In recent years, health insurance coverage for people with preexisting conditions has been a hot topic. However, when it comes to workers’ compensation in South Carolina, this issue has been settled. It is possible for an injured worker to receive workers’ compensation benefits when the injury aggravated a preexisting condition.
Specifically, S.C. Code Ann. § 42-9-35 provides (in part):
(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.
(B) The commission may award compensation benefits to an employee who has a permanent physical impairment or preexisting condition and who incurs a subsequent disability from an injury arising out of and in the course of his employment for the resulting disability of the permanent physical impairment or preexisting condition and the subsequent injury.
When an injured worker alleges that his work-related injury aggravated a preexisting condition, “it is the burden of the claimant to prove ‘by a preponderance of the evidence, including medical evidence, that . . . the subsequent injury aggravated the preexisting condition or permanent physical impairment; or . . . the preexisting condition or the permanent physical impairment aggravates the subsequent injury’ in order to be eligible for compensation for that injury.” Frampton v. S.C. Dep’t of Nat. Res., 432 S.C. 247, 259, 851 S.E.2d 714, 720–21 (Ct. App. 2020) (quoting S.C. Code Ann. § 42-9-35).
In other words, to be covered under the South Carolina Workers’ Compensation Act, the injured worker must prove that his workplace injury most probably aggravated his/her preexisting condition.
Over the years, I have handled numerous cases involving preexisting conditions. These issues seem to come up most often in the following circumstances (this list is not exhaustive by any means):
- Injuries involving the knee where there is preexisting arthritis or chondromalacia resulting in the need for knee replacement;
- Injuries involving the back/neck where there are preexisting degenerative issues;
- Injuries involving the shoulders where there is preexisting arthritis or even tearing resulting in the need for surgery (including total shoulder replacement and reverse total shoulder replacements);
- Exposure cases involving preexisting lung issues (such as asthma); and
- Head injuries resulting in concussion involving preexisting headache issues.
Because these cases are frequently denied and involve the need for expert medical opinions or testimony, getting a lawyer involved on your side early can make a big difference. Call me, Jeremy Dantin, at (864) 660-0465 or email me at jdantin@spartanlaw.com if you have questions about a case involving a preexisting condition in a workers’ compensation case or if you have any other workers’ compensation questions. Consultations for workers’ compensation matters are free, so it never costs you anything to find out whether we can help.
Workers’ compensation cases are handled on a contingency basis. The attorney’s fee is a percentage of total recovery before deducting costs. Clients are not liable for costs if there is no recovery.
Jeremy Dantin is a partner with the law firm KD Trial Lawyers. Click here to read more about Jeremy.
The posts on this website/blog are published as a service to our clients and friends. They are intended to provide general information only and should not be construed to be formal legal advice regarding any specific situation and should not be construed as forming an attorney-client relationship. Success in the past does not indicate the likelihood of success in any future representation.
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