The South Carolina Supreme Court recently weighed in on the standard of evidence required to prove (or disprove) a repetitive trauma claim. In Michau v. Georgetown County, the Court held that medical opinions related to causation submitted in repetitive trauma claims must be stated to a reasonable degree of medical certainty.
|Post by Aisha Taylor|
In Michau, the claimant alleged he sustained a compensable repetitive trauma injury to both shoulders. At the hearing, he presented an opinion of his treating orthopedist who stated, “I do believe within a reasonable degree of medical certainty that these repetitive work activities over the years of his shoulders [sic] have resulted in his severe osteoarthritis of both shoulders.”
The employer and carrier obtained a second opinion from an arthritis specialist. The specialist stated it was his opinion that the claimant had a long history of arthritis involving multiple joints with diagnosis of rheumatoid arthritis, and there was no indication from the job description or his employment that would relate any of the claimant’s shoulder problems to his work.
On appeal, the claimant disputed the admissibility of the second opinion report obtained by the carrier because it was not stated “to a reasonable degree of medical certainty.”
The Court agreed with the claimant and reversed the admission of the report. The Court said section §42-1-172(C) expressly creates an additional heightened standard for repetitive trauma injury cases. Specifically, it requires “medical evidence,” in the form of “expert opinion or testimony [to be] stated to a reasonable degree of medical certainty.” S.C. Code Ann. §42-1-172(C).
The Court also noted an injury is not considered a compensable repetitive trauma injury unless a commissioner makes a specific finding of fact by a preponderance of the evidence of a causal connection that is established by “medical evidence,” which in this case meant expert opinion or testimony stated to a reasonable degree of medical certainty.
Practice Point: Use the magic words! Make sure any and all physician opinions, whether by way of questionnaire, medical report, correspondence or deposition, are stated “to a reasonable degree of medical certainty.”