Many times when people are involved in a work accident, they will aggravate an old injury. We oftentimes hear concerns from these individuals that the Workers’ Compensation (“WC”) insurance carrier MAY NOT cover medical treatment for these types of re-injuries. So the question in South Carolina becomes, is a work accident that aggravates and/or makes worse a pre-existing injury covered by the employer’s WC insurance carrier?
The simple answer to this question is YES. According to S.C. Code Ann. § 42-9-35 –
(A) The employee shall establish by a preponderance of the evidence, including medical evidence, that:
(1) the subsequent injury aggravated the preexisting condition or permanent physical impairment; or
(2) the preexisting condition or the permanent physical impairment aggravates the subsequent injury.
What does this mean to my WC injury and claim? If your WC claim is denied because of an aggravation of a pre-existing injury, it is necessary that YOU obtain the opinion of your treating physician that “to a reasonable degree of medical certainty,” that it is more probable than not that the work accident aggravated the pre-existing condition. How can I obtain this medical opinion?
If your claim is denied because of this particular situation, it is always best to discuss your claim with attorneys experienced in these matters. As attorneys working with WC clients on a daily basis, Ernie Trammell and Roy Trammell have spent countless hours drafting doctor affidavits for clients whose claims are being temporarily denied because of this reason.
What if my pre-existing condition is degenerative in nature?
If your work accident aggravates and/or makes worse a condition like arthritis, your employer’s carrier must cover the claim. As noted above though, a treating physician does have to document that in his opinion based on a reasonable degree of medical certainty that it is more probable than not that the work accident aggravated the arthritis in the body part injured.
Regardless of your Workers’ Compensation question or issue, we are here to help. If you have been injured on the job, please give us a call for your free consultation. Call us at 1-864-231-7171, find us on Facebook, or Twitter. We are here to help.
THIS ARTICLE WAS WRITTEN BY ROY TRAMMELL, a Workers’ Compensation attorney.