S.C. Court of Appeals relies upon circumstantial evidence to find in favor of injured worker in a claim denied by Defendants on grounds of idiopathic injury.
The South Carolina Court of Appeals recently had its second go-around with a workers’ compensation claim filed by a nurse anesthetist against a temporary medical staffing agency and against the hospital where that agency placed her to work. In Shatto v. McLeod Regional Medical Center, Opinion No. 5239, filed June 11, 2014, the injured worker, Mildred Shatto, alleged she sustained an injury by accident resulting from a fall in an operating room at McLeod Regional Medical Center. The Defendants, Staff Care, Inc., and McLeod Regional Medical Center (“McLeod”) each denied an employment relationship with Shatto. Alternatively, and more relevant to this particular opinion, each also denied the accident and injury arose out of and occurred in the course of employment by alleging an idiopathic as the cause for her fall.
This case brings with it a rather complicated and tortuous procedural history. This particular opinion from the Court of Appeals on remand from the S.C. Supreme Court addresses only the Defendants’ argument of idiopathic injury as a basis for denying compensability under the Workers’ Compensation Act. For purposes of examining the Court of Appeals’ decision on this argument, the procedural history need not be examined in much detail. Suffice it to say that after the Court of Appeals found no employment relationship between Shatto and McLeod, the Supreme Court granted a writ of certiorari only to address the question of employment and right to control under South Carolina jurisprudence. The Supreme Court ultimately determined sufficient right to control rested with McLeod such that there was an employment relationship with Shatto. The Court then remanded the case to the Court of Appeals with instructions to rule on McLeod’s idiopathic argument, Shatto v. McLeod Regional Medical Center, 406 S.C. 470, 753 S.E.2d 416 (2013). The remand resulted in a Court of Appeals decision that McLeod’s idiopathic injury argument was not compelling. The Court affirmed the original finding of compensability by the Workers’ Compensation Commission.
In so ruling, the Court of Appeals cited established precedent that, “To be compensable, [an] injury is not required to be foreseen or expected, but after the event, it must appear to have originated in a risk connected with the employment and to have come from that source as a rational consequence.” Shatto v. McLeod Regional Medical Center, Opinion No. 5239, filed June 11, 2014 (citing Ardis v. Combined Ins. Co., 380 S.C. 313, 320-21, 669 S.E.2d 628, 632 (Ct. App. 2008)) The fundamental basis for any argument of idiopathic origin is that “the basic cause of the harm is personal, and the employment does not significantly add to the risk.” Crosby v. Wal-Mart Store, Inc., 330 S.C. 489, 493, 499 S.E.2d 253, 256 (Ct. App. 1998)
The crux of McLeod’s argument was that because Shatto could not present evidence as to exactly what in the operating room caused her to fall, it would be conjectural to conclude her employment was a contributing cause of her injury. In absence of any such employment related contributing cause, argued McLeod, the cause of such a fall could only be considered personal and therefore idiopathic. This argument finds roots in the Crosby opinion, cited above.
In examining the evidence of record, the Court quoted Shatto’s testimony at hearing that she was “preparing to anesthetize a patient and was walking around the patient’s bed when her foot became caught on something and she fell.” Shatto, Opinion No. 5239. On cross-examination by defense counsel, she stated:
The patient’s bed was an electric one, so it had an electrical cord to connect it. There was an I.V. pole with the patient, and it had a pump on it, so that had a cord to be plugged in, and there was an extra I.V. pole on it at the head of the bed towards the left side of the bed. I don’t know for sure what my foot caught on, but it was one of those three things: the I.V. pole or cords from the bed or the pump.
Id. The Court also noted that after the fall, Shatto’s shoe remained at the foot of the bed.
In rejecting McLeod’s idiopathic argument, the Court of Appeals stated, “Although Shatto did not directly and unequivocally testify to what specifically caused her to fall, there is ample circumstantial evidence in the record that Shatto’s fall was the result of conditions of her employment.” Id. (emphasis added) It is well-established a work related injury may be proven either by direct or circumstantial evidence. Tiller v. Nat’l Health Care Ctr. of Sumter, 334 S.C. 333, 513 S.E.2d 843 (1999) The Court simply refined the definition of circumstantial evidence, although not dramatically, to note such evidence need not be completely specific and unequivocal. It was enough for the Commission and the Court of Appeals to award benefits on grounds Shatto tripped on something and that she was able to narrow it down to one of three items commonly found in her work environment.
Practice Pointer: In considering denial of any claim, whether on an idiopathic basis or not, employers and carriers in South Carolina should keep in mind that an injured worker’s inability to recite exactly what happened may not always be sufficient to prevail.