Workers’ Comp FAQ
Talk to Columbia Workers Compensation Attorneys for Answers
South Carolina workers’ compensation is a necessary benefit for workers hurt on the job. It provides insurance to pay for medical treatment, lost income from being unable to continue working while injured and compensation for permanent disability or disfigurement caused by the work accident. These benefits allow employees to recover from work injuries without fear for how they will pay the medical bills. However, the process of gaining workers’ comp benefits can be confusing, especially when a workers’ compensation claim involving severe injuries, claim denials and employer disputes.
Our Columbia work injury attorneys provide the following workers’ comp overview of common questions those hurt at work may have about the workers’ compensation process in South Carolina. However, these answers are not meant to be legal advice for your specific situation. Our firm can help address your questions during a free attorney review of your workers’ comp case if you call us or submit a case review form on our site today.
- How do I report an on-the-job injury?
- Is there a deadline to report a workersâ€™ compensation injury?
- Do I need a lawyer in my workersâ€™ compensation case?
- How do I file a workersâ€™ compensation claim?
- What if my employer tells me there is no workersâ€™ compensation insurance available?
- Do I have to go to the doctor selected by my employer or its insurance company?
- What benefits do I receive in a workersâ€™ compensation case?
- How is the weekly compensation rate determined?
- When do I start getting paid for missing time from work because of my injury?
- When do my benefits end?
- Do I have to return to light duty work?
- Does workerâ€™s compensation cover conditions such as carpel tunnel syndrome or occupational diseases?
- Do I get reimbursed for my travel expenses when I go to the doctor?
- What if I do not have transportation to get to my doctorâ€™s appointments?
- Why do we have workersâ€™ compensation? Why canâ€™t I just sue my employer?
- Can I still get Workerâ€™s Compensation even if it is my fault that I got hurt on the job?
- Can I be fired for making a workerâ€™s compensation claim?
- What happens if my on-the-job injury was caused by the negligence of a third party?
How do I report an on-the-job injury?
When you are hurt on the job, report the injury immediately to your supervisor and ask for medical treatment to be provided. Clearly state and explain to the supervisor that you are reporting a work injury. Follow up with your supervisor as needed to ensure that the claim has been reported to your employerâ€™s workersâ€™ compensation insurance company.
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Is there a deadline to report a workersâ€™ compensation injury?
It is important to promptly report your injury and file a claim, and you should do so as soon as possible after you are injured. You may lose you workersâ€™ compensation benefits if you fail to report the injury within 90 days of the date of the accident. You or your dependents or family usually must file a workersâ€™ compensation claim with the South Carolina Workersâ€™ Compensation Commission within two years of the date of the work-related accident or death of an employee. Different rules may apply in certain cases, such as occupational diseases, and you should contact our lawyers to discuss your particular situation.
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Do I need a lawyer in my workersâ€™ compensation case?
If your injury is minor and your time out of work brief and your recovery quick and complete, you probably do not need a lawyer. Your employer or insurer should pay your compensation benefits and medical bills and you should soon be back at work.
However, if any of the following apply, you should contact our lawyers for a free consultation:
- When you believe you have a serious injury which is likely to result in being out of work for a substantial period
- When you believe you are likely to have a long-term or permanent injury
- When your employer or its insurer have denied your claim or are refusing to acknowledge it
- When your employer or its insurer are denying necessary medical treatment
- When your employer tells you that there is no workersâ€™ compensation coverage
- When your employer tells you that workersâ€™ compensation coverage does not apply in your situation.
How do I file a workersâ€™ compensation claim?
Your employer should report the claim to the Workersâ€™ Compensation Commission when you first report an injury. You should confirm that the employer has done so by asking your employer, or by contacting a lawyer or the Commission. Ask your employer to give you documentation that the claim has been reported. If your employer fails to report the claim or if your claim is denied or if you are not provided medical care, you or your lawyer may file a claim with the Commission. You should discuss your case with a lawyer to ensure all your legal rights are protected.
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What if my employer tells me there is no workersâ€™ compensation insurance available?
All employers with four or more employees are required to provide workersâ€™ compensation coverage. Both private and government employees are covered by the workersâ€™ compensation system. If your employer has illegally chosen not to buy the coverage, or if the coverage has lapsed for any reason, you still may be able to obtain benefits from a special fund which covers such situations. Contact our lawyers for a free consultation to discuss your case.
