Court Opinion

ID: 9577148
Source: CourtListenerOpinion
Date Created: 2023-08-21 21:32:06.289568+00
Date Added: 2024-06-11T13:20:01.007875
License: Public Domain

Goolsby, Judge
(dissenting):
I respectfully dissent, believing there is substantial evidence on the whole record that the claimant reached maximum medical improvement and sustained a twenty percent permanent disability to her back for which she received compensation. The finding of maximum medical improvement took into account any question of whether the claimant’s back injury or the treatment given the claimant for the injury either caused or aggravated an incontinence condition. See Ancrum v. Low Country Steaks, 317 S.C. 188, 452 S.E. (2d) 609 (Ct. App. 1994) (wherein, among other things, the court of appeals held, as it reversed the circuit court, substantial evidence on the whole record supported the commission’s finding *444that the claimant, who had suffered a back injury, had reached maximum medical improvement).
Although in Part II of its opinion the majority makes mention of the standard of review prescribed by the South Carolina General Assembly in S.C. Code Ann. § l-23-380(A)(6) (Supp. 1994), it effectively fashions, as it picks through the testimony and exhibits, crediting this and discrediting that, weighing this an not weighing that, a wide-open, liberal standard of review that turns the prescribed standard of review on its head. This new standard of review permits an appellate court to set aside findings made by an administrative agency when the appellate court disagrees with an agency’s decision not to credit certain evidence, whether the evidence is expert or otherwise, direct or indirect. For that is exactly what the majority has done here in holding “the [cjommission committed legal error” in ‘basting] its decision solely on the lack of a medical opinion” and in “ignoring] the medical and circumstantial evidence in the record. . . .” This liberal standard of review, if allowed to stand, will come back to haunt appellate courts. It was provide an appellate court that disagrees with an administrative agency’s decision with a vehicle to reach the opposite result, despite what other evidence in the record may show and despite the express injunction contained in section l-23-380(A)(6) that “[t]he [appellate] court shall not substitute its judgment for that of the agency as to the weight of the evidence on questions of fact.”
Only recently, the South Carolina Supreme Court, in full recognition of the narrow, conservative standard of appellate review of administrative decisions, declared in an opinion authored by Justice Toal that “[a] reviewing court may not substitute its judgment for that of the Commission as to the weight of the evidence on questions of fact.” McGuffin v. Schlumberger-Sangamo, 307 S.C. 184, 186, 414 S.E. (2d) 162, 163 (1992). In an opinion authored earlier by Justice Chandler, in which he quoted from Ellis v. Spartan Mills, 276 S.C. 216, 219, 277 S.E. (2d) 590, 591 (1981), the supreme court cautioned reviewing courts that “ ‘[i]t is not the task of courts to weigh the evidence as found by the [Cjommission.’” Ross v. American Red Cross, 298 S.C. 490, 492, 381 S.E. (2d) 728, 730 (1989). Most recently, in Parsons v. Georgetown Steel, — S.C. —, 456 S.E. (2d) 366 (S.C. Sup. Ct. 1995) (Davis Adv. Sh. No. 6 at 5), *445the supreme court rejected the argument of a disappointed claimant that the commission erred in giving “great weight” to the testimony of a doctor who was not the treating physician and who made conclusions concerning the claimant’s psychiatric problems allegedly before he was aware of the claimant’s work related injury. Id. at —, 456 S.E. (2d) 366. In so holding, the supreme court stated “[t]he credibility and weight of the doctor’s testimony is for the trier of fact.” Id.
Is there substantial evidence that the claimant had reached maximum medical improvement? There is. S.R. Littlepage, M.D., wrote on June 3, 1991, in a “neurosurgical follow up note,” which he copied to “Dr. Woody Long,” among others, the claimant had returned to his office and he felt “she ha[d] reached maximum medical improvement.”1 George R. Bruce, M.D., who examined the claimant on September 3,1991, at the request of her own attorney, also found, after reviewing her medical records,2 the claimant “ha[d] reached maximum medical [improvement].”3
Is there substantial evidence that the claimant’s incontinence problem did not result from the accident or the treatment for the accident? There is.4 Dr. Littlepage wrote on *446March 5,1991, in a “neurosurgical note” that the claimant “has had problems with her bladder and has had a hysterectomy” and that the claimant “is currently in a stage of ‘bladder retraining’ because of her hysterectomy” and “has not appreciated any change in her bladder function since her surgery.” The testimony of Barbara Elizabeth Dawson, a registered nurse with thirty years experience, also provides substantial evidence that the claimant’s incontinence problem resulted from something other than the accident or its treatment.5 Furthermore, the burden was on the claimant to prove otherwise by the greater weight of the evidence and to do so to the satis*447faction of the commission, not this court.6 Frady v. Pacific Mills, 231 S.C. 601, 99 S.E. (2d) 398 (1957); see Shealy v. Algernon Blair, Inc., 250 S.C. 106, 156 S.E. (2d) 646 (1967) (only the commission can pass upon the weight of the evidence in a workers’ compensation case).
