Filing a workers' compensation claim might sound simple in theory. After all, your employer does most of the work... right? Nevertheless, in practice, there are some easily-overlooked steps that you must take to avoid having your claim rejected.
In this article, we'll take a close look at what steps you need to take following a work-related injury in South Carolina.
If you're seriously injured in a work-related accident, the first and most important step is to seek emergency medical care.
In South Carolina, your employer has the right to select the doctor who will treat you if you receive workers' compensation benefits. If you receive treatment from an unapproved doctor, the treatment may not be covered. However, there's an exception for emergency medical treatment.
The bottom line:
Providing written notification to your employer is one of the most important parts of the workers' compensation claim process.
There are 2 main exceptions to the notification requirement. You don't need to report your work-related injuries to your employer if:
In South Carolina, you're not responsible for filing your workers' compensation claim. Rather, your employer is legally obligated to file your claim with the South Carolina Workers' Compensation Commission once you report your injuries.
If your employer refuses or otherwise fails to file your claim, you can file your own claim by submitting Form 50 (if you're injured) or Form 52 (if a family member is killed) to the Workers' Compensation Commission.
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”). A $50 fee is required.
Your employer has the right to file an answer on Form 51, in which they will admit or deny what you said in Form 50. Your case will then be assigned to a commissioner who will hear your case in 3-5 months.
At the hearing, you and your employer have the opportunity to present your respective cases.
You're not required to be represented by an attorney at your workers' compensation hearing. However, understand that your employer will almost certainly be represented by an attorney. What's more, a workers' compensation attorney can help you gather and present evidence, including testimony from doctors and witnesses.
Keep in mind that, although workers' compensation is an exclusive remedy (meaning you can't file a claim and sue your employer), there may be situations when you can file a third-party personal injury lawsuit. An attorney will be able to review your case and tell you whether there are any other legal remedies you should be pursuing.
Once the commissioner has ruled on your case, they will issue an “Opinion and Award,” which explains their decision and what relief, if any, you may receive.
If you're unhappy with the decision made by the Workers' Compensation Commission, you can appeal the decision to the circuit court and then, if necessary, to the South Carolina Supreme Court.
An appeal must be filed within 14 days from the date you receive the “Opinion and Award.”