Steps to follow to ensure you receive maximum workers’ comp benefits
Workers’ compensation is a program of no-fault insurance. This means that a worker who’s injured on the job doesn’t have to prove their employer was at fault.
All employers in South Carolina with at least 4 employees are required to carry workers’ compensation coverage. Employers usually purchase workers’ compensation insurance, but in rare circumstances, an employer could also self-insure.
South Carolina’s workers’ compensation laws are complex. In order to file a claim, you must comply with very strict rules.
Some unscrupulous employers or insurance companies will try to fabricate reasons to deny your claim. Therefore, you should contact an experienced workers’ compensation lawyer immediately after a work injury to ensure your rights are protected.
What workers’ comp benefits are available in South Carolina?
Workers’ compensation benefits include:
- Payment for medical and rehabilitation treatments, including travel expenses
- Replacement of lost income equal to two-thirds of your average weekly wage
- Partial disability and total disability benefits
- Compensation for disfigurement
- Death benefits to your dependents
For purposes of medical treatments, you must use a physician chosen by the workers’ compensation administrator.
It should be noted that benefits payable for workers’ compensation claims do not include compensation for pain and suffering, punitive damages awardable in ordinary personal injury cases, or benefits awardable under wrongful death actions. However, you and your lawyer should consider possible claims against third parties, if applicable.
Am I eligible for workers’ comp?
You are eligible for workers’ comp benefits if your employer has at least 4 employees and you are within the following statutory definition of “employee” according to South Carolina Statutes §42 1 130.
“The term “employee” means every person engaged in an employment under any appointment, contract of hire, or apprenticeship, expressed or implied, oral or written, including aliens and also including minors, whether lawfully or unlawfully employed.”
Additionally, “Any sole proprietor or partner of a business whose employees are eligible for benefits under this title may elect to be included as employees under the workers’ compensation coverage of the business if they are actively engaged in the operation of the business.”
How to apply for workers’ comp
- Seek immediate medical attention. This will not only ensure that you receive appropriate medical treatment to aid in your recovery but will also provide documentation that directly links your injury to your workplace accident, which is crucial to getting compensation.
- File an accident report as soon as possible but no more than 90 days after the accident. The content of your report sticks with you throughout the process so it should be constructed with the guidance of a lawyer.
- Get witness statements. Contact any co-workers who witnessed your injury and see if they are willing to provide written statements to corroborate the circumstances surrounding your injury. The success of your claim will be helped by having as much documentary evidence as possible.
- Contact an experienced workers’ compensation lawyer. That’s because a successful claim can be compromised by mistakes made early in the claims process. Your lawyer can help you avoid those mistakes.
You must file your claim within 2 years after your injury in order to qualify for compensation, but it’s recommended that you file it as soon as possible. Again, this claim should be filed with guidance from an experienced workers’ comp lawyer.
Follow-up medical treatments with an employer-authorized doctor
In order to qualify for benefits, your employer or their insurance company will require you to be examined by an employer-authorized doctor. If you do not follow the instructions given by this doctor, your benefits could be jeopardized.
You might be “invited” to return to work during your recovery. Your employer-authorized doctor will produce a report with restrictions on what physical activities you can perform during treatment and recovery.
Armed with that report, your employer might contact you to persuade you to return to a suitable job. They must also contact your lawyer with their proposal. Do not refuse or accept such employment without consulting your attorney.
Once you have been released by the doctor, their final report will prescribe the types of employment you can perform, considering any physical and mental limitations caused by your injuries.
If you refuse to accept suitable employment approved by the doctor, your compensation can be terminated. However, you can ask the South Carolina Workers’ Comp Commission for a determination that your refusal is justified.
If you’re injured on the job as a result of defective machinery or other equipment, you might have a product liability claim against the manufacturer or installer of the equipment.
You are not limited by South Carolina workers’ compensation law as to the amount of your third-party claim. However, you cannot “double-dip” for the same injury. Your workers’ compensation benefits will be offset by any recovery from third parties for the same injury.
If a workplace injury results in death, South Carolina workers’ compensation includes death benefits, which cover a portion of lost wages and funeral expenses.
South Carolina also has a wrongful death statute whereby a deceased’s personal representative can sue a third party on behalf of the deceased’s estate and surviving family members.
Can a deceased worker’s family sue the employer under the wrongful death statute?
Like most states, South Carolina embraces the “exclusivity doctrine.” That is, in exchange for a no-fault system (where an injured employee is compensated without proving the employer is at fault), the employee gives up the right to sue or recover compensation under any other civil remedy.
When to contact a South Carolina workers’ comp attorney
If you’re injured on the job, your exclusive remedy against your employer is the South Carolina workers’ compensation law. However, you may have a claim against one or more third parties. In order to qualify for maximum compensation, you should consult a lawyer with extensive experience with workers’ compensation claims.
At the law firm of Chappell, Smith & Arden, P.A., our experienced workers’ comp attorneys have more than 30 years of experience negotiating with employers and insurance companies to get injured South Carolina workers the maximum benefits to which they’re entitled. Contact us today for a free consultation of your case.