At any rate, I adhere to the previous majority opinion, an opinion in which the late Judge Randall T. Bell concurred fully. Mullinax v. Winn-Dixie Stores, Inc., Op. No. 2176 (S.C. Ct. App. filed April 25, 1994) (Davis Adv. Sh. No. 10 at 29). What follows is a modified version of the previous majority opinion, parts of which duplicate what I have written already.
The claimant injured her back as she was lifting bags of flour and sugar from pallets while working at Winn-Dixie Stores, Inc. on February 8, 1991. The claimant thereafter began receiving workers’ compensation payments.
Winn-Dixie applied to the South Carolina Workers’ Compensation Commission on June 19,1991, to stop compensation-payments to the claimant. On June 3, 1992, the commission filed an order adopting the order of the single commissioner, who found the claimant had suffered a twenty percent permanent partial disability to her back and had reached maximum medical improvement on June 3,1991.
An appeal by the claimant to the circuit court resulted in a reversal of the commission’s order. The circuit court found the commission’s order was not supported by substantial evidence. On appeal, Winn-Dixie argues the commission’s findings are supported by substantial evidence and the circuit court therefore erred in reversing the commission. I agree.
Dr. Littlepage, of Neurosurgical Associates in Greenville, began seeing the claimant in March, 1991. Dr. Littlepage per*448formed a CT scan and myelogram and found no evidence of a ruptured disc. Dr. Littlepage also noted in his medical report dated March 5,1991, that the claimant was “in a stage of ‘bladder retraining’ because of her hysterectomy.” The claimant had undergone a total hysterectomy in October, 1990, four months prior to the accident. Dr. Littlepage referred the claimant to the Pain Therapy Program in Greenville on April 3, 1991. On May 8, 1991, Dr. Littlepage noted the claimant began having stress urinary incontinence while participating in an exercise program. He also indicated her gynecologist did not perform a bladder tack-up at the time of her hysterectomy. When he released the claimant from his care on June 3, 1991, Dr. Littlepage felt she had reached maximum medical improvement and had suffered a five percent impairment of the whole person.7
The claimant underwent physical therapy at the Pain Therapy Center in Greenville. She was, however, discharged from the center on May 30, 1991, for poor attendance and noncompliance with the program. The claimant claimed her incontinence was aggravated by the therapy exercises.
In May, 1991, the claimant returned to work at Winn-Dixie under a Temporary Alternative Duty program and was scheduled to work two four-hour shifts per week in the delicatessen. The claimant, complaining of continuing back pain, did not complete this program.
Dr. Bruce, an orthopaedic surgeon, examined the claimant on September 3, 1991, and found no evidence of a herniated disc. Dr. Bruce, like Dr. Littlepage, felt the claimant had reached maximum medical improvement; however, unlike Dr. Littlepage, Dr. Bruce gave the claimant a ten percent physical impairment to her back.
Nurse Dawson viewed the claimant’s bladder problems as resulting from three pregnancies and from not having her bladder tacked when she underwent a hysterectomy in 1990.
In November, 1991, Commissioner Marvin Kittrell ordered independent evaluations by a urologist, Dr. J. David Rice, and an orthopaedist, Dr. Carol G. Trent. Dr. Trent examined the claimant and “looked at her myelogram and CAT scan,” which *449revealed “a fairly significant 4-5 central disc.” Dr. Trent then conducted an MRI, which revealed “a central right-sided 5-1 disc bulge.” Dr. Trent concluded the claimant was unfit for duty. Dr. Rice reported there were a umber of factors that could contribute to the claimant’s incontinence, but he also indicated the incontinence “may have been going on before the exercise program, but may have been exacerbated by [it] [sic].” Subsequently, Dr. Rice reported that certain symptoms were consistent with a neurogenic abnormality, as opposed to stress urinary incontinence that might be more likely associated with the claimant’s obesity, past hysterectomy, or inactivity.
The commission considered all of the medical evidence8 and other testimony9 and concluded the claimant’s bladder condition was unrelated to the accident, the claimant reached maximum medical improvement on June 3, 1991, and the claimant suffered a twenty percent permanent partial disability to the back. There is substantial evidence to support the commission’s findings. See S.C. Code Ann. § l-23-380(A)(6) (Supp. 1994) (a court shall not substitute its judgment for that of the agency as to the weight of the evidence on questions of fact); Lark v. Bi-Lo, Inc., 276 S.C. 130, 276 S.E. (2d) 304 (1981) (a court may not disturb findings of the commission that are supported by substantial evidence).
Where there is conflicting medical evidence, as in this case, the findings of fact of the commission are conclusive. E.g., Hoxit v. Michelin Tire Corp., 304 S.C. 461, 405 S.E. (2d) 407 (1991); Solomon v. W.B. Easton, Inc., 307 S.C. 518, 415 S.E. (2d) 841 (Ct. App. 1992); S.C. Dig. (2d) Workers’ Compensation Key No. 1939.3 at 621 (1992). This court ought to follow this rule.
*450I would reverse.

