Nursing Home Abuse – Signs of Neglect – What to Do First

The article below was found in Lawyers and Settlements.com. It is very informative regarding types of elder abuse, signs of neglect, and what laws are available to protect your loved ones if the unthinkable happens. As our parents and grandparents grow older, we may face the decision to place them into assisted living or even skilled nursing care facilities. It is an extremely stressful and guilt producing time for everyone involved. They do not go there to die. Rather, the elderly should be cared for and allowed to live out the rest of their lives fully. Sadly, with low Medicare rates and a bad economy, there are often too few staff to give proper care, and elderly residents fall, break hips, become dehydrated or malnourished, develop bed sores, and even die prematurely. If you suspect your loved one is being neglected or worse, secure their safety first. Move them to a different facility if you can. Then, call an experienced nursing home abuse attorney and let’s look at what can be done to protect your family. Compare our attorneys’ credentials and experience to any other law firm.

At Reeves, Aiken & Hightower, LLP, all of our attorneys are seasoned trial lawyers with over 70 years combined experience. Whether it is criminal or civil, our litigators are regularly in Court fighting for our clients. Two of our firm’s partners, Art Aiken and Robert Reeves, are lifetime members of the Million Dollar Advocates Forum. Mr. Reeves has also been named one of the Top 100 lawyers for South Carolina in 2012 by the National Trial Lawyers Organization. Our attorneys include a former SC prosecutor, a former public defender, a former NC District Attorney intern, a former Registered Nurse (RN), and former insurance defense attorneys. As a result of their varied backgrounds, they understand the criminal, insurance defense, and medical aspects of complex cases. We welcome an opportunity to sit down and personally review your case. Call us today for a private consultation. www.rjrlaw.com

 

Elder Care and Nursing Home Abuse

You may have gone to great lengths and expense to find the right elder care facility or nursing home for a member of your family or someone you know. It is a traumatic and difficult decision to place someone in a nursing home and you can only hope that they will receive the best possible care. Unfortunately, nursing home abuse is more prevalent than you might think. Often, due to a shortage of staff or staff that has not been adequately trained, the best nursing home care is not always readily available, and nursing home residents become victims of the “hidden crime.”

Nursing Home Abuse and Neglect

Nursing home residents often require constant attention, and may not be able to communicate nursing home abuse or neglect from their caregivers. And they are unaware of elder care law. Nursing home neglect is often unreported because it isn’t always physical abuse. Emotional, psychological, and financial abuse or exploitation is all too frequent.Institutional entities include skilled nursing facility (SNF) or homes, foster homes, group homes, and board and care facilities. Abusers may be staff members, other patients and even visitors.If a staff member refuses to allow family or friends to see the resident or insists on being present during the visit, it is possible that abuse is taking place. Other examples of abuse are:

  • Withholding food or not providing food according to prescribed schedule
  • No access to water / dehydration
  • Medication errors
  • Poor toileting facilities
  • Inadequate daily care and grooming, or abandonment
  • Failure to diagnose or recognize heart attack or stroke
  • Failure to treat or provide emergency care for stroke or heart attack
  • Elopement or wandering, where the patient leaves the nursing home without authorization
  • Intimidation or use of threats

Some Signs of abuse are:

nursing home abuse and personal injury lawyersEmotional: behavior and/or personality changes; withdrawn and uncommunicative; dementia; depression; anxiety and agitation.

Physical: Unexplained accident or injury; Decubitus Ulcers (Bedsores); Frozen joints; Contractures; Brittle bones or Fracture; Muscle atrophy; Burns; Fearfulness; Broken eyeglasses; Rapid, unexplained weight loss; Unwarranted use of physical restraints

Sexual: Unexplained venereal disease;Genital infections;Vaginal or anal bleeding;Torn or stained underclothing;Bruising around breasts, upper abdomen, or inner thighs

Nursing Home and Elder Law 

By law, nursing homes must provide care to maintain the highest practicable physical, mental and psycho-social well-being of each resident. Federal and state laws were designed to protect nursing home residents and the abuse or neglect that occurs there and in other assisted living facilities. Many states also require that nursing homes meet individual state standards relating to the type and quality of care required.

Failure to comply with elder law has resulted in abuse that in turn caused illness, discomfort and death. This abuse is often referred to as “institutional abuse”.

State Elder Law

Most states have addressed the institutional abuse issue with laws that require doctors, nurses and other health care professionals to report suspected neglect to a designated state office. Laws further require nursing homes to investigate and report any abuse incidents that occur within their facility. Physicians, hospitals, nurses, therapists, aides, orderlies and administrators must provide adequate care, medical treatment and protection to the residents and patients in their facility.

State laws typically require a nursing home to be licensed in order to operate, provides for annual inspections, sets up a procedure for handling complaints, prohibits discrimination, and imposes sanctions for violation, such as licensure suspension and revocation. The state regulatory agency investigates any reports of alleged abuse or violations.

Federal Elder Law

nursing home abuseIn 1987, the federal government passed the Nursing Home Reform Act (NRA), and nursing homes that receive federal funds must comply with the act. The NRA sets standards for care, establishes a list of rights for residents, such as the right to be treated with dignity and to exercise self-determination, sets up a monitoring system for nursing homes, and specifies sanctions for non-compliance. The Act covers resident care and rights, staffing, the quality of care, restraints, privacy, and record keeping. The law applies to all the various types of nursing homes who receive funds under Medicaid or Medicare programs.

