Heirs of injured workers who later die from causes that have nothing to do with their workplace accidents can collect permanent total disability benefits, even if the workers’ compensation claim was still pending at the time of death, the South Carolina Court of Appeals has ruled.
In deciding Timothy McMahan v. S. C. Department of Education, a unanimous three-judge panel for the appellate court settled a debate about whether pending disability benefits claims survived claimants’ deaths and provided guidance in determining how much disability money the heirs should receive.
“They’re looking at the totality of the circumstances and using all of them to determine the extent of the disability. And I think that’s something new,” said Mount Pleasant workers’ comp attorney Gary Christmas of Howell & Christmas. He was not involved in McMahan.
“This case answers a lot of questions that a lot of practitioners had that hadn’t been answered at the appellate level,” he added. “It lets us know that you can argue disability as if the person were alive and whatever the [Workers’ Compensation] Commission decides that disability is, then it goes to the next wholly dependent.”
The SCDOE planned to appeal the decision, said John Coggiola of Willson Jones Carter & Baxley in Columbia. He declined further comment. Attempts to speak with the attorney for McMahan’s estate, Kevin Smith of the Hoffman Law Firm in North Charleston, were unsuccessful.
McMahan, a mechanic for the state Department of Education, had his spine crushed in 2011, when a bus he was working on fell on him. The doctor that the SCDOE authorized to treat McMahan determined in 2012 that he had reached maximum medical improvement, or MMI, and would need a wheelchair for the rest of his life. He died of an unrelated heart condition almost a year later.
His widow subsequently filed a claim for workers’ comp benefits for injuries to McMahan’s head, brain, back, internal organs, teeth, legs, mouth and ribs. The SCDOE argued that McMahan had injured only his back.
A workers’ comp commissioner ruled that the widow was entitled to the unpaid balance of McMahan’s permanent total disability benefits based on the severity of his back injuries and his doctor’s determination that he had 54 percent impairment to his “whole person” and was not going to improve before he died.
But the commission’s appellate panel reversed the commissioner’s order, finding that McMahan had not reached MMI before he died and therefore his widow could not collect his permanent total disability benefits.
In reversing the panel’s decision and awarding benefits to the widow, Court of Appeals Judge H. Bruce Williams held that the “only medical evidence in the record established McMahan attained MMI prior to his death.”
However, Williams asserted that the central question hinged not on the MMI issue, which everyone in the case had been focused on, but whether McMahan’s workplace injury was covered under the state law that allows dependents of hurt workers to collect their benefits after they die from conditions that are unrelated to their initial comp claims. The applicable law includes back injuries.
“Based upon our review of case law and a plain reading of the applicable statutes, so long as McMahan sustained an injury covered by the second paragraph of section 42-9-10 or 42-9-30 and died from a cause unrelated to the injury, the estate is entitled to recover the unpaid balance of McMahan’s compensation,” Williams wrote.
He also found that the workers’ comp appellate panel had “misstated the law” in its order when it found that it was “well settled in South Carolina that the award of disability benefits is premature prior to the claimant reaching MMI.”
In fact, the state Supreme Court has never held that a MMI diagnosis was required to collect disability, according to Williams.
He went on to reject the SCDOE’s assertion that McMahan’s widow could not collect compensation because her husband died before his comp claim was finalized. Williams called the argument “absurd.”
“In our view,” he wrote, “this is why the General Assembly specifically chose the language ‘receives or is entitled to compensation’ when it drafted this [applicable] statute, and we hold any different conclusion would run afoul of legislative intent.”
The SCDOE also failed in arguing that its due process rights were violated because it had not conducted full discovery, cross-examined and presented witness or introduced evidence before McMahan’s widow was awarded benefits.
Williams noted that the SCDOE had a chance to cross-examine the widow when she testified at the hearing with the single commissioner, but did not. The agency also backed out of a deposition it had scheduled with McMahan’s doctor and never tried to depose the surgeon who operated on McMahan’s back, according to the Court of Appeals opinion.
The SCDOE’s final argument that the widow was not entitled to benefits because McMahan was paraplegic also fell flat on appeal.
State law does not provide compensation for heirs of paraplegics who die of non-work related causes. But McMahan’s doctor and surgeon did not diagnose him with paraplegia. The doctor wrote in his notes that McMahan “walked with a markedly pitched forward gait.”
Also, the SCDOE had initially denied McMahan’s claim for leg injury, arguing that they were not affected by the bus accident. That led Williams to conclude that it would be “illogical” to allow the SCDOE to turn around and assert on appeal that McMahan’s “legs were affected for purposes of establishing paraplegia” to prevent his widow from receiving benefits.
The 13-page decision is McMahan v. S.C. Department of Education-Transportation (Lawyers Weekly No. 011-056-16). A digest of the opinion can be found at sclawyersweekly.com.
Follow Phillip Bantz on Twitter @SCLWBantz