South Carolina Employment Law Letter: Procedurally undone: SC injury case vaults from one forum to another
In every employment law case, you must deal with the substantive law (i.e., what an employee or an employer must show to win the dispute) and also the procedural steps (i.e., the rules one must follow to address the core issues being litigated). Both the substantive and procedural aspects are important to success in every matter. Employers can find each part frustrating but need to understand how the substantive and the procedural work in a case. Read on to see how one recent South Carolina case turned on a procedural issue.
Factual and procedural background
On October 30, 2013, James Ashford sustained an injury when his right hand and wrist were caught and crushed in a machine while he was working for Prysmian Power Cables & Systems, USA. The accident resulted in a crush injury, right dorsal wound, right ulnar styloid fracture, right triangular fibrocartilage complex tear, and carpal tunnel syndrome.
On February 16, 2015, Ashford filed an employee’s notice of claim and/or request for a hearing—Form 50—with the South Carolina Workers' Compensation Commission (WCC) alleging injuries to his right upper extremity, right lower extremity, and right side and a resultant psychological injury. In addition, he alleged the injuries resulted in permanent disability and that mediation was required under Section 67-1802 of the South Carolina Code of Regulations (Supp. 2018).
In response, Prysmian filed the employer’s answer to a request for a hearing—Form 51—on March 12, 2015, admitting a compensable injury to Ashford's right wrist but denying injuries to his right lower extremity, right side, and/or psyche. The employer argued mediation wasn’t appropriate in the matter "until there is a finding regarding the compensability of the alleged body parts. If the claim is limited to a single scheduled member, mediation cannot be ordered." The company also raised all affirmative defenses and reserved the right to amend and plead additional defenses.
Prysmian filed an employer’s request for a hearing—Form 21—on April 30, 2015, seeking to stop the compensation. In its filing, the employer asserted Ashford had reached maximum medical improvement (MMI), asked for the compensation to be terminated, and requested a credit for overpayment of temporary compensation.
Commissioner sides with employee. On June 23, 2015, a single commissioner held a hearing to address Prysmian's Form 21. At the hearing, the employer objected to Ashford's submission of reports and opinions from Todd Hanson, a licensed marriage and family therapist. The company claimed they were untimely and that the therapist didn’t qualify as an expert on the issue of psychological injuries or conditions.
The commissioner allowed the admission of the therapist’s reports and opinions. Furthermore, he said he would address Hanson's qualifications in his order. The commissioner also indicated he would "leave the record open so that [Prysmian] could depose the doctor."
The commissioner issued an order on May 4, 2016, determining:
- Ashford was not at MMI for his wrist injury;
- He was entitled to future medical treatment for his wrist injury by a physician of his choosing; and
- Prysmian was prohibited from stopping temporary total disability benefits.
Concerning the issue of additional injuries to the employee’s psyche, right lower extremity, and right side and permanent and total disability, the commissioner ruled the issues required mandatory mediation and therefore weren’t timely for purposes of the hearing and weren’t properly before him.
Appellate panel mostly agrees with commissioner. Prysmian appealed the commissioner's order to the appellate panel, which held a hearing on August 15, 2016. At the hearing, the employer argued the commissioner should have determined Ashford's claim for the psyche injury. The employee argued again that his additional injuries were subject to mandatory mediation.
The panel issued an order affirming the commissioner's finding that Ashford hadn’t attained MMI and was entitled to future medical treatment for his wrist. On the subject of temporary total disability benefits, however, the panel reversed the commissioner's finding and allowed Prysmian to terminate the benefits. The employer was awarded a credit against benefits paid as of May 4, 2015.
In regard to the other injuries, the panel, like the commissioner, determined Ashford has a pending Form 50 alleging injuries to his psyche, right lower extremity, and right side that weren’t timely for the
purposes of the panel’s hearing and weren’t properly before them.
Prysmian appealed the panel's order, arguing the findings were in error and violated its due process rights.
The South Carolina Administrative Procedures Act (APA) sets the standard for judicial review of WCC decisions. Generally, there must be a final decision before a person or party can appeal an administrative agency decision. Specifically, Section 1-23-380 of the APA allows judicial review when a party has exhausted all administrative remedies, and the agency issues a final decision.
Ashford argued the WCC hadn’t made a final decision. He pointed out the appellate panel's order determined he had not reached MMI and was entitled to future medical treatment. The panel also reversed the commissioner's determination that he was entitled to temporary total disability benefits. However, it declined to address his other injuries and his claim for permanent disability.
Ashford also claimed the WCC must address those issues to resolve the entire action. The appeals court noted the appellate panel's decision wasn’t final for purposes of Section 1-23-380 and was reviewable only if a review of the final agency decision would not provide an adequate remedy.
According to the appeals court, Ashford’s case had not reached a final judgment that would have disposed of the whole subject matter of the claim. Additional items needed to be resolved before the case could be final. In other words, some further act must be done to determine the parties’ rights. Consequently, the order being appealed was “interlocutory” (an intermediate decision between the commencement and termination of a claim).
With that background, the appeals court noted Prysmian was seeking a decision about Ashford's other injuries and his claim for permanent disability benefits. The WCC hadn’t addressed the issues, which is the crux of the appeal, but the agency isn’t precluded from addressing them. A final agency decision is the exact remedy Prysmian seeks in the appeal.
However, Prysmian had an adequate remedy available—if not through mediation, then through the normal course of the docket scheduling as provided in regulation 67-1804. A review of that decision would provide an adequate remedy should either of the parties assert an error in the decision. Therefore, Section 1-23-380 did not allow judicial review of the issue Prysmian appealed. Accordingly, the appeals court dismissed the appeal.
Lessons for SC employers
Ashburn’s litigation is an example of “slow walking” a case through the administrative process. While an argument might be made that the WCC had reached a final decision, the appeals court noted other items remained undecided, including an MMI determination. The upshot is, employers must fully understand not only the substantive components of any litigation but also the procedures. Prysmian's appeal involved issues the parties had yet to litigate. Thus, they could still seek an adequate remedy through the review of a final agency decision.