Under the Nursing Home Reform Act, nursing homes must also do the following in order to meet the basic tenet of the Act:

  • Employ sufficient nursing and other staff in order to provide nursing and related services
  • Be administered in a way that enables the nursing home to use resources effectively and efficiently
  • Within 14 days of admission, perform an initial comprehensive, accurate, standardized, reproducible assessment of each resident’s functional capacity. After significant changes in the resident’s physical or mental status and/or at least once every 12 months, perform such an assessment.
  • Develop comprehensive individualized care plans for residents. Care plans must include measurable objectives and schedules to meet each resident’s medical, nursing, mental and psychosocial needs as identified in the comprehensive assessment discussed above. The care plan must be developed within 7 days after completion of the comprehensive assessment. It must detail the services that are to be provided. The care plan must also be periodically reviewed and revised by a team of qualified persons after each assessment.
  • Provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs) to meet the needs of each resident.
  • Provide supervised medical care by a physician. The nursing home must provide or arrange for the services of a physician on a 24 hour per day basis in case of an emergency.
  • Prevent the deterioration of a resident’s ability to bathe, dress, groom, transfer and ambulate, toilet, eat, speak or otherwise communicate.
  • Provide necessary services and assistance in order to maintain good nutrition, grooming, and personal and oral hygiene if the resident suffers from any impairment daily living activities.
  • Ensure that residents do not develop pressure sores. If a resident has pressure sores, the nursing home must provide the necessary treatment to promote healing and prevent infection and development of new sores.
  • Provide treatment and services to incontinent residents to restore as much normal bladder functioning as possible and to prevent urinary tract infections.
  • Ensure that residents receive proper treatment and any devices to maintain hearing and visual abilities.
  • Ensure that residents receive adequate supervision and assistive devices to prevent falls.
  • Ensure that residents maintain acceptable parameters of nutritional status, such as body weight and protein levels.
  • Provide residents with enough fluid to maintain hydration and health.
  • Prevent medication errors.
  • Care for residents in a way that promotes maintenance or enhancement of their quality of life.
  • Promote resident care in a way and in an environment that enhances each resident’s dignity and respect in full recognition of individuality.
  • Ensure that residents can choose activities, schedules, and health care consistent with individual interests, assessments, and plans of care.
  • Maintain clinical records on each resident in accordance with accepted professional standards and practices that are complete, accurate, accessible, and systematically organized.

In 2008, The U.S. Department of Health and Human Services’ Office of the Inspector General released a report detailing the “Trends in Nursing Home Deficiencies and Complaints” that showed over 90 percent of that nation’s nursing homes were cited for federal violations from 2005-2007. The most common deficiency categories cited in each of the past 3 years were quality of care, resident assessment, and quality of life.

The report also showed a greater percentage of For-Profit nursing homes were cited for deficiencies than non-for-profit and government nursing homes from 2005-2007.

 

SC Workers’ Compensation – Accident Claim Investigation – Limited Time to Complete

The article below is a summary and commentary written by Stanford E. Lacy of Collins & Lacy, P.C. in Columbia, South Carolina. It is located on his firm’s website and blogosphere. I am proud to be counted as one of Stan’s biggest fans and routinely follow his sage postings. I will always appreciate Stan for giving me my first job as an attorney and training me in workers’ compensation law. Although written from a defensive perspective, this recent case confirms that claimant’s attorneys must also investigate claims early and secure evidence to prove a case is compensable. He can also hold employers and their insurance carriers accountable before the Commission if they improperly stop paying weekly benefits after 150 days from the date of accident. Because the law only provides that an injured worker can receive only 2/3 of their average weekly wage, every check matters. No one pays 1/3 in taxes, at least not yet. As a result, you find yourself “getting behind” each week. Having a carrier abruptly stop paying without following the law can literally cost you and your family everything. Better make sure your attorney knows about this case and what to do to protect you. Compare our attorneys’ credentials to any other law firm.

At Reeves, Aiken & Hightower LLP, our lawyers are experienced workers’ compensation attorneys.  Robert J. Reeves is a former Registered Nurse (RN) who has actually treated patients with the same type of serious injuries he now represents in workers’ compensation cases.  Both Robert J. Reeves and Arthur K. Aiken are former insurance defense attorneys who know how to anticipate and prepare for defenses and insurance company tactics.  During our twenty-two (22) years each of practicing law, we have successfully handled virtually every type of workers’ compensation injury, including neck, back, shoulder, knee accidents, closed head / brain injury, herniated disks, bulging disks, diskectomy surgery, fusion procedures, arthroscopy, automobile accidents on the job, psychological / post traumatic stress, permanent and total disability claims, and wrongful death. We welcome the opportunity to sit down and personally discuss your case. Compare our attorneys’ credentials to any other firm. Then call us for a private consultation. www.rjrlaw.com

Section 42-9-260 Does Not Prohibit Denying Compensability after 150 Days; But the Doctrines of Laches and Estoppel Can
The issue was addressed by the Court of Appeals in the case of Jervey v. Martint Enviromental, Inc., Opinion No. 4930 (filed January 23, 2012).In 1996, South Carolina’s workers’ compensation system changed radically.  Prior to June 18, 1996, our system required the parties enter into a Form 15 in which the carrier agreed to pay, and the claimant agreed to accept TTD.  It was a contract.  Once executed, the carrier was stuck. If the employer found out later the claim was not compensable, the issue was deemed waived. The only escape was to prove the employee fraudulently induced the carrier into the agreement.  The result was a system in which carriers were loath to accept a claim except in the most obvious circumstances.  Compensable claims had to wait months to be heard by a commissioner while injured workers languished waiting for benefits.  A different system was needed.In 1996, the old contract-based system was replaced by the present notice-based system. Now, the carrier can initiate benefits and simply notify the South Carolina Workers’ Compensation Commission that benefits have commenced.  There is no need for signatures because there is no contract.  The carrier now has 150 days from the date the employer is notified of the accident to investigate the claim and unilaterally suspend benefits if the carrier determines the claim is not compensable.  Read all about it in South Carolina Code of Law Section 42-9-260.After the 150 day period, the Commission’s regulations control suspension and termination of benefits, which simply return us to the old system but without the contract aspect.  They require compensation continue until the claimant signs a Form 17 after working 14 calendar days or the carrier files a Form 21 and obtains an order from the Commission.   This is the same procedure used prior to 1996 whenever the carrier wanted to suspend or terminate benefits.The question recently arose whether §42-9-260[1] acted as a statute of limitations to deny compensability.  If the statute gives the carrier 150 days to unilaterally suspend compensation if the claim is deemed not compensable, is the right to raise compensability as a defense barred after 150 days?The issue was addressed by the Court of Appeals in the case of Jervey v. Martint Enviromental, Inc., Opinion No. 4930 (filed January 23, 2012).  In Jervey, Claimant suffered sulfuric acid burns to neck, face and back.  Martint immediately initiated TTD and provided medical treatment.  Fifteen months later, Jervey filed a Form 50 seeking treatment for a cervical disc problem and asking the Commission to designate Dr. Donald Johnson as the authorized treating physician.  Martint filed a Form 51 denying the claim was compensable.  Jervey objected and argued the defense was barred by §42-9-260. Additionally, Jervey argued Martint should be barred from raising the defense by the doctrines of laches and estoppel.  I’ll spare you the back and forth that went on from the hearing commissioner to the Court of Appeals.  Suffice it to say, the Court held that the plain reading of the statue did not create a statute of limitations, so the issue of compensability is not barred by the statue.  However, the employer/carrier can, by their actions, be estopped from denying compensability.   The doctrine laches likewise can be applied.The moral is this.  While the legislature did not create a statute of limitations for raising a defense, the Commission and the Courts can utilize equitable principles to reach what they deem to be a just result.