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Do I have to go to the doctor selected by my employer or its insurance company?
In South Carolina, the employer or its insurer is allowed by law to decide which doctor will provide your medical care. The law requires the workersâ€™ compensation insurer to pay for all necessary medical treatment, including future treatment, related to your work injury and which is likely to lessen your disability so that you may earn a living. Workersâ€™ compensation generally pays for physician visits, surgical procedures, hospitalization, therapy, medical supplies, prosthetic devices and prescriptions.
In some cases, the workersâ€™ compensation insurer at your request may pay for you to see another doctor to obtain a second opinion about a recommended medical treatment. If the insurer refuses to do so, you may ask the Workersâ€™ Compensation Commission to order the insurer to pay for a second opinion.
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What benefits do I receive in a workersâ€™ compensation case?
You are entitled to receive the following benefits:
- Weekly compensation checks while you are out of work, which are known as â€śtemporary total disabilityâ€ť benefits when your injury prevents you from working completely.
- While you are recovering, if your injury does not prevent you from working completely but does reduce your income because you are on light duty, work fewer hours, have to be assigned to another position, etc. then you may be entitled to weekly benefits for â€śtemporary partial disability.â€ť
- Medical care and treatment for the work-related injury, including physician visits, surgical procedures, hospitalization, therapy, medical supplies, prosthetic devices and prescriptions. Future medical treatment may be covered.
- Payment for any partial or total permanent physical impairment or loss of ability to earn income, which is determined at the end of your case.
How is the weekly compensation rate determined?
Your employer must submit information showing all wages paid to you during the year before your injury, which is used to determine your â€śaverage weekly wage.â€ť Your weekly compensation rate is 66 2/3 percent of your average weekly wage. The law sets a minimum and maximum average weekly wage. If you are working two or more jobs at the time of the accident, wages from the other jobs must be included in determining your average weekly wage and compensation rate.
If you have unusual circumstances, such as a short period of employment before your injury, the law provides for other ways to calculate your average weekly wage and compensation rate in a manner that must be fair to the employee and employer. Call one of our lawyers to discuss your particular situation.
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When do I start getting paid for missing time from work because of my injury?
Workersâ€™ compensation benefits are not paid for the first seven days. Once you are out of work for more than seven days, you should receive a check from the insurance company. If you end up out of work for 14 days, workerâ€™s comp is required to go back and pay you for the first seven days that you were out as well. Weekly checks should be sent directly to you by the insurance company until the doctor releases you to return to work and until the employer or its insurer takes certain actions to terminate the benefits.
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When do my benefits end?
You should receive weekly compensation benefits until your doctor determines that you have reached â€śmaximum medical improvement.â€ť In other words, the doctor must determine that you have received all necessary medical treatment for your injury, although in some cases future treatment or medications may be necessary to enable you to work. The doctor may impose restrictions based on your medical condition, such as limits on weight you may lift or carry, or limits on standing, walking, or kneeling.
If you are released by the doctor to return to work within 150 days of notification of the accident, the insurance company may stop your weekly compensation checks by sending you a Form 15. If you disagree, you or your lawyer may object and request a hearing before the Workersâ€™ Compensation Commission.
If you are released by the doctor to return to work after 150 days of notification of the accident, your employer or its insurer may ask you to sign a Form 17 after you have been or presumably could have been back at work for 15 days. The insurer cannot unilaterally stop sending your weekly compensation benefits, but may ask for a hearing before the Commission if you refuse to agree to stop the benefits.
At the end of your case, you are entitled to receive compensation benefits for any partial or total permanent physical impairment (which is called â€śdisabilityâ€ť under workerâ€™s compensation law) or any reduction in ability to earn income. The method of calculating your right to such benefits is a complex issue governed by various laws and regulations. If you do not have a lawyer, the insurance companyâ€™s representative may or may not discuss this issue with you. Regardless, you should understand that the representativeâ€™s job is to pay you as little as possible and it is unlikely that your rights will be fully explained to you. If your injury is significant or permanent, or if you are out of work for a substantial period, you should discuss your case with a lawyer as soon as possible to ensure your rights are protected.
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Do I have to return to light duty work?
