James Freshley v. Conbraco Industries

THIS OPINION HAS NO PRECEDENTIAL VALUE. IT SHOULD NOT BE
CITED OR RELIED ON AS PRECEDENT IN ANY PROCEEDING
EXCEPT AS PROVIDED BY RULE 268(d)(2), SCACR.

THE STATE OF SOUTH CAROLINA
In The Court of Appeals

James Freshley, Claimant, Appellant,

v.

Conbraco Industries, Inc., Employer, and Great
American Alliance Insurance Company, Carrier,
Respondents.

Appellate Case No. 2023-000185

Appeal from the Workers' Compensation Commission

Unpublished Opinion No. 2025-UP-310
Heard February 12, 2025 – Filed September 10, 2025

REVERSED AND REMANDED

Stephen J. Wukela, of Wukela Law Office, of Florence,
for Appellant.

David Alan Wilson, of Wilson & Englebardt, LLC, of
Greenville, for Respondents.

PER CURIAM: Appellant James Freshley appeals the South Carolina Workers'
Compensation Commission's (the appellate panel) order denying his claim that he
suffered a disabling occupational disease. Freshley challenges the appellate panel's
denial on the grounds that the appellate panel erred by (1) failing to properly apply
the legal standard for occupational disease contrary to the substantial evidence and
(2) failing to find that Freshley suffered from a disabling occupational disease. We
reverse and remand.

FACTS AND PROCEDURAL HISTORY

In August 2019, Freshley filed a claim seeking workers' compensation
benefits on the ground that he suffered from reactive airway disease—occupational
asthma—as a result of exposure to chemicals during his employment at Respondent
Conbraco Industries (Conbraco), a valves manufacturer.

Freshley worked for Conbraco from 2007 to 2020. During most of his
employment, Freshley worked on the "zinc line"—which required bathing
manufactured parts in a variety of chemicals—a process that emitted visible fumes.
The zinc line was located in the shipping department alongside other processes that
used chemicals. In May 2019, Freshley informed Renee Chaisson, Conbraco's
human resources manager, that he believed fumes from the zinc coating process
were causing him to experience shortness of breath. On May 8, 2020, while Freshley
was out on leave for unrelated surgery, he and thirteen other employees were laid
off.

In February 2019, Freshley had expressed concern to his cardiologist, Dr.
Prabal Guha, that exposure to workplace chemicals may be causing his shortness of
breath. While Freshley had previously experienced shortness of breath related to an
atrial fibrillation (afib) diagnosis, the shortness of breath persisted even when his
afib had successfully been treated. Dr. Guha referred Freshley to Dr. Vinod Jona, a
pulmonologist, to address the issue.

After ordering a series of tests including a CT scan, a VQ scan, and spirometry
tests, Dr. Jona diagnosed Freshley with occupational asthma. Dr. Jona found that
his chemical exposure in the workplace was clinically significant, there was a
temporal association between the exposure and symptom onset, and Freshley
worked in an occupation known to be at risk for the development of lung disease.
Dr. Jona referred Freshley to Dr. Robert Miller, another pulmonologist, to verify the
cause of his symptoms.

Dr. Miller ultimately agreed with Dr. Jona that Freshley's symptoms were
consistent with reactive airway disease—i.e., occupational asthma—caused by
exposure to chemicals in the workplace. Dr. Miller conducted several tests,
including a spirometry test, an x-ray, a diffusion test, a cardiopulmonary stress test
(CPET), a CAT scan, and a pulmonary function test (PFT), to exclude alternative
causes of Freshley's shortness of breath such as cardiopulmonary disease, pleural
disease, and chronic obstructive pulmonary disease. Additionally, Dr. Miller
referred Freshley to Dr. John Sturdivant, a cardiologist specializing in
electrophysiology, to determine the relationship between Freshley's cardiac issues
and his shortness of breath. Dr. Sturdivant concluded Freshley's cardiac issues were
not the cause of his shortness of breath.

During Dr. Miller's deposition, after viewing Material Safety Data Sheets
(MSDS) for the seventeen chemicals used in Conbraco's shipping department, he
testified that while he had not seen the MSDS prior to this deposition, his diagnosis
was consistent with exposure to these chemicals. On cross-examination, Dr. Miller
conceded that, while treating Freshley, he did not have an independent source of
information as to the type and extent of chemical exposure other than Dr. Jona's
notes and Freshley's self-report.

