What benefits are you entitled to after suffering a work-related injury?
Workers’ compensation insurance provides financial benefits to workers who are injured on the job. The benefits you may receive depend, in part, on the severity of your injury.
Let’s take a look at workers’ compensation benefits in South Carolina, as well as what steps you can take to ensure you receive the benefits you deserve.
3 types of workers’ comp benefits
Workers’ compensation benefits in South Carolina are described in Title 42 of the South Carolina Code and the accompanying regulations. To receive any of these benefits, you need to file a workers’ compensation claim.
There are 3 main types of benefits:
1. Medical expenses
Workers’ compensation pays for all “reasonable and necessary” medical treatment following your work-related injury. This includes, but is not limited to:
- Ambulance transportation
- Doctor and hospital visits
- Blood work
- Diagnostic testing
- Surgical procedures and follow-up appointments
- Prescription medication
- Physical or occupational therapy
- Medical devices
- Adaptive equipment (wheelchairs, walkers, etc.)
Does workers’ compensation cover the cost of traveling to receive medical treatment?
Yes. South Carolina Regulation 67-1601 provides for the reimbursement of expenses incurred by a claimant for travel over 5 miles to receive medical treatment. Alternatively, the claimant can receive reimbursement for the cost of public transportation.
Medical expenses are covered for a period of 10 weeks, but this period may be extended depending on the nature of your injury.
2. Income replacement (or wage loss) benefits
If your injury requires you to miss work or changes the type of work that you can perform, you’re entitled to income replacement benefits (sometimes called “wage loss benefits”).
The amount of compensation you’ll receive depends on the classification of your injury:
- Permanent total disability (PTD). If your injury prevents you from doing any work in the future, you’ll receive PTD benefits. The amount you’ll receive is 2/3 of your average weekly wage prior to your injury up to the state statutory maximum. These benefits will continue up to 500 weeks.
- Permanent partial disability (PPD). If your injury is permanent but you can still work in some capacity, you’ll receive PPD benefits. The amount you’ll receive is 2/3 of the difference between your pre-injury average weekly wage and your post-injury average weekly wage (up to the state statutory maximum). The length of time you receive the benefits depends on whether your injury is “scheduled” or “unscheduled.”
Injuries that are listed in the South Carolina schedule of losses are considered scheduled. The duration of the benefits is equal to the number of weeks assigned to the injured body part in the schedule of losses.
Injuries that aren’t specifically listed in the South Carolina schedule of losses are considered unscheduled. For unscheduled injuries, your doctor will assign a “degree of impairment,” which will be used to determine the duration of your benefits up to 500 weeks.
- Temporary total disability (TTD). You have a TTD if you’re unable to return to the same or a similar job for more than 7 days. You’ll receive 2/3 of your average weekly wage prior to your injury up to the state statutory maximum.
- Temporary partial disability (TPD). If you can continue to work as you recover, but in a limited capacity, you’ll receive 2/3 of the difference between your wages before your injury and what you’re able to earn after your injury up to the state statutory maximum.
What is my average weekly wage?
Regardless of your classification, you’ll need to know your “average weekly wage” in order to calculate your benefit award.
Your average weekly wage is determined by your total gross earnings for the preceding 4 quarters (or 1 year) as reported to the Employment Security Commission. If the employment period is short, your employer can use the average weekly wage of a similarly situated employee who has worked in the same position with the same employer at the same rate of pay.
3. Death benefits
If a work-related accident causes the death of a worker within 6 years of the accident, dependents of the deceased employee can receive the following benefits:
- Two-thirds of the deceased employees average weekly wage for 500 weeks
- An additional $2,500 for funeral costs
If the deceased employee had no dependents, the full cost of the funeral is paid and additional benefits are paid to the deceased employee’s parents (or the estate if no parents are living).
Tips for getting the benefits you deserve
There are a few simple things you can do to improve your chances of receiving the maximum benefits you deserve:
- Always get approval from your employer before receiving medical treatment (unless it’s an emergency)
- Listen to your doctor’s medical advice
- Keep track of all your medical expenses
- Avoid posting anything about your injury on social media
If you have questions about the workers’ compensation claims process, or you feel the benefits you’re receiving are not sufficient, reach out to a South Carolina workers’ compensation attorney.
An experienced workers’ compensation attorney can guide you through the claims process, negotiate benefits, represent you in a hearing and through the appeals process (if necessary). What’s more, an experienced attorney can determine whether a third-party lawsuit or some other legal recourse may be available.