Injured worker’s benefits reinstated

An appeal court in South Carolina ordered a new hearing for an injured worker with both physical and mental injuries, reversing an earlier decision by an appellate panel with the Workers’ Compensation Commission that ruled that an injured worker’s “lack of credibility undermined the medical opinions and treatment received.”

The worker was hurt in July 2011 while working for Philips Electronics, which accepted his injury as compensable and covered treatments and surgeries, which led to chronic pain and mental injuries, according to documents in Opinion No. 5809, filed in the Court of Appeals of South Carolina in Columbia.

“Over the years since his injury… medical providers have also addressed his mental health, attempting to combat the depression and anxiety caused by his persistent pain,” documents state. 

At the hearing before one state workers compensation commissioner, the man sought an award of permanent and total disability, “alleging injuries to his back, left leg, left hip, and left foot, as well as psychological overlay.”

During testimony, it became known that (the man) had claimed a back injury in 2006 while working for another company in Florida and he had filed for workers compensation and unsuccessfully sought Social Security disability income in 2008 and 2009 related to that injury.

The worker “had not disclosed this to Philips, who highlighted at the hearing that (the man) claimed extensive physical limitations and pain symptoms in his SSDI paperwork (in 2008 and 2009) and that he had sought mental health treatment. It was also discovered (he) had presented to a local hospital several months before the 2011 injury complaining of back pain,” documents state.

The commissioner ruled in favor of the worker finding that he was “totally and permanently disabled due to loss of use of fifty percent of his back,” in accordance with state law. A full panel reversed, concluding that the man’s “lack of credibility undermined the medical opinions and treatment received . . . as the opinion and conclusions of (his) providers were based upon self-serving assertions of the claimant.”

The order noted the man’s “lack of truthfulness” was “an impediment to supporting the Single Commissioner’s decision.”

The state appeals court disagreed, citing medical evidence and medical testimony weighed in the man’s favor, writing that although the single commissioner deemed the man “not credible at all,” the commissioner “still fairly and impartially weighed the medical evidence” in awarding him full disability benefits.

“The Panel concluded the doctors’ opinions were based upon ‘self-serving assertions of the claimant,’ but no doctor has said this,” the latest ruling states. “What people say when seeking medical help is usually self-serving and sometimes unreliable. Doctors are trained to detect such things, and we are confident that if the doctors believed they were duped into their opinions they would have said so.”