In June 2021, a single commissioner held a hearing on Freshley's workers'
compensation claim. 1 Freshley, Chaisson, and Karen Brooks, Conbraco's
environmental health and safety manager, testified at the hearing. Other medical
evidence consisted of patient notes from Dr. Guha, Dr. Jona, Dr. Miller, and Dr.
Sturdivant; deposition testimony from Dr. Miller and Dr. Sturdivant; and medical
test results. The MSDS were also before the single commissioner. Additionally,
Conbraco entered into evidence the medical opinion of Dr. Gregory Feldman 2 in the
form of a two-page letter.

Dr. Feldman disagreed with Freshley's diagnosis. Dr. Feldman explained that
reactive airways dysfunction syndrome 3 is not an appropriate diagnosis if the

1
Initially, Freshley claimed injury to his lungs, skin, and resulting headaches. The
single commissioner found Freshley failed to meet his burden of proving injury by
accident or occupational illness within the course and scope of his employment. On
appeal, Freshley challenged the findings as to only the injury by accident or
occupational disease to his lungs.
2
Dr. Feldman is triple-board certified in the specialties of internal medicine,
pulmonary medicine, and critical care.
3
Notably, Freshley claimed to suffer from occupational asthma, or reactive airway
disease, not reactive airway dysfunction syndrome. Dr. Feldman's letter refers only
to reactive airway dysfunction syndrome, while Dr. Miller appears to reference both
reactive airway disease and reactive airway dysfunction syndrome. At oral
treating physician lacks a "clear understanding of the chemical involved [and] the
extent of the exposure" and has not ruled out alternative explanations for the patient's
symptoms. In Dr. Feldman's opinion, Dr. Miller failed to exclude other causes of
Freshley's shortness of breath. Dr. Feldman ultimately concluded the medical
evidence did not support a diagnosis of reactive airway dysfunction syndrome
because the diagnosis requires an exclusion of alternative explanations, and he
believed the "presence of multiple comorbidities more than adequately explain[ed]
all [Freshley's] symptoms." Conbraco also entered into evidence an addendum to
Dr. Feldman's opinion in which he noted that Freshley's complaints about shortness
of breath were "highly non-specific" and had been complained of "over the years."
Dr. Feldman opined that the shortness of breath was "more likely than not related to
his several significant comorbidities that include anemia, obesity, and heart
condition[.]"

The single commissioner denied Freshley benefits on the ground that Freshley
failed to meet his burden of proving a compensable injury by occupational illness to
his lungs within the course and scope of his employment. Freshley appealed to the
appellate panel. The appellate panel affirmed the single commissioner's order and
mirrored the single commissioner's findings with a few amendments. This appeal
followed.

STANDARD OF REVIEW

"Our review is limited to deciding whether the [appellate panel]'s decision is
unsupported by substantial evidence or is controlled by some error of law." Skinner
v. Westinghouse Elec. Corp., 394 S.C. 428, 432, 716 S.E.2d 443, 445 (2011).
"'Substantial evidence' is not a mere scintilla of evidence, nor the evidence viewed
blindly from one side of the case, but is evidence that, considering the record as a
whole, would allow reasonable minds to reach the same conclusion as the [appellate
panel]." Pack v. State Dep't of Transp., 381 S.C. 526, 536, 673 S.E.2d 461, 466 (Ct.
App. 2009). "When the evidence is conflicting over a factual issue, the findings of
the [a]ppellate [p]anel are conclusive." Brunson v. Am. Koyo Bearings, 395 S.C.

argument, counsel for both parties were questioned about this discrepancy.
Freshley's counsel acknowledged that the terms were used interchangeably but
confirmed that reactive airway disease is the alleged diagnosis. Conbraco's counsel
argued these are separate, distinct diseases and conceded that Dr. Feldman's opinion
spoke only about reactive airway dysfunction syndrome rather than the disease with
which Freshley was diagnosed. We have elected to treat the terms as
interchangeable, consistent with the appellate panel's approach.
450, 455, 718 S.E.2d 755, 758 (Ct. App. 2011). "The final determination of witness
credibility and the weight to be accorded evidence is reserved to the [a]ppellate
[p]anel." Id. (quoting Frame v. Resort Servs. Inc., 357 S.C. 520, 528, 593 S.E.2d
491, 495 (Ct. App. 2004)). "The possibility of drawing two inconsistent conclusions
from the evidence does not prevent an administrative agency's finding from being
supported by substantial evidence." Jones v. Harold Arnold's Sentry Buick, Pontiac,
376 S.C. 375, 378, 656 S.E.2d 772, 774 (2008) (quoting Lee v. Harborside Cafe,
350 S.C. 74, 78, 564 S.E.2d 354, 356 (Ct. App. 2002)).

