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Will Workers’ Compensation Cover an Aggravation of a Pre-Existing Injury?

Workers' Compensation

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.

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Injured on the Job? Too ‘Job Scared’ to File a Workers’ Compensation Claim?

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Many times we see potential clients fail to follow through with a Workers’ Compensation claim because they are “job scared.”  Some of the individuals may have a promising but new career with their employer, other times the individual has been employed with the same company for 20+ years and fear losing a good job.  If you have been injured on the job and are job scared, please read this before deciding NOT to pursue a Workers’ Compensation claim.

It is illegal in South Carolina for an employer to fire an employee for initiating a Workers’ Compensation claim.  S.C. Code Ann. § 41-1-80 states:

 “no employer may discharge or demote any employee because the employee has instituted [in good faith]. . .” a Workers’ Compensation claim.

If you are legitimately injured while on the job and file a Workers’ Compensation claim against your employer, your employer can not terminate you for that reason. 

However, the law cited above does state that while you are pursuing a claim, your employer can fire you for other reasons, most commonly:

  1. a) intoxication on the job;
  2. b) destruction of the employer’s property;
  3. c) habitual tardiness or absence from work;
  4.       d) failure to meet established employer work standards;
  5.       e) malingering; or
  6.       f)  embezzlement.

If you do decide to pursue a Workers’ Compensation claim, while still working, we inform our clients to ALWAYS report to work on time and stay on their best behavior while on the clock. If your employer is attempting to fire you while under a Workers’ Compensation claim, they will try and find a justifiable reason to terminate you that is unrelated to your job injury.

If you are injured on the job but afraid of being terminated for pursuing your rights under the South Carolina Workers’ Compensation laws, it is always advisable to speak with an attorney first.  We offer free consultations, so do not hesitate to call Ernie Trammell or Roy Trammell at the Trammell & Mills Law Firm, LLC located in upstate South Carolina as soon as possible after your work injury.

THIS ARTICLE WAS WRITTEN BY ROY TRAMMELL, a Workers’ Compensation attorney

Call and let Roy handle your case today, 864-231-7171 or trammellandmills.com 

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Are You Covered By Workers’ Compensation If You Fall at Work?

Workers' Compensation , , , , ,

Don’t fall victim to the “There Ain’t Nothing Wrong With the Floor” defense. If you trip over an object on the floor at work and fall, you are almost certain to be covered by the workers’ compensation laws.  But what happens if you simply fall at work on a completely level floor or on a smooth rug and there is no obvious cause for your fall?  What if your employer responds that you can not get workers’ compensation benefits because “there ain’t nothing wrong with the floor” to have caused you to fall?  Is the employer right?

Are you covered by workers’ compensation if you fall at work?

Let’s look at three different scenarios:

Situation 1

Let’s assume that my paralegal, Ashley, is walking down the hallway at our office with a hand full of files and trips over a magazine that was inadvertently dropped on the floor by a client.  Is she covered under our workers’ compensation laws?

Yes, she is covered because she suffered an injury by accident at work during the course and scope of her employment.

Situation 2

Let’s now assume that my paralegal, Ashley, is walking down the hallway at our office with a hand full of files and loses her balance and falls for no apparent reason.  There was nothing specifically on the floor that caused her to fall.  Is she covered under our workers’ compensation laws?

Yes, she needs only to prove a causal connection between the conditions under which the work is required to be performed and the resulting injury. The fact that she suffered an “unexplained fall” does not preclude Ashley from being covered by workers’ compensation.  There does not have to be some work hazard on the floor causing the employee to fall in order for there to be workers’ compensation coverage.  Instead, she again only needs to prove that she was injured during the course and scope of her employment.  It is no defense for the employer to deny coverage because  “there ain’t nothing wrong with the floor” to have caused you to fall.

Situation 3

Let’s assume that Ashley has a bad knee which has bothered her for years.  As she is walking down the hall with a hand full of files, her bad knee simply gives away and she falls.  There was nothing on the floor to cause her to fall.  As she was being helped up from the floor by her co-workers, Ashley says to everyone that “my knee just gave away.”  Is she covered under our workers’ compensation laws?