When your doctor determines that you are able to return to light duty work with your employer, you usually must do so. If you do not, the employer or its insurer may stop paying your weekly compensation benefits, although it must do so according to certain regulations. The employer is required to abide by the restrictions imposed by your doctor and must actually give you light duty work.
If you believe you cannot do the light duty work or if your employer refuses to abide by the restrictions and requires you to perform tasks beyond your physical ability, you may request a hearing before the Workersâ€™ Compensation Commission. If you return to light work before you are fully discharged by the doctor at a wage less than you were earning at the time of your original injury, you are entitled to weekly compensation at the rate ofÂ 66 2/3% of the difference between your average weekly wage and your new, lower wage.
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Does workerâ€™s compensation cover conditions such as carpel tunnel syndrome or occupational diseases?
Workerâ€™s compensation benefits are available for repetitive motion injuries such as carpel tunnel syndrome. Workerâ€™s compensation also can provide benefits for respiratory disorders or other occupational diseases that are acquired as result of exposure in the work place. Repetitive motion injuries and occupational disease claims are subject to various statutes and regulations that govern what is required in order for you to qualify for compensation. Please contact one of our attorneys for more information.
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Do I get reimbursed for my travel expenses when I go to the doctor?
You should be reimbursed by the insurance company for your mileage to your physicianâ€™s office or pharmacy if the round trip distance is more than 10 miles from your home. You must keep a log of the mileage and visits. You will be reimbursed at the rate allowed state employees for mileage.
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What if I do not have transportation to get to my doctorâ€™s appointments?
If you do not have transportation to get to the doctor or therapy appointments scheduled by the insurance carrier, upon request made in advance, the insurance carrier is required to provide you with transportation to the appointment.
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Why do we have workersâ€™ compensation? Why canâ€™t I just sue my employer?
In the mid- to late 1800s, as the Industrial Age inexorably drew people off the farms and into factories where working conditions were often hazardous, the law of negligence slowly developed to allow workers to sue their employers in a court of law. But employees were often left to fend for themselves while a lawsuit slowly proceeded in court, while employers were faced with expensive, time-consuming lawsuits by workers.
By the 1940s, most states had enacted workersâ€™ compensation statutes. There was a tradeoff under these statutes. Employees lost the right to freely sue their employer in court for on-the-job injuries (which benefited employers) and employers had to provide workersâ€™ compensation coverage to provide medical treatment and compensation quickly and efficiently to injured employees (which benefited employees). Under todayâ€™s laws, an employee usually cannot sue his or her employer in court for a work-related injury, but is limited to the exclusive remedy of workersâ€™ compensation.
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Can I still get Workerâ€™s Compensation even if it is my fault that I got hurt on the job?
In most cases, the fact that you might have been negligent or careless and were therefore partially at fault for your own injury does not prevent you from making a claim for workerâ€™s compensation. The workerâ€™s compensation system is there to provide medical care and compensation for injured workers, so you should not hesitate to make your claim even if you feel that your injury would not have happened if you had been more careful. There are certain exceptions that apply, including situations in which your injury was caused by you being under the influence of drugs or alcohol. Contact one of our attorneys to discuss the circumstances of your injury and your right to pursue a claim.
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Can I be fired for making a workerâ€™s compensation claim?
South Carolinaâ€™s workerâ€™s compensation statutes make it illegal for an employer to terminate an employeeâ€™s employment in retaliation for making a workerâ€™s compensation claim. Complex issues arise when an employee is injured and the injury limits their ability to perform their prior job. In addition to workerâ€™s compensation benefits, injured workers may have rights under the Family Medical Leave Act (FMLA), the Americans with Disabilities Act (ADA), and other state or federal law.
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What happens if my on-the-job injury was caused by the negligence of a third party?
When an employee is injured while working due to the negligence of a third party, the employee may first obtain his benefits in workersâ€™ compensation. The employee may then sue the at-fault third party in a court of law to recover damages for his or her injuries.
For example, if you are injured in a wreck while driving a vehicle for your employerâ€™s business, and the wreck was caused by another person, you may obtain workersâ€™ compensation benefits and also later bring a claim or lawsuit against the at-fault driver. As another example, an employee may have a third-party claim when he or she is injured at work while using a machine made by an outside company that could result in claim under the law of products liability. Contact one of our lawyers for a free consultation to discuss your workersâ€™ compensation case or third-party claim.
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