"Where the evidence is susceptible of but one reasonable inference, the
question is one of law for the court rather than one of fact for the [appellate panel]."
Mullinax v. Winn-Dixie Stores, Inc., 318 S.C. 431, 437, 458 S.E.2d 76, 80 (Ct. App.
1995). "[I]f all the evidence points to one conclusion or the [appellate panel]'s
findings 'are based on surmise, speculation or conjecture, then the issue becomes one
of law for the court . . . .'" Clemmons v. Lowe's Home Centers, Inc.-Harbison, 420
S.C. 282, 288, 803 S.E.2d 268, 271 (2017) (quoting Polk v. E.I. duPont de Nemours
Co., 250 S.C. 468, 475, 158 S.E.2d 765, 768 (1968)).

LAW/ANALYSIS

Freshley argues the appellate panel erred in denying his claim because its
finding that he did not have an occupational disease is unsupported by the substantial
evidence. We agree.

In order to receive workers' compensation benefits for contracting an
occupational disease, a claimant must (1) prove a disease, and:

2. The disease must arise out of and in the course of the
claimant's employment;

3. The disease must be due to hazards in excess of those
hazards that are ordinarily incident to employment;

4. The disease must be peculiar to the occupation in which
the claimant was engaged;

5. The hazard causing the disease must be one recognized as
peculiar to a particular trade, process, occupation, or
employment; and
6. The disease must directly result from the claimant's
continuous exposure to the normal working conditions of
the particular trade, process, occupation, or employment.

Fox v. Newberry Cnty. Mem'l Hosp., 319 S.C. 278, 281, 461 S.E.2d 392, 394 (1995)
see S.C. Code. Ann. § 42-11-10(A); see also Sturkie v. Ballenger Corp., 268 S.C.
536, 542, 235 S.E.2d 120, 123 (1977) ("The settled rule is that where the work and
its own environment of circumstance expose the employee to the happening of an
event causing an accident, the accident arises out of the employment."). "An
occupational disease is one which develops over a period of time as opposed to an
injury that is attributable to a one-time event." Brunson, 395 S.C. at 456, 718 S.E.2d
at 759. "[C]ircumstantial evidence may be used to prove causation." Mullinax, 318
S.C. at 437, 458 S.E.2d at 80.

"Expert medical testimony is designed to aid the [appellate panel] in coming
to the correct conclusion. Therefore, the [appellate panel] determines the weight and
credit to be given to the expert testimony. Once admitted, expert testimony is to be
considered just like any other testimony." Corbin v. Kohler Co., 351 S.C. 613, 624,
571 S.E.2d 92, 98 (Ct. App. 2002) (citations omitted). However, "a medical opinion
which conflicts with the physical facts will not be permitted to control the
determination of a factual controversy." Poston v. Se. Const. Co., 208 S.C. 35, 38,
36 S.E.2d 858, 860 (1946) (quoting Moyle v. Mutual Life Ins. Co., 201 S.C. 146, 21
S.E.2d 561, 564 (1942)).

The appellate panel concluded that Freshley did not sustain any compensable
occupational disease, noting its findings were "based primarily on the medical
evidence" and that the medical evidence did not support "a causal connection"
between Freshley's medical symptoms and any alleged exposure at work. The
appellate panel made the following findings to support its decision:

23. It is noteworthy that none of the treating or evaluating
physicians had specific details regarding the specific
department in which [Freshley] worked or any specific
chemicals to which [Freshley] was directly exposed and
for what amounts of time, if any.

24. Additionally, none of the physicians could exclude
[Freshley's] serious pre-existing comorbidities as the basis
or at the very least a contributing factor to [Freshley's]
medical condition. As such, the undersigned could not
exclude those factors as well. . . .

25. In reaching our conclusion that [Freshley] has failed
to meet his burden of proof, specifically, we give great
weight to the opinions and testimony of Dr. Feldman . . . .
Dr. Feldman was uniquely positioned to comprehensively
review all of the relevant medical evidence, including Dr.
Miller's testimony, and after doing so, was unable to draw
a causal relationship between [Freshley's] employment
and his symptoms, but instead concluded that the presence
of [Freshley's] multiple comorbidities more adequately
explained [Freshley's] symptoms. He further found that
the diagnosis of [reactive airway dysfunction syndrome]
was neither supported by the required criteria for
exclusion of alternative explanations nor was it supported
by any reliable medical evidence.