No, in this case Ashley would be determined to have suffered an “idiopathic fall.”  That is a fall caused solely by an inherent medical condition (the bad knee) or weakness which is specific to Ashley.  An “idiopathic fall” is much different than an “unexplained fall” described above in Situation 2.  In an “idiopathic fall” the burden of proof is on the employer to establish that the fall was caused solely by Ashley’s inherent medical condition.  It will be easy for the employer to prove that Ashley’s fall was idiopathic because she admits it when she tells everyone that “my knee just gave away.”  A fall caused by fainting is also an example of an idiopathic fall.

The Moral of the Story

If you suffer a fall a work, you will be covered by workers’ compensation if a specific work hazard (like water on the floor or an object on the floor) causes you to fall or if your fall is simply unexplained.  The only way you lose is if the employer can prove that your “unexplained fall” was actually an “idiopathic fall” in that it was caused solely by your inherent medical condition which had nothing at all to do with your work or work environment.  Therefore, if you do have the misfortune of falling at work, don’t haphazardly make a statement in the midst of your natural embarrassment that you fell because your bad knee gave away!

If you fall at work and have questions regarding your claim, please do not hesitate to contact Ernie Trammell at Trammell & Mills Law Firm, LLC.   Ernie Trammell has been a practicing law for 32 years and has focused the last 15 years of his practice solely on representing injured workers in workers’ compensation claims in South Carolina and Georgia.

****Regardless of anything mentioned above, the first thing you should do after injuring yourself at work is notify your supervisor of the accident and any injuries sustained.  Next, call the attorneys at the Trammell & Mills Law Firm, LLC, to determine your rights under WC.  Mr. Trammell is very experienced in a wide range of issues clients face everyday when injured on the job.  Along with our knowledgeable and experienced staff, the attorneys at the Trammell & Mills Law Firm, LLC, will personally work day-to-day on your WC claim.

RELATED ARTICLES by Ernie Trammell:

Injured at Work in South Carolina? What you need to know. (Part 1)

Injured at Work in South Carolina? What you need to know. (Part 2)

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Workers Compensation Lawyers in Anderson, SC

Why Do You Need a Lawyer for a Workers’ Comp Case?

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Nobody wants to get hurt while they’re at work. You’re just trying to make money to pay your bills, right? But work injuries do occur, and it’s important for you to know what to do if it happens to you. We at Trammell & Mills Law Firm remind you to remember these three things: report it, seek medical attention, and get legal help to file a workers’ compensation claim.

Work injuries can vary, but some of the most common ones are cuts or lacerations, ligament sprains, muscle or tendon strains, bruising or swelling contusions, burns, eye injuries, bone fractures, and cumulative or continuous trauma. Other work injuries might include slips and falls, vehicle collisions, toxic fumes, or exposure to loud noise. Any of these might cause you to miss work while recovering.

If your injury requires you to go to the hospital immediately, do that first.  Otherwise, you should report your injury to your employer right away, so there will be a record that it happened. Make sure you tell your boss or supervisor, because the word of a co-worker isn’t always enough to prove your case later. You need proper proof you were injured.

Your employer should give you the name of a recommended medical professional where you can get proper evaluation and treatment.  Even if you don’t think it’s that serious, don’t put it off! Failure to report an accident within 90 days may disqualify you from getting workers’ comp benefits.

Your employer should guide you on the paperwork you need to fill out to file for workers’ comp benefits. But be warned—not all employers want to do this. They may be afraid their insurance premiums will go up, or that filing one claim might lead to other employees making claims. You have a legal right to file your claim, so don’t let them drag their feet.

That’s where expert legal guidance from Trammell & Mills can make a difference. We’ll help you push through all the paperwork get authorization for proper medical treatment. And we will fight hard to make sure you get fair compensation for lost income, or for any permanent disability or disfigurement from your injury. We won’t let your employer push you around.

Most properly-filed workers’ comp claim disputes are resolved through an out-of-court settlement with the employer.  Less than 10% are denied.  And about 5% of claim disputes actually go to a court trial. But taking on the legal red tape by yourself can lead to big disappointment…and losing money. Our goal is to make sure you get your medical bills paid for any work injury, and to get any income you’ve lost due to missing work.

Be safe in your workplace, but make sure you know what to do if you get hurt on the job. Let the professionals at Trammell & Mills Law Firm guide you through the workers’ compensation process. We’re local, we’re experienced, and we’re ready to fight for your rights.

Give us a call at (864) 485-8585.