[1]  §42-9-260 (F) reads in its entirety: After the one-hundred-fifty-day period has expired, the commission shall provide by regulation the method and procedure by which benefits may be suspended or terminated for any cause, but the regulation must provide for an evidentiary hearing and commission approval prior to termination or suspension unless such prior hearing is expressly waived in writing by the recipient or the circumstances identified in Section 42-9-260(B)(1) or (B)(2) are present. Further, the commission may not entertain any application to terminate or suspend benefits unless and until the employer or carrier is current with all payments due.

SC Workers’ Compensation – Additional Medical Treatment After Release From Care

This recent SC Court of Appeals decision deals with an issue that comes up frequently in workers’ compensation cases. An injured worker is initially released from care by the authorized treating physician and tries to return to work. However, due to ongoing symptoms, the worker seeks additional medical treatment only to be denied by the insurance carrier. At what point can an employer stop paying weekly benefits if the injured worker tries to return to work but cannot continue? And what happens if the employee is fired from their job during this recovery period?  In this case, the Court of Appeals found because Claimant had returned to work for more than 15 days after the accident and because the employer had provided suitable employment within his restrictions during that time, Section 42-9-260(B)(1) did not require restart of  weekly benefits after Claimant’s termination. The Court also addressed the interplay between awards for disfigurement and permanent impairment. In some cases, a claimant may be entitled to receive awards for both. Better make sure your attorney is aware of these critical distinctions in the law. Compare our attorneys’ credentials to any other law firm.

At Reeves, Aiken & Hightower LLP, our lawyers are experienced workers’ compensation attorneys.  Robert J. Reeves is a former intensive care unit Registered Nurse (RN) who has actually treated patients with the same type of serious injuries he now represents in workers’ compensation cases.  Both Robert J. Reeves and Arthur K. Aiken are former insurance defense attorneys who know what to anticipate and how to prepare for trial and insurance company tactics.  During our twenty-two (22) years each of practicing law, we have handled virtually every type of workers’ compensation injury, including neck, back, shoulder, knee accidents, closed head / brain injury, herniated disks, bulging disks, diskectomy surgery, fusion procedures, arthroscopy, automobile accidents on the job, psychological / post traumatic stress, permanent and total disability claims, and wrongful death. We welcome the opportunity to sit down and personally discuss your case. Compare our attorneys’ credentials to any other firm. Then call us for a private consultation. www.rjrlaw.com

THE STATE OF SOUTH CAROLINA
In The Court of Appeals


Beau D. Cranford, Employee, Appellant,

v.

Hutchinson Construction, Employer, and Companion Property & Casualty Group, Carrier, Respondents.


Appeal From Richland County
Appellate Panel, Workers’ Compensation Commission


Opinion No.  4939
Heard December 6, 2011 – Filed February 8, 2012


AFFIRMED IN PART and REMANDED IN PART


Stephen B. Samuels, of Columbia, for Appellant.

Michael W. Burkett, of Columbia, for Respondents.

WILLIAMS, J.: In this workers’ compensation appeal, Beau Cranford (Cranford) challenges the Appellate Panel of the Workers’ Compensation Commission’s (Appellate Panel) findings that he was not entitled to temporary disability compensation, permanent partial disability compensation, and additional medical treatment for injuries he incurred while working for his employer, Hutchinson Construction (Hutchinson).  Additionally, Cranford contends the Appellate Panel erred in failing to make specific findings regarding whether he had reached maximum medical improvement (MMI) and in implicitly finding he had reached MMI.  We affirm in part and remand in part.

FACTS

Cranford’s claim for benefits and medical treatment stems from an injury he sustained while working for Hutchinson.  Hutchinson hired Cranford on June 26, 2007, as a day laborer, to assist in assembling a steel building at one of Hutchinson’s project sites.  On July 20, 2007, Cranford was working in a forklift basket approximately ten feet above ground.  Cranford testified the basket was lowered to the ground, and his co-worker climbed out of the basket.  When Cranford was raised back in the air, the basket began to tilt forcing Cranford to jump out of the basket.  Cranford sustained injuries to both hands, both arms, and his back as a result of the fall.

Cranford was taken immediately to Conway Medical Center for treatment.  Dr. Michael Ellis treated the lacerations on Cranford’s arms and noted Cranford complained of mid-lumbar pain when he would sit upright.  Dr. Ellis discharged Cranford with instructions to refrain from “heavy lifting or strenuous activity” and to return the following week.  At his follow-up visit, Dr. Ellis’ notes reflect he instructed Cranford to “be taking it easy” and to notify Dr. Ellis if he experienced any additional problems.

