Gattis v. MURRELLS INLET VFW 10420

576 S.E.2d 191, 353 S.C. 100, 2003 S.C. App. LEXIS 11
CourtCourt of Appeals of South Carolina
DecidedJanuary 21, 2003
Docket3592
StatusPublished
Cited by20 cases

This text of 576 S.E.2d 191 (Gattis v. MURRELLS INLET VFW 10420) is published on Counsel Stack Legal Research, covering Court of Appeals of South Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gattis v. MURRELLS INLET VFW 10420, 576 S.E.2d 191, 353 S.C. 100, 2003 S.C. App. LEXIS 11 (S.C. Ct. App. 2003).

Opinions

CURETON, J.:

In this workers’ compensation action, the full commission awarded Patricia Gattis (“Claimant”) temporary total disability payments (TTD) and ordered her employer, Murrells Inlet VFW # 10420, to pay for medical treatment rendered by out-of-state medical providers. The circuit court affirmed the disability award and reversed the award of medical payments. Claimant appeals the circuit court’s reversal of the award of medical payments. Murrells Inlet VFW # 10420 and National Union Fire Insurance Company (collectively “Employer”) also appeal. We affirm in part and reverse in part.

FACTS

Claimant suffered an admitted back injury on March 17, 1995, while performing her duties as a bartender. Employer paid workers’ compensation benefits after the accident.

[105]*105Claimant visited various doctors between 1995 and 1997 in South Carolina and North Carolina and was referred to Duke University Medical Center in North Carolina, Coastal Orthopaedics in South Carolina, and Emory University Spine Center in Georgia. In August of 1997, Dr. William Horton at the Emory Spine Center independently evaluated Claimant. Employer denied Claimant’s request for authorization to receive treatment from Dr. Horton.

Claimant filed a Form 50 on November 6, 1997, seeking additional treatments from Dr. Horton. Employer admitted the accident, denied Claimant was entitled to medical payments for Dr. Horton’s treatments, and argued Claimant had reached maximum medical improvement (“MMI”). After an August 19,1998 hearing, the single commissioner found Claimant had not reached MMI and ordered Employer to pay for medical treatment provided by Dr. Horton. Employer appealed. The full commission found Claimant reached MMI on March 9,1998, upon her release by her treating physician, Dr. Wilkins. At the hearing before the full commission, Claimant sought to introduce a letter from Dr. Horton, which was not included in the record before the single commissioner. The commission refused to admit the letter, noting instead that the letter would provide Claimant with “the opportunity for a change of condition” request.

The commission found a 25% permanent impairment to Claimant’s back. As explained by the circuit court: . “The [commission] also found that the treatment rendered by Dr. Horton as indicated in the record at that time and considered by the Single Commissioner did not arise out of the accident, and also found that [Employer] was not responsible for such treatment. There was no appeal from this order.”

On January 28, 1999, Claimant filed a Form 50 for a change in condition “as evidenced by attached medical documentation and additional medical documentation which may be submitted.” As medical documentation, Claimant relied on patient notes and two letters from Dr. Horton, and patient notes and a letter from Dr. John Glaser, another treating physician. Dr. Horton’s notes, dated June 12, 1997, stated that Claimant “might well be a candidate for endoscopic fusion.” Dr. Horton reiterated in a letter to Claimant dated January 30, 1998: “I [106]*106would tell you that surgery remains a possibility although I cannot yet definitely recommend it.” In the second letter to Claimant’s attorney, dated August 18,1998, Dr. Horton wrote: “Assuming L5-S1 is the source of her pain, a successful fusion at L5-S1 would very likely decrease the tenure and/or severity of [Claimant’s] pain and impairment.” Dr. Glaser’s patient notes and letter dated October 14, 1998, corroborated Dr. Horton’s recommendation for surgery. In his notes, Dr. Glaser wrote: “I basically agree with what Dr. Horton had to say. I think surgery is an option for her.”

On February 2, 1999, Employer filed a Form 51 denying a change of condition. The single commissioner found Claimant had experienced a change in condition effective August 18, 1998, the date of Dr. Horton’s second letter and reinstated Claimant’s TTD. The commissioner further found Employer should be responsible for Claimant’s previous evaluations and treatment, and for further evaluation, diagnostic testing, treatment and surgery by Dr. William Horton or his designees as “it has been shown that such treatment may tend to lessen the tenure and severity of Claimant’s disability pursuant to 42-17-90.”

By order filed January 11, 2000, the full commission affirmed the single commissioner. Employer appealed to the circuit court. While the matter was pending before the circuit court, Claimant filed a motion to compel reinstatement of TTD. By order dated June 12, 2000, the Honorable Howard P. King, circuit court judge, affirmed the finding of a change in condition but reversed the award of medical payments for out-of-state providers concluding “the Commission lacks the authority to order additional treatment outside the state.” Judge King thus ordered further proceedings by the full commission regarding Claimant’s treatment. Employer and Claimant appealed to this court.

By order filed November 1, 2000, the Honorable John L. Breeden, Jr. acted on the pending motion to compel past-due medical payments. Judge Breeden ordered Employer to pay accrued installmént payments for TTD from August 18, 1998, and imposed a penalty. Employer appealed this order.

[107]*107 Employer’s Issues

1. Is Judge King’s order finding a change in condition, reinstating Claimant’s TTD, and requiring Employer to cover future medical care and treatment, supported by substantial evidence?1

2. Did the commission exceed its authority in ordering Employer to pay for Claimant’s medical bills under S.C.Code Ann. § 42-17-90?

3. Did Judge Breeden have jurisdiction to rule on Claimant’s motion to compel payment of past due workers’ compensation benefits?

Claimant’s Issue

1. Did Judge King err in concluding any medical treatment to which Claimant is entitled should be performed only in South Carolina by a physician chosen by Employer?

STANDARD OF REVIEW

The determination of whether a claimant experiences a change of condition is a question for the fact finder. Krell v. S.C. State Hwy. Dept., 237 S.C. 584, 588, 118 S.E.2d 322, 323-24 (1961). In Krell, our supreme court stated:

It is not the province of this Court to determine whether the greater weight of the evidence supported the finding that a change had taken place in the condition of the claimant such as would warrant an extension or enlargement of the award, or whether the greater weight of the evidence supported the finding that such change resulted from the injury.... Such facts must be determined by those whose duty it is to find the facts.

237 S.C. at 588, 118 S.E.2d at 323-24 (quoting Cromer v. Newberry Cotton Mills, 201 S.C. 349, 371, 23 S.E.2d 19, 28 (1942)). The Administrative Procedures Act establishes the substantial evidence standard of review for factual findings made by the commission. Lark v. Bi-Lo, Inc., 276 S.C. 130, 133, 276 S.E.2d 304, 305 (1981). Under the substantial evidence standard of review, this court may reverse the commis[108]*108sion’s findings only when they are unsupported by substantial evidence. S.C.Code Ann.

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Gattis v. MURRELLS INLET VFW 10420
576 S.E.2d 191 (Court of Appeals of South Carolina, 2003)

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Bluebook (online)
576 S.E.2d 191, 353 S.C. 100, 2003 S.C. App. LEXIS 11, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gattis-v-murrells-inlet-vfw-10420-scctapp-2003.