Medical Benefits

In South Carolina, most employees are eligible to receive medical benefits for illnesses or injuries sustained on-the-job through the Workers’ Compensation benefits. Workers’ Compensation is a no fault insurance system, meaning that injured employees do not need to prove that their employer was at fault in any way to receive benefits. They only need to demonstrate that their injury or illness is work related.

Medical Costs

Injured employees are eligible to receive an array of benefits under the Workers’ Compensation system, including partial recovery for lost wages, potential vocational rehabilitation training, and medical benefits. An injured employee’s employer or their insurance company should pay for necessary and reasonable medical treatment stemming from the work-related injury. Treatment for pre-existing conditions could be covered under the program if a physician agrees the pre-existing condition has been permanently aggravated or exacerbated by the work injury.

All related medical costs covered include:

  • Doctor’s visits
  • Copays
  • Hospital stays
  • Prescriptions
  • Prescription copays
  • Physical therapy
  • Surgery
  • Other necessary treatment
  • Medical Mileage reimbursement for certain travel

Injured employees who visit a treatment provider of their own choosing may not be eligible to receive any medical benefits through the Workers’ Compensation system. However, if you visit the doctor or hospital chosen by your employer or their insurance representative, you will not have to pay any costs out of pocket. Rather, your employer or their insurer will pay your medical treatment provider directly.

Medical benefits are paid regardless of how long you are ill, or how extensive your injuries are. Medical treatment is automatic for a period of up to 10 weeks. After the 10 weeks, medical treatment can be authorized if the South Carolina Workers’ Compensation Commission determines that it will tend to lessen the employees’ period of disability. An employer can always elect to provide employees with additional treatment as needed.

What to Do If You Have Been Injured On-the-Job

If you were injured in an accident at work or have acquired an illness that you believe may be work-related, it is important that you report this to your employer as soon as possible. It is always best to notify your employer in writing. Your employer then should report the issue to the Workers’ Compensation Commission, which oversees the payment of benefits to injured employees.  If your employer fails to file a claim on your behalf, you can file a claim with the Commission yourself.

If you do not receive all the benefits that you need or believe you are entitled to, you can also file a claim with the Commission. If your employer denies your claim, you have the right to file with the Commission. It is not uncommon for employers to deny claims by asserting that the injury or illness is not work-related. If you do not report your injury within 90 days, you may be barred from receiving benefits. Once you notify your employer of your injury in writing, you have up to two years to file a claim for benefits.

Am I Eligible for Benefits?

An experienced Workers’ Compensation lawyer can help you determine whether you are eligible for benefits. Not all employees are eligible for benefits under the Workers’ Compensation system, including federal employees working in the state, agricultural workers, employees of businesses with less than four employees, railroad workers, corporate officers, and certain realtors and temporary employees. In South Carolina, the family of a deceased worker may be eligible to recover medical benefits if the fatality arose out of the course of the decedent’s employment.

Columbia Workers’ Compensation Lawyers at Chappell Smith & Arden, P.A. Fight for Injured Workers

If you or a loved one has been injured in a work-related accident, you have rights under South Carolina law. To learn more, schedule a free consultation with a dedicated Columbia Workers’ Compensation lawyer at Chappell Smith & Arden, P.A. by filling out our online contact form or calling us at 803-929-3600.

With offices located throughout South Carolina, we provide skilled representation to clients in Columbia, Aiken, Camden, Sumter, Orangeburg, Greenville, Florence, Beaufort, Irmo, Spartanburg, Myrtle Beach, Hilton Head Island, West Columbia, Rock Hill, Charleston, Lexington, Winnsboro, Summerville, and throughout the counties of Lexington County, Richland County, Sumter County, Charleston County, Aiken County, Florence County, Lancaster County, York County, Spartanburg County, Orangeburg County, Kershaw County, and Newberry County.