Cranford was out of work for three weeks, during which time Hutchinson paid him $265 per week in lieu of temporary disability benefits.  When Cranford returned to work on August 13, 2007, Hutchinson restricted him to light-duty activities, but then Hutchinson terminated Cranford on August 31, 2007, for being unsafe on the job site.  Because Cranford had worked a minimum of fifteen days prior to his termination, Hutchinson filed a Form 15 claiming he was no longer entitled to temporary compensation.

After Hutchinson fired Cranford, he obtained employment with a greenhouse from early September until November 21, 2007.  While working at the greenhouse, Cranford made deliveries, watered plants, and lifted fifty to sixty pound bags of fertilizer two to four times per day twice a week.  He earned on average $163.96 per week.

Cranford’s complaints of back pain resurfaced following his brief employment with the greenhouse.  In response to his complaints of back pain, Hutchinson sent him to Doctor’s Care on January 11, 2008.  Doctor’s Care restricted him from lifting more than ten pounds and instructed him to return for a follow-up visit in one week.  Cranford returned ten weeks later on March 25, 2008. Doctor’s Care then referred him to an orthopedic surgeon, Dr. William Edwards.[1]   

Cranford saw Dr. Edwards on May 15, 2008, with lower back complaints.  Dr. Edwards’ notes reflect that Cranford told him he had been out of work since his initial injury.  Dr. Edwards ordered an MRI on May 21, 2008, and Cranford returned to Dr. Edwards on June 3, 2008.  On June 3, 2008, Dr. Edwards concluded Cranford had reached MMI with no evidence of permanent impairment.  Dr. Edwards noted Cranford could return to work with “the use of good body mechanics and careful lifting techniques.”

Upon referral from Cranford’s attorney, Cranford underwent a subsequent evaluation with Dr. Timothy Zgleszewski on July 22, 2008.  Dr. Zgleszewski diagnosed Cranford with sacroiliitis and opined to a reasonable degree of medical certainty that Cranford was not at MMI and should remain out of work until further testing and treatment were completed.  Hutchinson refused to provide the treatment recommended by Dr. Zgleszewski.

After Cranford saw Dr. Edwards and Dr. Zgleszewski, he briefly worked at a machinery plant as a machine operator from September 12, 2008 until November 7, 2008.  He testified this position did not require any heavy lifting responsibilities.  Cranford earned $469.98 per week as a machine operator before he was laid off by the machinery plant. 

In response to Hutchinson’s refusal to provide additional medical treatment, Cranford filed a Form 50 on January 15, 2009, in which he requested a hearing as well as additional medical treatment for his back and arms and temporary disability benefits.  In response, Hutchinson timely filed a Form 51, admitting laceration/disfigurement to the right and left arms and an injury to the back.  Hutchinson, however, maintained Cranford reached maximum medical improvement (MMI) for all injuries and denied Cranford was entitled to temporary disability benefits.

Prior to Cranford’s hearing, he again returned to Dr. Zgleszewski on April 23, 2009, with complaints of reoccurring lower back pain, occasional numbness in his hands, and problems with lifting and twisting.  Dr. Zgleszewski opined Cranford suffered a 10% impairment rating to his back and a 9% whole person impairment rating based on the scars on his arms.

The single commissioner held a hearing on May 14, 2009.  The commissioner subsequently issued an order on September 28, 2009, awarding Cranford four weeks of compensation to his left arm and eight weeks of compensation to his right arm for the disfigurement caused by his fall.  The commissioner agreed with Dr. Edwards’ conclusions that Cranford had suffered no permanent impairment to his back and consequently found a 0% disability to Cranford’s back.  In addition, the single commissioner found Cranford failed to demonstrate by a preponderance of the evidence that he was entitled to any temporary disability benefits or additional medical treatment.  Cranford appealed the single commissioner’s order, and in a form order, the Appellate Panel affirmed the single commissioner in full.  This appeal followed.

STANDARD OF REVIEW

The Administrative Procedures Act (APA) establishes the standard for judicial review of workers’ compensation decisions.  Pierre v. Seaside Farms, Inc., 386 S.C. 534, 540, 689 S.E.2d 615, 618 (2010).  Under the APA, this court can reverse or modify the decision of the Appellate Panel when the substantial rights of the appellant have been prejudiced because the decision is affected by an error of law or is clearly erroneous in view of the reliable, probative, and substantial evidence considering the record as a whole. Transp. Ins. Co. & Flagstar Corp. v. S.C. Second Injury Fund, 389 S.C. 422, 427, 699 S.E.2d 687, 689-90 (2010).

When the evidence is conflicting over a factual issue, the findings of the Appellate Panel are conclusive.  Hargrove v. Titan Textile Co., 360 S.C. 276, 290, 599 S.E.2d 604, 611 (Ct. App. 2004).  In workers’ compensation cases, the Appellate Panel is the ultimate finder of fact.  Shealy v. Aiken Cnty., 341 S.C. 448, 455, 535 S.E.2d 438, 442 (2000).  “The final determination of witness credibility and the weight to be accorded evidence is reserved to the Appellate Panel.”  Frame v. Resort Servs. Inc., 357 S.C. 520, 528, 593 S.E.2d 491, 495 (Ct. App. 2004) (internal citation omitted).  Accordingly, this court will not overturn a finding of fact by the Appellate Panel “unless there is no reasonable probability that the facts could be as related by a witness upon whose testimony the finding was based.”  Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981) (internal citation omitted).

LAW/ANALYSIS

I.  Temporary Disability Compensation

Cranford first claims the Appellate Panel erred in failing to order Hutchinson to pay him temporary disability benefits.  We disagree.

Section 42-1-120 of the South Carolina Code (1985) defines disability as the “incapacity because of injury to earn the wages which an employee was receiving at the time of the injury in the same or some other employment.”  During the period of disability, an employer may pay temporary total or partial compensation, or salary in lieu of compensation, to the injured employee.  See 25A S.C. Code Ann. Regs. 67-503(B) (Supp. 2010).  Whether compensation is partial or total depends on whether the employee is partially or totally incapacitated from the injury.  See S.C. Code Ann. §§ 42-9-10, -20 (1985 & Supp. 2010), 25A S.C. Code Ann. Regs. 67-502(E), (F) (Supp. 2010).