In a report dated two days later, Dr. Long merely restated the claimant’s complaint about incontinence during exercises. He drew no conclusions about the claimant’s claimed incontinence being somehow connected to her work injury.

 Dr. Bruce’s report states he waited for the claimant’s medical reports before dictating his conclusions about her condition and about whether she had reached maximum medical improvement. I refuse to believe the claimant’s own lawyer would not have made certain the doctor had all information necessary to do his evaluation, particularly any medical records favorable to the claimant.

 Interestingly, Dr. Bruce, whose report is dated September 3, 1991, the date that he states he saw the claimant, indicated “[t]he patient’s chief complaint today is back pain with radiation down both legs when she does any standing.” His report makes no mention of incontinence.

 The burden, of course, was on the claimant to show that her pre-existing infirmity or diseased condition was aggravated by the injury complained of. Cross v. Concrete Materials, 236 S.C. 440, 114 S.E. (2d) 828 (1960). WinnDixie had no burden to show the claimant’s treatment did not aggravate her pre-existing condition.
The majority opinion mentions Dr. David Rice’s observation in his office notes that the claimant’s bladder problem “may have been exacerbated by [the exercise program].” This evidence, even when read in the context of the notes, is a far cry from what is necessary to establish a causal tie between the accident and the claimant’s subsequent injury. In order to establish a causal connection between an accident and a subsequent injury, the opinion of a medical *446expert must be at least that the disability “most probably” resulted from the accidental injury. Cross, 236 S.C. at 442, 114 S.E. (2d) at 829. Here, Dr. Rice noted several factors that could have contributed to this particular claimant’s incontinence problem, including the claimant’s prior pregnancies, moderate obesity, and hysterectomy. The single commissioner’s finding that “Dr. Rice, the [ujrologist, does not proximately link the [cjlaimant’s bladder condition to her work related injury,” therefore, is not unfounded.
One further note about Dr. Rice. The majority says on “December 3,1991, Dr. Rice had prescribed medication for the [incontinence] problem and had scheduled [the claimant] for further evaluation.” The single commissioner made his decision on February 10,1992, more than two months later. Apparently, the “active[] and aggressiveQ” effort of Dr. Rice, as the majority describes it, “to discover the cause of [the claimant’s] incontinence” did not result in his filing any additional medical report. If Dr. Rice issued a report subsequent to December 3, 1991, the record does not reflect the claimant made any attempt to ask the single commissioner to consider it. The single commissioner’s finding that “Dr. Rice, the [u]rologist, does not proximately link the [claimant's bladder condition to her work related injury,” was not, as the majority suggests, unreasonable under the circumstances.

 The transcript of Barbara Elizabeth Dawson’s testimony reflects the following:
Q. [Employer’s Counsel] Based then on your education and your experience and your review of the medical files and your dealings that you’ve had with [the claimant], assuming all of her physical characteristics, medical history such as you had, knowing the direct history of hysterectomy — the history of hysterectomy in October 1990 and your testimony in particular that no bladder tack was done; the question to you is whether or not you have an opinion as to the probable cause of the stress incontinence that she experiences?
A. It’s common for a woman of that age with three (3) pregnancies to have a bladder suspension as well as a rectocele because it is a common occurrence for women of that age to develop stress incontinence when they get a little older in life. Usually while physicians are there if there’s any indication, they’ll go ahead and do a bladder tack and it’s called on EMP repair.

On May 8, 1991, a month or so before Dr. Littlepage found the claimant had reached maximum medical improvement, he mentioned in a neurosurgical follow up note the claimant “had a hysterectomy a year ago, and at that time there was no bladder tack-up performed by her gynecologist.” He also stated “I think that this would come under a work related event related to her exercise” and he would “see her back in three weeks.” What he does not state at this time is that the incontinence “most probably” was connected to the injury-
Again, on June 3,1991, Dr. Littlepage found the claimant had reached maximum medical improvement. He also found she had sustained a five percent impairment of the whole person. The commission could have concluded from these findings that Dr. Littlepage took into consideration any aggravation of the claimant’s pre-existing bladder problem.

 Dr. Littlepage could not give a specific percentage of impairment to the claimant’s back.

The single commissioner expressly notes in his order he asked the claimant “to undergo two (2) additional independent medical evaluations” by Dr. Rice and Dr. Trent. He also expressly notes he received reports from the two doctors, “reports” of Dr. Rice “from November 12,1991, through December 3,1991,” and “report” of Dr. Trent “from November 15,1991, through December 6,1991.”

Before making his findings of fact, the single commissioner recites he had reviewed the evidence, considered “the medical evidence and lay testimony,” and gave “liberal weight to [the claimant’s] evidence of back pain and limitation of lifestyle activities.”