What Is Workers’ Compensation?
Workers’ compensation is a no-fault insurance product that provides benefits to employees who are injured on the job while working within the course and scope of their employment. Workers’ compensation insurance provides payment for injuries stemming from accidents, occupational illness, and repetitive motions. It covers physical and mental workplace injuries. Injured workers receive weekly payments that replace a portion of their wages, as well as medical benefits.
To receive workers’ compensation benefits, injured workers must carefully follow the workers’ compensation claim process.
Who Qualifies for Workers’ Compensation in South Carolina?
Most South Carolina workers are covered by workman’s comp insurance, including full-time and part-time employees. Most employers in South Carolina are required to maintain workers’ compensation insurance except:
- Companies with four or fewer employees
- Companies with annual payrolls of less than $3,000
- Agricultural employers of employees excepted under Farm Labor Laws
- Employers of railroad employees exempt under the Federal Employers Liability Act
Workers’ compensation insurance provides coverage for employees, so independent contractors are generally not covered under this type of insurance. General contractors are required to maintain workers’ compensation insurance.
Other common industries that may be covered include:
Common Causes of Workplace Injuries
No matter how “safe” a job might seem, people can still get hurt on the job. Some of the most common workplace injuries are caused by:
- Motor vehicle accidents
- Overexertion
- Falls, slips, and trips
- Workplace violence
What Does Workers’ Compensation Cover in South Carolina?
Workers’ compensation benefits in South Carolina include the following:
Medical Care
South Carolina workers’ compensation covers the full cost of necessary treatment-related medical expenses. Medical benefits might include payment for:
- Hospital treatment expenses
- Doctor’s visit expenses
- Prescription costs
- Mileage to visit the doctor
Partial Disability
If workplace injuries cause the worker to miss time from work, they may be able to receive partial income replacement benefits. These benefits are calculated based on the employee’s average weekly wage for the last four quarters, subject to the state maximum.
If the worker is injured and unable to perform their regular job duties, they may be assigned to light work. Partial disability benefits are equal to two-thirds of the difference between the current wages while the worker is on restricted duties and their average weekly wage before the injury.
Total Disability
In cases that involve serious injuries or death, permanent disability benefits may be paid. If the injured worker is unable to return to work, they can receive two-thirds of their average weekly wage, for up to 500 weeks. Some injuries like paralysis or brain damage pay out lifetime benefits.
If the workplace accident was fatal, the family may receive reimbursement for burial expenses. Additionally, they may receive two-thirds of their loved one’s average weekly wage, for up to 500 weeks.
What Benefits Are Available Through Workers’ Compensation?
If you were hurt in an accident on the job, your injuries and associated expenses may be covered by workers’ compensation. Call our injury compensation law firm to find out if you could be eligible to claim financial benefits. No matter how “safe” a job might seem, people can still get hurt on the job.
Some of the most common workplace injuries are caused by:
- Medical treatment, including reimbursement for mileage to visit the doctor or pick up prescriptions
- Partial replacement of lost wages
- Permanent disability
- Physical impairment (including loss of limbs)
- Disfigurement
In the most severe workplace accidents that result in death, workers’ comp benefits may provide surviving family members with death benefits.
How Long Do Workers’ Compensation Benefits Last in South Carolina?
Following your injury event, your employer’s workers’ comp policy should pay you 66.67% of your average weekly pay up to a limit, according to the South Carolina Workers’ Compensation Commission.
If you sustain an injury that causes lasting impairment, a doctor will determine whether you may qualify to receive permanent disability benefits. If you’re an injured worker who has been permanently disabled, you will be assigned a disability rating or whole-person impairment rating by the doctor. That personal impairment or disability rating will be used to determine the compensation you’re entitled to from the insurance company.
If your injury prevents you from ever working again, you could be eligible to receive disability benefits for the rest of your life. Phone our South Carolina workers’ comp law firm to find out more about becoming one of our clients.
The South Carolina Workers’ Compensation Lawyers at Stewart Law Offices Can Help You
Workers’ compensation benefits are supposed to provide payment to people who are injured in workplace-related accidents. However, the process to obtain benefits is often complex. Injured workers may have their claims disregarded, delayed, or denied if they do not follow the proper protocol.
