Injured employee’s advantages reinstated | Enterprise Insurance coverage
A South Carolina appeals court ruled a new hearing for an injured worker with physical and mental injuries and overturned an earlier appeal board ruling at the Workers’ Compensation Commission that ruled that an injured worker’s lack of credibility was against medical reports undermined and received treatment. “
The worker was injured in July 2011 while working for Philips Electronics, which accepted his injury as a indemnity and covered treatments and surgeries that resulted in chronic pain and psychological injury. This is evident from documents in Opinion No. 5809 filed in the Court of Appeal of South Carolina, Colombia.
“Over the years since his injury … medical providers have also looked into his mental health and tried to combat the depression and anxiety caused by his persistent pain,” the records read.
At the hearing before a state compensation commissioner, the man applied for an award for permanent and complete disability, “with the allegation of injuries to his back, left leg, left hip and left foot as well as psychological overlay”.
During the testimony, it was revealed that (the man) had alleged a back injury in 2006 while working for another Florida company. He had applied for employee compensation in 2008 and 2009 and unsuccessfully applied for a social security disability income related to that injury.
The employee “did not inform Philips, who at the hearing pointed out that (the man) had alleged extensive physical limitations and symptoms of pain in his SSDI files (2008 and 2009) and sought psychological treatment. It was also found that he had been presented to a local hospital a few months before the 2011 injury that complained of back pain, “the records read.
The commissioner ruled in favor of the worker, who found that he was “completely and permanently disabled due to the loss of use of fifty percent of his back” under state law. A full panel turned back and concluded that the man’s “lack of credibility undermined the medical reports and treatment received. . . as the opinion and conclusions of (its) providers were based on selfish claims made by the applicant. “
The order stated that the man’s “lack of truthfulness” was “an obstacle to backing the single commissioner’s decision.”
The state appeals court disagreed, citing medical evidence and medical testimonials that were weighted in favor of the man, and wrote that while the commissioner considered the man “not at all credible”, the commissioner “always considered the medical evidence fair and impartial balance ”by giving him fully-honored disability benefits.
“The panel concluded that doctors’ opinions were based on” selfish claims made by the applicant, “but no doctor said so,” the latest ruling said. “What people say when they seek medical help is usually selfish and sometimes unreliable. Doctors are trained to see such things, and we are confident they would have said it had the doctors believed they had been misled of their opinion. “
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