26. In fact, in analyzing the evidence and reaching his
conclusions, Dr, Feldman noted, among other things, that
it was no longer appropriate for any physician to make a
[reactive airway dysfunction syndrome] diagnosis without
a clear understanding of the chemical involved and the
extent of exposure. No one has been able to identify with
any specificity the chemicals to which [Freshley] was
supposedly exposed and even Dr. Miller acknowledged
during his deposition that he could not say exactly to what
chemical [Freshley] was exposed. For this, among other
reasons, we find that Dr. Feldman's conclusions are not
based on conjecture or speculation but are well supported
by reliable and probative evidence contained in the record.
Accordingly, we give greater weight to his opinions and
conclusions than to any other treating or evaluating
specialist.

(emphases added).

We hold the appellate panel erred in denying Freshley's claim because the
substantial evidence in the whole of the record does not support the appellate panel's
findings. Skinner, 394 S.C. at 432, 716 S.E.2d at 445 ("Our review is limited to
deciding whether the [appellate panel]'s decision is unsupported by substantial
evidence or is controlled by some error of law."). While this court must not
second-guess the appellate panel's weighing of evidence, the factual conclusions of
the appellate panel may be reversed "if they are arbitrary or clearly wrong . . . ."
Russell v. Wal-Mart Stores, Inc., 445 S.C. 387, 394–95, 914 S.E.2d 838, 842 (2025);
Etheredge v. Monsanto Co., 349 S.C. 451, 456, 562 S.E.2d 679, 681 (Ct. App. 2002)
("A court 'may not substitute its judgment for that of any agency as to the weight of
the evidence on questions of fact unless the agency's findings are clearly erroneous
in view of the reliable, probative, and substantial evidence on the whole record.'"
(quoting Tiller v. Nat'l Health Care Ctr. of Sumter, 334 S.C. 333, 339, 513 S.E.2d
843, 845 (1999))).

Here, the substantial physical evidence in the record does not support
appellate panel's findings. Pack, 381 S.C. at 536, 673 S.E.2d at 466 ("'Substantial
evidence' is not a mere scintilla of evidence, nor the evidence viewed blindly from
one side of the case, but is evidence that, considering the record as a whole, would
allow reasonable minds to reach the same conclusion as the [appellate panel].").
First, the appellate panel found it "noteworthy" that Freshley's physicians did not
have specific details about the department where he worked or the specific chemicals
to which he was exposed. However, medical notes in the record indicate that Dr.
Jona and Dr. Miller specifically discussed Freshley's job description, the length of
time he had been in that position, and at least some of the chemicals to which he was
exposed while in that position. Doctors are trusted to be able to differentiate between
self-serving or unreliable information shared by patients and that which is medically
relevant or significant. See Clark v. Philips Elecs./Shakespeare, 433 S.C. 186, 193–
94, 857 S.E.2d 378, 381 (Ct. App. 2021) ("What people say when seeking medical
help is usually self-serving and sometimes unreliable. Doctors are trained to detect
such things, and we are confident that if the doctors believed they were duped into
their opinions they would have said so."). Further, the MSDS for the seventeen
chemicals in the shipping department revealed that many of the chemicals used in
that department were harmful if inhaled as a vapor, mist, or fume. Dr. Miller testified
that exposure to the chemicals on the MSDS was consistent with his opinion that
Freshley's reactive airway disease was caused by exposure at his workplace.

Second, the appellate panel found that none of the physicians excluded
Freshley's comorbidities as the basis of or as a contributing factor to his medical
condition. However, this finding contradicts the conclusions reached by the
physicians who physically treated Freshley. Russell, 445 S.C. at 394–95, 914 S.E.2d
at 842 (noting that the factual conclusions of the appellate panel may be reversed "if
they are arbitrary or clearly wrong"). The record contains evidence that Freshley's
shortness of breath was not explained by any of his comorbidities: Dr. Miller, Dr.
Jona, Dr. Guha, and Dr. Sturdivant all examined Freshley and ordered tests to
determine the cause or causes of Freshley's shortness of breath, and both Dr. Jona
and Dr. Miller determined his symptoms were caused by occupational asthma and
not by comorbidities or other conditions. Dr. Sturdivant eliminated Freshley's
cardiac issues as the cause of his shortness of breath. While the appellate panel is
free to disregard these tests and conclusions, Russell, 445 S.C. at 394, 914 S.E.2d at
842 (noting that the appellate panel does not have to "accept even uncontradicted
evidence"); finding that none of the physicians could exclude comorbidities as a
cause of Freshley's shortness of breath does not comport with the record. Rather,
this finding reflects the conclusion reached by Dr. Feldman, which we address
below.