Temporary disability benefits are triggered “[w]hen an employee has been out of work due to a reported work-related injury . . . for eight days[.]”  S.C. Code Ann. § 42-9-260(A) (Supp. 2010).  Once temporary disability payments have commenced, these benefits “may be terminated or suspended immediately at any time within the one hundred fifty days if . . . the employee has returned to work; however, if the employee does not remain at work for a minimum of fifteen days, temporary disability payments must be resumed immediately[.]”  S.C. Code Ann. § 42-9-260(B)(1) (Supp. 2010).

Cranford claims he was not released to work without restriction, and Hutchinson failed to provide him suitable employment during his period of incapacity.  Although Cranford was under work restrictions at the time he returned to work, we find Cranford failed to prove he was entitled to temporary disability benefits.  Hutchinson afforded Cranford suitable employment based on his light-duty work restrictions for the requisite amount of time under section 42-9-260(B)(1).  When Cranford was discharged from Conway Medical Center on July 21, 2007, Dr. Ellis placed minimal work restrictions on Cranford, which included refraining from heavy lifting and strenuous activity.  When Cranford returned to Dr. Ellis one week later, Dr. Ellis’ instructions were limited to “taking it easy.”  Cranford was out of work from July 21, 2007 until August 13, 2007, during which time Hutchinson paid Cranford his salary in lieu of temporary total compensation.

When Cranford returned to work three weeks after his accident, he acknowledged that his supervisor assigned him to light-duty tasks.  Specifically, Cranford testified, “[Hutchinson] wouldn’t let me get in the basket more than four foot [sic] up off the dirt or anything.  He had me picking up trash and doing the weather sealing panels for a roof.”  Cranford even admits in his brief that “Hutchinson provided work suitable to Cranford’s light duty capacity” prior to being terminated[2] by Hutchinson.  Moreover, because Cranford returned to work for at least fifteen days and was provided suitable employment during that time, Hutchinson was not required to resume temporary disability payments under the plain language of section 42-9-260(B)(1).  See § 42-9-260(B)(1) (“[T]emporary disability payments . . . may be terminated or suspended immediately at any time within the one hundred fifty days if . . . the employee has returned to work; however, if the employee does not remain at work for a minimum of fifteen days, temporary disability payments must be resumed immediately[.]”).

Cranford also argues the Appellate Panel erred in failing to award him temporary benefits because Hutchinson failed to properly commence and terminate Cranford’s benefits.  While Cranford raises a meritorious argument, he argues this specific issue for the first time on appeal.  Thus, this issue is not preserved for review.  See Smith v. NCCI, Inc., 369 S.C. 236, 256, 631 S.E.2d 268, 279 (Ct. App. 2006) (“Only issues raised [to] and ruled upon by the [Appellate Panel] are cognizable on appeal.”); see also Creech v. Ducane Co., 320 S.C. 559, 564, 467 S.E.2d 114, 117 (Ct. App. 1995) (“[O]nly issues within the application for review are preserved for the full commission.”).  Accordingly, we affirm the Appellate Panel’s decision to deny Cranford temporary disability benefits.

II.  Maximum Medical Improvement

Next, Cranford claims the Appellate Panel erred in affirming the single commissioner’s finding that he had reached MMI for his back and arms, particularly when the single commissioner failed to explicitly find Cranford reached MMI.  We agree in part.

“Maximum medical improvement is a term used to indicate that a person has reached such a plateau that in the physician’s opinion there is no further medical care or treatment which will lessen the degree of impairment.”  O’Banner v. Westinghouse Elec. Corp., 319 S.C. 24, 28, 459 S.E.2d 324, 327 (Ct. App. 1995).  “MMI is a factual determination left to the discretion of the [Appellate] [P]anel.”  Gadson v. Mikasa Corp., 368 S.C. 214, 224, 628 S.E.2d 262, 268 (Ct. App. 2006).

Regarding Cranford’s back, the single commissioner did not make any explicit findings about whether Cranford achieved MMI.  However, the single commissioner agreed with Dr. Edwards’ 0% impairment rating and concluded that Cranford had a 0% disability to his back.  Additionally, the single commissioner concluded as a matter of law that based on Dr. Edwards’ testimony, “no further medical treatment will lessen [Cranford’s] period of disability.”  In making these conclusions, the single commissioner, and ultimately the Appellate Panel, implicitly held that Cranford had achieved MMI for his back.  See O’Banner, 319 S.C. at 28, 459 S.E.2d at 327 (“Maximum medical improvement is a term used to indicate that a person has reached such a plateau that in the physician’s opinion there is no further medical care or treatment which will lessen the degree of impairment.”) (emphasis added).

Additionally, there is substantial evidence in the record to conclude Cranford attained MMI no later than June 3, 2008.  Specifically, Cranford was able to maintain two jobs after his injury, the first of which involved routine stooping, bending over, and lifting.  Despite Cranford’s testimony that he was limited in the tasks he could undertake, he also testified on the date of the hearing he was physically capable of working “full time at medium to light duty.”  In addition, Cranford did not seek medical treatment for almost six months after his injury.  When Cranford eventually sought medical treatment, he was instructed by Doctor’s Care to follow up in one week, yet Cranford failed to return for another ten weeks.  When Cranford did return, the X-Rays of his back were normal.

Because Cranford claimed continued back pain, Doctor’s Care referred him to Dr. Edwards.  After an MRI scan, Dr. Edwards noted a minimal disc protrusion at his L5-S1 disc, but he noted it did not likely have any clinical significance.  Dr. Edwards also concluded Cranford had attained MMI and stated returning to work was acceptable with “the use of good body mechanics and careful lifting techniques.”  Cranford claims Dr. Edwards’ caveat and prescription of Flexeril for his muscle spasms is evidence that Cranford has not reached MMI.  To the contrary, Dr. Edwards’ report coupled with the thirty-day prescription of Flexeril constitutes evidence from which the single commissioner could conclude the medication would help to temporarily alleviate Cranford’s remaining symptoms, but his medical condition would not further improve.  See O’Banner, 319 S.C. at 28, 459 S.E.2d at 327 (disagreeing with claimant’s assertion that doctor’s prescription of medication after discharge was evidence claimant had not reached MMI because substantial evidence in record existed to show that medication helped to temporarily alleviate claimant’s remaining symptoms despite the fact that his medical condition would not further improve).

