State Accident Fund v. South Carolina Second Injury Fund

Summary

The South Carolina Supreme Court reviewed a workers’ compensation carrier’s request for reimbursement from the South Carolina Second Injury Fund for medical benefits paid after a work-related knee injury aggravated the claimant’s preexisting diabetes. The court held that the carrier was entitled to the statutory presumption that the diabetes was a permanent physical impairment constituting a hindrance or obstacle to employment, and that the Commission improperly evaluated rebuttal evidence. The court also held that increased medical costs alone could support reimbursement under the statute, reversed the Commission’s decision, and remanded for determination of the reimbursement amount.

Holdings

1. Because the State Accident Fund established the facts necessary to invoke S.C. Code Ann. § 42-9-400(d), it was entitled to a presumption that the claimant's diabetes was permanent and constituted a hindrance or obstacle to obtaining employment or reemployment.
2. The Second Injury Fund failed to rebut the presumption with substantial evidence, and the Commission's conclusion that the evidence rebutted the presumption was clearly erroneous.
3. The State Accident Fund satisfied § 42-9-400(a) by establishing that aggravation of the claimant's preexisting diabetes caused substantially greater medical-payment liability than would have resulted from the knee injury alone, and it was entitled to reimbursement for those medical payments.

Questions Presented

1. Whether the State Accident Fund was entitled to the statutory presumption that the claimant's preexisting diabetes was permanent and constituted a hindrance or obstacle to obtaining employment or reemployment.
2. Whether the South Carolina Second Injury Fund presented substantial evidence rebutting that presumption.
3. Whether the State Accident Fund established entitlement to reimbursement for substantially increased medical payments under S.C. Code Ann. § 42-9-400(a), even without increased compensation liability.

Disposition

reversed_and_remanded