Finally, we hold Dr. Feldman's opinion—to which the appellate panel gave
great weight—is neither reliable nor substantial because it is directly contradicted
by the physical evidence in the record. Id. at 394–95, 914 S.E.2d at 842 ("[T]he
[a]ppellate [p]anel's factual decisions may be reversed if they are arbitrary or clearly
wrong[.]"); Poston, 208 S.C. at 38, 36 S.E.2d at 860 ("[A] medical opinion which
conflicts with the physical facts will not be permitted to control the determination of
a factual controversy." (quoting Moyle, 201 S.C. at 146, 21 S.E.2d at 564)). Dr.
Feldman concluded that Freshley's medical records did not support the diagnosis
reached by Freshley's treating physicians because they lacked knowledge about the
specific chemicals to which Freshley was exposed and because they failed to exclude
comorbidities or pre-existing medical conditions as the cause of Freshley's
symptoms, specifically shortness of breath. Dr. Feldman ultimately concluded that
Freshley did not have any asthma-like disease at all. However, Dr. Feldman did not
review the MSDS, nor did he access Dr. Sturdivant's notes or deposition that ruled
out Freshley's cardiac issues as the cause of his shortness of breath. Additionally,
contrary to Dr. Feldman's opinion, the record contains evidence that excludes several
of the conditions described by Dr. Feldman as potential alternative causes of
Freshley's symptoms. For example, the record shows that Freshley had been
compliant with his CPAP for years when he received the reactive airway disease
diagnosis; he no longer had cardiomyopathy; and the CPET showed abnormal
cardiac and pulmonary impairment. Additionally, the medical evidence reflects that
Freshley responded to bronchodilators, which indicates the presence of a small
airways disease and contradicts Dr. Feldman's conclusion that Freshley's shortness
of breath stemmed not from an airway disease but rather from one of his other
diagnosed conditions. Given that Dr. Feldman's opinion appears to conflict with the
record as a whole, it must "not be permitted to control the determination" of the
factual controversy in this case, i.e., whether Freshley suffered from an occupational
disease. Poston, 208 S.C. at 38, 36 S.E.2d at 860.

In sum, we reverse the appellate panel's decision because its findings are
unsupported by reliable, substantial evidence in the record. We are not in the
position to weigh the remaining evidence—Dr. Miller's deposition and notes, Dr.
Sturdivant's deposition and notes, Dr. Jona's and Dr. Guha's medical notes, the
hearing testimony from Freshley, Brooks, and Chaisson, the MSDS sheets, and
various medical testing results—to determine the remaining elements of the Fox v.
Newberry County Memorial Hospital six-element test. Thus, we remand to the
appellate panel to apply the test to determine whether Freshley met his burden to
proving he contracted an occupational disease.

As our holding on this issue is dispositive, we need not reach the remaining
issues on appeal.4 Futch v. McAllister Towing of Georgetown, Inc., 335 S.C. 598,
613, 518 S.E.2d 591, 598 (1999) (holding an appellate court need not address
remaining issues when disposition of prior issue is dispositive).

CONCLUSION

Based on the foregoing, the appellate panel's order is reversed and remanded.

WILLIAMS, C.J., and GEATHERS and TURNER, JJ., concur.

4
While we do not reach the remaining issues, we take note of our courts' precedent
that, once an employee has proven a compensable disease, the burden of proving the
percentage of the claimant's disability caused by non-compensable causes shifts to
the employer. See Hanks v. Blair Mills, Inc., 286 S.C. 378, 385, 335 S.E.2d 91, 95
(Ct. App. 1985) (holding the employer failed to present any evidence of the
percentage of the claimant's disability caused by non-compensable causes); Mizell
v. Raybestos-Manhattan, Inc., 281 S.C. 430, 434, 315 S.E.2d 123, 125 (1984)
(holding that though the evidence revealed the claimant had smoked cigarettes for
years and smoking can cause lung cancer, the employer and its insurer failed to elicit
medical testimony that smoking caused a percentage of the disability which resulted
in death).