As to Cranford’s arms, the single commissioner never made a finding of MMI to his arms.  The single commissioner’s only finding pertaining to Cranford’s arms was an award for disfigurement for his keloid scars in the amount of four weeks of compensation for his left arm and eight weeks of compensation for his right arm.  We note a disfigurement award is generally not proper prior to a finding of MMI.  See Halks, 208 S.C. at 48, 36 S.E.2d at 855-56 (reversing award for disfigurement when claimant was receiving temporary total disability benefits because receipt of temporary disability established he had not attained MMI, which was a prerequisite for permanent disfigurement award).  However, both parties stipulated to this award, and Cranford does not appeal the propriety of the disfigurement award.  Regardless, the issue of disfigurement is separate from the issue of permanent disability in the instant case.[3]  As such, an explicit finding for MMI is still necessary because it is also relevant to Cranford’s entitlement to permanent disability.  Thus, we remand for specific findings on this issue.

III.  Permanent Disability Benefits

Next, Cranford contends the Appellate Panel erred in failing to award him permanent partial disability benefits based on the injuries to his back, arms, and skin.  We agree in part.

In the single commissioner’s order, he concluded Cranford did not sustain any permanent partial disability to his back under section 42-9-30 of the South Carolina Code (Supp. 2010).  In making this conclusion, the single commissioner considered Cranford’s six-month delay in seeking medical treatment from Doctor’s Care in addition to his failure to follow-up with Doctor’s Care for ten weeks, despite instructions to return within one week of his initial visit.

Further, Dr. Edwards’ medical opinion supports the single commissioner’s and the Appellate Panel’s conclusion.  After being referred to Dr. Edwards, Cranford underwent an MRI, which revealed no evidence of a fracture.  Dr. Edwards found a minimal disc protrusion at L5-S1, but he concluded it was likely of no clinical significance.  Dr. Edwards noted Cranford sustained a lumbar sprain and accordingly prescribed him one month of Flexeril to temporarily alleviate his discomfort.  In approving the occasional use of Flexeril for a limited period of time, he concluded Cranford was capable of returning to work with “the use of good body mechanics and careful lifting techniques.”  The single commissioner acknowledged Cranford’s visit to Dr. Zgleszewski.  Hutchinson claims the Appellate Panel afforded less weight to Dr. Zgleszewski’s medical reports based on the timing of Cranford’s visits and the fact that his visits were at the behest of Cranford’s attorney.  The nature and timing of Cranford’s visits do not discredit Dr. Zgleszewski’s medical opinion.  We find both parties presented credible conflicting medical evidence.  The single commissioner, and ultimately the Appellate Panel, had the discretion to weigh the conflicting evidence in rendering its decision.  Thus, we defer to its findings on this issue.  See Mullinax v. Winn-Dixie Stores, Inc., 318 S.C. 431, 435, 458 S.E.2d 76, 78 (Ct. App. 1995) (“Where the medical evidence conflicts, the findings of fact of the [Appellate Panel] are conclusive.”).

The single commissioner, however, failed to make any conclusions on whether Cranford sustained permanent disabilities to his skin or arms.  Without specific findings regarding whether Cranford suffered a permanent impairment to his arms and skin, we remand this issue to the Appellate Panel to make specific findings on Cranford’s impairment to his arms and skin based on the evidence, and consequently, his entitlement to permanent partial disability benefits.  See Baldwin v. James River Corp., 304 S.C. 485, 486, 405 S.E.2d 421, 422 (Ct. App. 1991) (finding that without specific and definite findings upon the evidence, this court could not review the Appellate Panel’s decision that a claimant sustained neither an injury to his back nor a permanent disability to his right arm, particularly when those were material facts in issue).

IV.  Additional Medical Treatment

Finally, Cranford contends the Appellate Panel erred in affirming the single commissioner’s finding that he was not entitled to additional medical treatment for his back.  We disagree.

Section 42-15-60 of the South Carolina Code (Supp. 2010) provides for “[m]edical, surgical, hospital and other treatment, including medical and surgical supplies as may reasonably be required, for a period not exceeding ten weeks from the date of an injury to effect a cure or give relief and for such additional time as in the judgment of the Appellate Panel will tend to lessen the period of disability . . . .”  Pursuant to this section, an employer may be liable for a claimant’s future medical treatment if it tends to lessen the claimant’s period of disability even if the claimant has returned to work and has reached maximum medical improvement.  Dodge v. Bruccoli, Clark, Layman, Inc., 334 S.C. 574, 583, 514 S.E.2d 593, 598 (Ct. App. 1999); see also Scruggs v. Tuscarora Yarns, Inc., 294 S.C. 47, 50, 362 S.E.2d 319, 321 (Ct. App. 1987) (holding substantial evidence supported a finding of maximum medical improvement despite the claimant continuing to receive physical therapy); O’Banner, 319 S.C. at 28, 459 S.E.2d at 327 (finding claimant’s receipt of prescriptive medicines after he had reached maximum medical improvement constituted substantial evidence from which the single commissioner could conclude the medication helped to temporarily alleviate the claimant’s remaining symptoms, but his medical condition would not further improve).