Once a workers’ compensation claim is filed, the employer’s workers’ compensation insurance carrier will investigate the claim and determine whether they believe the injury is covered by the policy. However, it is important to note that insurance companies are often very strategic about minimizing payouts while maximizing the premiums they receive. This is how they make their money.
When a person is injured in a workplace accident or otherwise suffers occupational injuries, it is essential that they are represented by a workers’ compensation lawyer who is knowledgeable about workers’ compensation law and the insurance company. Workers’ compensation attorneys stand up for the rights of their clients and seek full benefits on behalf of injured workers.
Our South Carolina workman’s comp lawyers are prepared to help you navigate the complex workers’ compensation claims process by:
- Investigating the accident
- Identifying all responsible parties and determining whether a third-party claim can be filed
- Collecting evidence to support your case
- Handling communication with the insurance company
- Negotiating fair compensation for your workplace injuries
- Abiding by South Carolina’s worker’s compensation timelines
What If the Workers’ Comp Claim Is Denied?
If your workers’ comp claim is contested or denied by your employer’s insurance provider, you’ll want to immediately seek legal assistance. Your attorneys can draft and file a Form 50 with the Workers’ Compensation Commission. A Form 50 will include the following details: all parties involved in the injury accident, a description of the accident, the name and role of the individual to whom the accident was reported, the extent of the injury, and the treatment required.
Your employer’s insurance carrier will submit a Form 51. Form 51 details the accidental injury event from their perspective and makes a case for why the insurance claim is invalid.
Once they have heard from both parties involved in the claim, the Workers’ Compensation Commission will assign the matter to an individual Commissioner.
Workers’ compensation insurance carriers may deny claims for a variety of reasons, such as:
- They claim the injury did not occur on the job; ex: injuries on lunch breaks
- They dispute the severity of the injury
- They claim the worker did not provide proper notice to their employer
- They claim there is a lack of evidence
The letter you receive should state the reason for the denial. Carefully review this letter. If you disagree with it, reach out to a workers’ comp attorney from our law firm who can help you with the appeals process.
The Appeals Process
This process involves a hearing in front of one of the South Carolina workers’ compensation commissioners. At the hearing, you will be able to present evidence to support your workers’ compensation claim. There are multiple levels of appeal. Your lawyer can explain whether you have grounds to file an appeal.
The Commissioner assigned to your case will review each submission and schedule a hearing.
South Carolina hearings are typically scheduled to take place within five months of the involvement of the Workers’ Compensation Commission. At the hearing, each side will present their case along with supporting evidence. The physician who treated your injury will likely provide a medical testimony – essentially their professional assessment of your injury at the time you were treated. Similarly, the insurance carrier will submit any records or evidence supporting their case.
Based on the reports and hearing, the Commissioner will make a legal ruling that outlines the benefits you are entitled to receive as a result of the injury. Either party can appeal this decision.
Appeals are subject to a joint review that will be conducted by a panel of the Workers’ Compensation Commissioners in your jurisdiction. Following the order issued after this committee review, any additional appeals will be referred to the relevant Circuit Court, and then the state Court of Appeals.
What to Do if You’ve Been Hurt on the Job in South Carolina?
Your priority should always be your health and well-being. If your injury is serious, you need to seek emergency treatment immediately. You can report the injury to your employer once you are in a stable condition and out of immediate medical jeopardy.
If your injury is minor enough that it does not require immediate medical attention, you’ll need to report the injury to your employer before seeking medical treatment. That’s because your employer has the right to refer you to a medical professional of their choice for evaluation and treatment.
Choosing a doctor on your own without receiving your employer’s permission could absolve your employer of the responsibility to cover the medical costs associated with your evaluation and treatment.
If you experience an injury that seems minor, it is crucial that you still seek treatment and file a claim. An injury may seem insignificant at the time it occurs but may become complicated over time.
It’s also important to keep in mind that you will need to report any workers’ compensation-related injury to your employer within 90 days. If you do not report your injury within 90 days, you risk missing out on the benefits that you are entitled to.
We understand that you may have many more questions about Workers’ Compensation. Please remember to phone our attorneys. We are here to help.
