Understanding your rights and responsibilities if you're injured on the job
If you're injured in a work-related accident, you typically have to file a workers' compensation claim instead of a personal injury lawsuit to recover damages.
With that in mind, let's take a look at workers' compensation claims in South Carolina, including what steps you should take immediately following a work-related accident, how to file a claim, and what benefits you may be able to recover.
What is workers' compensation?
Workers' compensation is a type of insurance that provides financial benefits to employees who are injured on the job.
There are 2 key characteristics of workers' compensation insurance:
- Workers' compensation insurance is a no-fault insurance system, meaning injured workers can receive benefits regardless of who's at fault for their injury.
- Workers' compensation is an exclusive remedy, meaning you typically can't sue your employer or colleague if you're injured in a work-related accident.
Does your employer have workers' compensation insurance?
Chances are pretty good your employer provides workers' compensation insurance.
There are only a few exceptions.
- Casual employees (employees who don't work regular hours and only work when needed)
- Employers with less than $3,000 in annual payroll in the previous year
- Agricultural employees
- Railroad or railway express company employees
- People selling agricultural products
- Licensed real estate agents working for a broker
- Federal employees of the state
Is your injury covered by workers' compensation insurance?
Workers' compensation covers both traumatic and occupational work injuries:
- Traumatic work injuries are those that result from a one-time accident at work (e.g., amputation as a result of a machine accident).
- Occupational injuries occur over a period of time (e.g., repetitive movement injuries).
In order to be covered, your injury must "arise out of and in the course of" your employment.
An injury does NOT arise out of an in the course of your employment if it occurred at work but would have occurred even if you weren't at work. For example, if you have a heart attack at work due to a genetic heart issue, you probably won't receive workers' compensation benefits because the heart attack wasn't directly related to your employment.
Along these lines, mental-health issues are generally NOT covered in South Carolina unless a physical injury accompanies them or they're "extraordinary and unusual in comparison to the normal condition of the particular employment."
Are injuries that occur on your way to work covered?
In South Carolina, you generally can't receive workers' compensation benefits for an injury that occurs on your way to work or on your way home from work. This is called the "coming-and-going rule."
There are a few exceptions to this general rule. Most notably, you might be able to receive workers' compensation if you're commuting in a company vehicle.
What benefits does workers' compensation provide?
In South Carolina, injured workers can receive the following workers' compensation benefits:
- Reasonable and necessary medical expenses (doctor's visits, surgeries, prescriptions, physical therapy, etc.)
- Wage loss benefits
- Death benefits for certain dependents
Wage loss benefits are ⅔ of your average weekly wage prior to the injury (subject to the maximum average weekly wage determined each year by the South Carolina Department of Employment and Workforce).
How long wage loss benefits last depends on the nature of your injury, with injuries falling into 1 of 3 categories:
|If you're able to return to work part-time while you're recovering or you're unable to return to work for a short period of time, you may be eligible for temporary disability benefits. Temporary disability benefits are available until you reach your medical maximum improvement or until you return to your normal job.
|Permanent partial disability
|If you suffer a permanent injury but are still able to work in some capacity, you may be eligible for permanent partial disability benefits. The length of time you can receive permanent partial disability benefits depends on your specific injury.
|Permanent total disability
|If you're totally and permanently disabled, you may be able to receive benefits for up to 500 weeks. For certain spinal injuries, you may be able to receive benefits for the rest of your life.
What should you do if you're hurt on the job?
If you're seriously injured in a work-related accident, your first step should be to seek emergency medical care if necessary.
Once you've taken care of any emergency health issues, it's time to provide written notification of your injury to your employer.
Providing written notification is one of the most important parts of the workers' compensation claim process. You must report your work-related injuries to your employer within 90 days of the accident. If you fail to do so, you may not receive benefits.
There are 2 main exceptions to the notification requirement. You don't need to report your work-related injuries to your employer if:
- Your employer already knows about the accident and injuries, or
- You're physically or mentally incapable of reporting your injuries.
How do you file a workers' compensation claim?
In South Carolina, you’re not responsible for filing your workers’ compensation claim. Rather, your employer is legally obligated to notify the South Carolina Workers' Compensation Commission of your claim once you report your injuries. Your employer’s workers’ compensation insurer will handle your claim and process your benefits.
What happens if my claim is denied?
If your workers' compensation claim is denied, you have the right to request a hearing before the Workers' Compensation Commission. To do so, complete and submit Form 50. When filling out the form, be sure to check box 13b (which states "I am requesting a hearing").
Your case will then be assigned to a commissioner who will hear your case in 3-5 months.
If you're unhappy with the decision made at the hearing, you can appeal the decision to the circuit court and then, if necessary, to the South Carolina Supreme Court.
Ready to get started? Find the best South Carolina injury attorney near you to get help through the process and secure the compensation you need and deserve.
- South Carolina Workers' Compensation: What Are Your Rights?
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The basis for personal injury law is fairly straightforward:
If you're injured because of someone's negligence, then you're entitled to recover for your financial losses related to the injury.
The premise for the workers' compensation system is similar:
Your employer is required to have specific insurance that provides benefits if you're injured at work.