South Carolinians who are injured or disabled in a work accident have a form of insurance provided by their employers called workers’ compensation in exchange for the worker not suing the company for negligence.
The state’s Workers’ Compensation Act requires most employers to fund workers’ compensation insurance for medical costs and wage replacement. But sometimes an employer argues that the injury was not work-related or resists paying the full amount of compensation.
That is when a South Carolina workers’ compensation lawyer can help. Contact a qualified personal injury lawyer that can fight tirelessly to build a solid personal injury case for you.
Understanding the Workers’ Compensation System
There are many misconceptions about workers’ compensation benefits. In many cases, employers are all too happy to allow these misconceptions to spread. While the system is complex, a South Carolina workers’ compensation attorney could help you understand it.
The first thing to appreciate is that South Carolina operates a “no-fault” system. This means that benefits could be available no matter who caused the accident. The commissioners that determine the outcome of each claim do not consider fault when making a determination. They do, however, consider other factors that could lead to a denied claim, including:
- Injuries not related to work
- Claims not filed on time
Another misconception about the system is that any benefit money comes out of the employer’s pockets. This is not the case. Employers are required to carry insurance policies to cover these claims. While an employer could see their premiums go up, the insurance company will ultimately be on the hook for the bill.
What Does Workers’ Compensation Cover?
Workers receive compensation for medical treatments using the employer’s choice of physicians except in emergencies, permanent disability, and disfigurement, vocational rehabilitation if unable to return to their previous work, diseases common of their occupations, and wage replacement because of work time missed but only at 66 percent of the employee’s weekly wages. Rates for classifications for all workers’ compensation insurers are determined by the South Carolina Department of Insurance.
South Carolina prohibits claims for stress and mental injuries as well as heart attacks, strokes, and aneurysms if those ailments did not result from a work-related injury. Employers that are not covered under workers’ compensation are companies employing fewer than four people, federal employees, agricultural workers, some casual workers, some real estate sales staff, and corporate officers. Businesses that are not required to have workers’ compensation are railroad and railway express companies and so their employees are not covered under this act.
What Are the Potential Consequences of Filing a Claim?
Even though an employer is not ultimately responsible for paying a claim, they have their own motivations for wanting to see the claim denied. It is no surprise, then, that many workers are concerned about the potential for retaliation.
The good news is that the law prohibits an employer from retaliating against a worker for filing an injury claim. In fact, a South Carolina workers’ compensation attorney could file a civil suit in federal court against the employer if they retaliate against an employee.
Filing Workers’ Compensation Claims in a Timely Manner
An injured or disabled worker needs to promptly report the accident to the employer or medical costs and wage compensation could be at risk. A claim for compensation must be filed for South Carolina’s workers’ compensation within two years of the injury date. Failing to meet the deadline likely prevents benefits from being awarded. A South Carolina workers’ compensation attorney can help individuals file their claims in a timely manner. After the employer is told about the accident, the company has 10 days to report it to a Workers’ Compensation Commission commissioner in the appropriate district.
Right to Appeal
A worker who is dissatisfied with the results of the claim can apply for a hearing before a commissioner of the Workers’ Compensation Commission if:
- The employer did not report the injury within 10 days to a commissioner
- The employer decides the injury did not happen within the scope of the worker’s job
- The employee believes some benefits were not provided
- The worker and the employer cannot agree to compensation within 14 days after the employer notified the commission of the injury
- A disagreement over weekly payments exists
Injured employees can dispute the decision of the hearing commissioner to the full commission and, losing there, to the Court of Common Pleas and the State Appellate Courts.
Role of a Workers’ Compensation Attorney
A South Carolina workers’ compensation lawyer will prepare and submit the claim, ensure that temporary disability benefits are properly and thoroughly calculated so the client receives the full entitled amount, and will strive to achieve the full amount of permanent disability and other benefits that are allowed.
If a hearing becomes necessary, the attorney will aggressively and thoroughly represent the worker’s interests, and should the decision not be satisfactory, the attorney will argue the case before the South Carolina Workers’ Compensation Commission. If you have been injured while working, speak with an attorney that can fight to get you the damages you deserve.