The relevant inquiry is not whether Cranford attained MMI for his back, but whether additional medical treatment and medication will tend to lessen his period of disability.  See generally Dodge, 334 S.C. at 581, 514 S.E.2d at 596 (finding whether employee reached MMI was irrelevant to entitlement to permanent disability benefits because “‘[m]aximum medical improvement’ is a distinctly different concept from ‘disability.'”).  Again, because the medical evidence is conflicting on this issue, we must defer to the Appellate Panel.  SeeTiller v. Nat’l Health Care Ctr. of Sumter, 334 S.C. 333, 338, 513 S.E.2d 843, 845 (1999) (“Where there is a conflict in the evidence, either by different witnesses or in the testimony of the same witness, the findings of fact of the Commission are conclusive.”).  In Dr. Edwards’ June 3, 2008 report, he diagnosed Cranford with a lumbar strain/sprain, but he concluded it was acceptable for Cranford to take an occasional Flexeril for muscle spasms and wrote Cranford a thirty-day prescription for Flexeril.  Because Dr. Edwards opined Cranford suffered no permanent impairment, the single commissioner concluded Cranford sustained a 0% disability to his back.  Although Dr. Zgleszewski documented muscle spasms on July 22, 2008 and on April 23, 2009, and opined that additional treatment would alleviate Cranford’s pain, numbness, and spasms in his back, the Appellate Panel afforded more weight to Dr. Edwards’ testimony in determining further medical treatment would not lessen Cranford’s period of disability. See id. at 340, 513 S.E.2d at 846.  (“Expert medical testimony is designed to aid the Commission in coming to the correct conclusion; therefore, the Commission determines the weight and credit to be given to the expert testimony.”).  Accordingly, we affirm the Appellate Panel on this issue.

CONCLUSION

Based on the foregoing, we affirm the Appellate Panel’s decision to deny Cranford temporary disability benefits.  We affirm the finding of MMI to Cranford’s back but remand the issue of MMI for Cranford’s arms to the Appellate Panel based on its failure to rule on this issue.  We affirm the Appellate Panel’s conclusion that Cranford is not entitled to permanent partial disability benefits for his back but remand the issue of permanent disability for his arms and skin to the Appellate Panel based on the single commissioner’s and Appellate Panel’s failure to rule on these issues.  Lastly, we affirm the Appellate Panel’s conclusion that Cranford was not entitled to additional medical treatment.

Accordingly, the Appellate Panel’s decision is

AFFIRMED IN PART and REMANDED IN PART.

SHORT and GEATHERS, JJ., concur.

[1] Dr. Edwards’ notes reflect that Cranford’s mother also requested Doctor’s Care refer Cranford to Dr. Edwards for additional medical treatment.

[2] Hutchinson terminated Cranford on August 31, 2007, seventeen days after returning to work, for being unsafe on the job site.  Cranford testified Hutchinson fired him because “he was getting worried [about] me getting hurt in another accident, getting killed or dying of a heart attack.”  While Cranford argues in his brief that Hutchinson’s motivation for firing him was pretextual, the propriety of his firing is not before this court.

[3] An employee may be entitled to both a disability and a disfigurement award when an injury is in the form of a keloid scar.  SeeS.C. Code Ann. § 42-9-30(23) (Supp. 2010) (“[P]roper and equitable benefits must be paid for serious permanent disfigurement of the face, head, neck, or other area normally exposed in employment, not to exceed fifty weeks.  Where benefits are paid or payable for injury to or loss of a particular member or organ under other provisions of this title, additional benefits must not be paid under this item, except that disfigurement also includes compensation for serious burn scars or keloid scars on the body resulting from injuries, in addition to any other compensation.”) (emphasis added); see generally Mason v. Woodside Mills, 225 S.C. 15, 21, 80 S.E.2d 344, 347-48 (1954) (finding employee was entitled to disability and disfigurement for work-related accident that caused not only loss of use to his arm but significant atrophy to his arm resulting in disfigurement).

SC NC Personal Injury – Taser Gun Injury – Too Much Force?

The following article below was found in the local Fayetteville, North Carolina, newspaper. Thanks to James Halpin for bringing this story to light. Tasers have become much more frequently used by police over the years. Some would argue they are used too often. In this case, the woman was clearly creating a disturbance and not following police commands. Nevertheless, given the known dangers of tasers, it might be safer for all involved to get her out of the car the “old fashioned way.” As the story shows, this suspect eventually came out of the car but was “flopped out…like a fish.” She could have easily, and may actually have been, injured. In the past, people, while being tased, have suffered serious injury, including broken bones, heart attacks, and even closed head injuries. For a short period, the city of Charlotte actually banned all use of tasers. Sadly, they have started reusing a “new and improved” taser. Hopefully, police will use great care and considered judgment before subjecting non-violent suspects to this excruciatingly painful experience. If told by the police to do something, please do it. Do not argue with police on the street. That strategy never works out well. Instead,  let us argue on your behalf later, in Court. Be Safe. Get Home.

At Reeves, Aiken & Hightower, LLP, all of our attorneys are seasoned trial lawyers with over 70 years combined experience. Whether it is criminal or civil, our litigators are regularly in Court fighting for our clients. Two of our firm’s partners, Art Aiken and Robert Reeves, are lifetime members of the Million Dollar Advocates Forum. Mr. Reeves has also been named one of the Top 100 lawyers for South Carolina in 2012 by the National Trial Lawyers Organization. Our attorneys include a former SC prosecutor, a former public defender, a former NC District Attorney intern, a former Registered Nurse (RN), and former insurance defense attorneys. As a result of their varied backgrounds, they understand the criminal, insurance defense, and medical aspects of complex cases. We welcome an opportunity to sit down and personally review your case. Call us today for a private consultation. www.rjrlaw.com

Cumberland County Sheriff’s deputies use Taser on woman blocking McDonald’s drive-through

By James Halpin
Staff writer

Deputies used a Taser on a woman who wouldn’t surrender to them after she cut into a McDonald’s drive-through line and then refused to move her car without being served, according to the Cumberland County Sheriff’s Office.

Evangeline Marrero Lucca, 37, of the 100 block of Snow Hill Church Road, pulled up to the window of the McDonald’s on Legion Road, near Black and Decker Road, on Friday afternoon and held up the line for about 20 minutes before deputies arrived, said Debbie Tanna, a Sheriff’s Office spokeswoman.

