The South Carolina Workers’ Compensation Act provides for the possibility of reopening a workers’ compensation award if there is a change in the medical condition of the worker. See S.C. Code § 42-17-90. The purpose of the change of condition doctrine is to enable the Workers’ Compensation Commission to change the benefits awarded to an injured worker if the worker’s medical condition worsens, including by ordering additional medical treatment or increasing compensation when warranted. This article discusses how — and under what circumstances — that may be done.
What is “Change of Condition” in Workers Compensation?
If a worker’s medical condition worsens within the statutory time limits, the worker can seek to reopen his or her case and have the amount of compensation increased. Under South Carolina case law, there are several requirements including:
(1) The worsened condition must be “causally connected with the original compensable accident” — that is, a newly manifested symptom of an original injury;
(2) The change of condition must not actually be a separate injury which could have been included in the original claim, but was not; and
(3) The change of condition must have occurred after the original award — that is, if the change took place during the time when the worker COULD have added the change of condition to his or her original application, the change of condition is barred.
Note that the Workers’ Compensation Commission can make distinct rulings with respect to claims of change of condition. For example, in Estridge v. Joslyn Clark Controls, Inc., 482 SE2d 577 (S.C. Ct. App. 1997), the worker was involved in a series of accidents in 1989 and 1990. The worker’s job duties involved the repetitive movement of “cranking” machinery and he injured his left elbow, and later, his right elbow. This, in turn, led to his back, neck, and right shoulder injuries. He filed for benefits, which he received. Later, he filed for review based on a change of condition. He claimed that his left arm had worsened and also claimed that he was now suffering psychological problems due to his injuries, such as elevated levels of paranoia, schizophrenia and psychothenia.
The Commission made a split decision, awarding additional compensation for the worsened condition of the left arm but rejecting the claims related to the psychological issues. On appeal, the court reversed the part of the Commission’s decision that rejected the psychological claims, since the Commission did not actually make a determination on whether the psychological issues were causally related to the workplace injuries.
Timing of Change of Condition in a Workers Compensation Case
There are two important timing issues for Change of Condition. First, any change of condition must occur AFTER the first award is made for the worker.
Second, any review of an award “… must not be made after 12 months from the date of the last payment of compensation pursuant to an award provided by this title.” See S.C. Code § 42-17-90(A).
“Change of Condition” Case Example: Houston v. Garda World Security
A good illustration of the requirement to prove a change of condition can be found in the case of Houston v. Garda World Security, Case No. 2018-UP-094 (S.C. Ct. App. February 21, 2018) (unpublished). In Houston, the worker suffered injuries to his right knee as a result of a car accident while working. The worker settled his workers’ compensation claim in February 2010, but the condition of his knee worsened after the settlement. In November 2010, the worker filed a request for hearing alleging a change of condition to his right knee (among other body parts). The Court of Appeals affirmed the re-opening of the worker’s application. The change of condition related to the original injury claim (the right knee), the change occurred after the original award, and the application was make within the one-year time period after the last payment in accordance with section 42-17-90.