when asked whether he had ever had medical attention for back injury, backache or back pain. Michelin has not proven that Claimant’s false representation was causally connected to his 2017 back injury. 

We reverse the Workers’ Compensation Commission’s denial of benefits. 

The Commission found that Claimant’s neurosurgeon, Dr. Scott Boyd, was not aware of “the extent” of Claimant’s 1997 back injury. However, the record contains no evidence that the 1997 injury did not resolve, and the record does not indicate the “extent” of the injury. In the medical notes from 1997, the Richtex doctor noted that Claimant had been improving. 

The record contains no medical evidence that Claimant’s 1997 back injury somehow contributed to his June 24, 2017, injury or that he was predisposed to back injury. Indeed, Claimant worked at Westinghouse for 16 years without a back injury. 

Because the medical testimony is the only competent evidence in the record relating to a causal connection, or lack thereof, between Claimant’s false representation of the 1997 back injury and the 2017 injury, the Commission erred in finding Michelin proved its fraud in the application defense. 

Capers 

Claimant recovered from his 1997 back injury, and there is no indication in the record that he could have expected to have similar back problems at Michelin in 2017. Significantly, Claimant worked at Westinghouse for 16 years with no back problems. 

Claimant testified his 1997 back injury was in a different area of his back than the 2017 injury. Dr. Boyd’s testimony and opinion, which is the only medical testimony and opinion relating to the 2017 injury, do not support the theory that Claimant’s 2017 injury was non-accidental and could have been expected given past experience. 

The Commission erred in finding that Claimant’s claim was barred by Capers v. Flautt, 305 S.C. 254, 407 S.E.2d 660 (Ct. App. 1991). 

• 42-9-60

S.C. Code Ann. § 42-9-60 provides, in part, “No compensation shall be payable if the injury or death was occasioned by the intoxication of the employee or by the wilful intention of the employee to injure or kill himself or another.” 

The record contains no evidence that Claimant deliberately intended to injure himself as described in this section. 

Credibility 

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 at Michelin 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. 011-066-22, 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.