Staff at the restaurant reported that Lucca drove her Ford Taurus to the pickup window, bypassing the order screen and payment window, and tried to order her food there, she said.

“She did not want to wait in line,” Tanna said. “They told her she had to go around and wait like everybody else did and place her order that way, that they weren’t set up at that window to take her order or take her money. … She wasn’t having any of that.”

The woman refused to move her vehicle and became confrontational with the employees, she said.

“When we arrived, she really got mad,” Tanna said.

Attempts to reach Lucca for comment were unsuccessful Friday.

Customer Anthony Rich said he pulled into the parking lot to order lunch and found a long line of cars at the drive-through. He said he got in line and waited, eventually getting up to the first window, where he commented about the long line.

An employee told him the woman was refusing to move, Rich said.

The employee told him the woman frequently comes to the restaurant and cuts in line, and that, “We’re not having it anymore, so we called the cops,” Rich said.

Lisa Powell, who owns the franchise for that McDonald’s location, said in a prepared statement that employees called deputies “after lengthy conversation with the customer” about why her actions were unsafe.

Rich said deputies soon arrived at the scene and ordered Lucca to get out of the car, but she refused. The deputies continued their orders for about 20 minutes, until they finally removed a young girl, he said.

“Two or three officers entered the car with her and started trying to forcibly drag her out of the car, and that’s when you could hear the clicking sound of the Taser one time,” Rich said. “They pulled on her a couple of times, and then they Tased (stunned) her again, and when they Tased (stunned) her the second time, she just flopped out of the car like a fish.”

Lucca was charged with second-degree trespassing. Social workers took custody of her 3-year-old child who was in the car, Tanna said.

Tanna said deputies are not allowed to use Tasers on a person who simply refuses to comply with orders without danger involved, but in this case Lucca was engaging in “threatening behavior.”

“Our top priority was making sure people weren’t hurt because we didn’t know if she was going to drive the car off and run over somebody,” Tanna said. “Then there was the baby in the car we were concerned about.”

The deputies performed a “drive stun” on Lucca, a technique that does not involve firing probes into the target’s skin, she said.

A drive stun involves removing the Taser cartridge and touching the weapon directly on the skin to create a “pain compliance effect,” according to the Fayetteville Police Department’s use of force policy. A drive stun is applied to pressure points on the surface of the skin and allows officers to restrain a suspect without full incapacitation.

SC Automobile Accident – Bar / Homeowner Liability for Drunk Drivers

The following pending case below is a sad example of what can happen if you drink and drive. Serious injury can happen in an instant. In this case, she is left paralyzed from the waist down. This case is rather unique as it is the impaired driver herself who is suing. Certainly, there are several key defenses which will most probably end her case before it ever reaches a jury. Nevertheless, the facts highlight the need for bar owners and homeowners who serve alcolhol to be certain any customers or guests are of legal age and that they are safe to drive before leaving to get on the road. If these basis safety steps are not followed, then perhaps they should be held accountable. Tonight while enjoying the Super Bowl, please be aware of what can happen. Be Safe. Get Home.

At Reeves, Aiken & Hightower, LLP, all of our attorneys are seasoned trial lawyers with over 70 years combined experience. Whether it is criminal or civil, our litigators are regularly in Court fighting for our clients. Two of our firm’s partners, Art Aiken and Robert Reeves, are lifetime members of the Million Dollar Advocates Forum. Mr. Reeves has also been named one of the Top 100 lawyers for South Carolina in 2012 by the National Trial Lawyers Organization. Our attorneys include a former SC prosecutor, a former public defender, a former NC District Attorney intern, a former Registered Nurse (RN), and former insurance defense attorneys. As a result of their varied backgrounds, they understand the criminal, insurance defense, and medical aspects of complex cases. We welcome an opportunity to sit down and personally review your case. Call us today for a private consultation. www.rjrlaw.com

A South Carolina woman is suing the bar that served her alcohol as a minor the night she had a car accident that left her paralyzed.

Hess was 20 years old on Aug. 8, 2009 when she went to Jock’s Sports Grill in Beaumont, S.C. for a game of billiards, according to her lawsuit.

She alleged that she ordered an alcoholic drink at the bar and was served without being asked for identification. The legal drinking age in South Carolina is 21.

Hess accused the bar of several forms of negligence, including failure to “request and examine proof of identification,” serving alcohol to minors, and “failing to ascertain whether Plaintiff was impaired by the consumption of alcoholic beverages at the time Plaintiff purchased the alcoholic beverage.”

At about 1:05 a.m., Hess left the bar driving her own car and had a serious accident.

“The wheels of the motor vehicle Plaintiff was operating suddenly dropped off into a large unmaintained area on the shoulder of Alljoy Road, which caused Plaintiff to loose [sic] control of her vehicle and causing her to roll the vehicle over off the side of the road,” the lawsuit said.

As a result, Hess “suffered serious, permanently debilitating injuries causing the plaintiff to be paraplegic.” She blames the accident on the bar.

“The accident that resulted in Plaintiff being a paraplegic was due to and proximately caused by the negligence, recklessness, and willfulness and gross negligence of Defendant Jock’s Sports Grill,” the lawsuit said.

Attorneys representing the defendants deny “each and every allegation,” they each said in responses to the Hess’ lawsuit.

Their response lists eight possible ways Hess may have been negligent including driving while intoxicated, failing to keep her car under proper control, driving too fast for the conditions, and “failing to act in a reasonable and prudent manner.”

 

Partner Bea Hightower Becomes Adjunct Professor, University of South Carolina

Columbia Attorney Bea Hightower has accepted an invitation to become an Adjunct Professor at the University of South Carolina, Department of Criminal Justice and Criminology. In addition to her private law practice as a partner at Reeves, Aiken & Hightower, LLP, she will be teaching a course on the American Criminal Court Systems to undergraduate college students at USC. Congratulations, Bea. Your partners are very proud of you and your latest accomplishment.