Answers to the most frequently asked questions from injured employees and their employers in the Palmetto State
Workers' compensation is a form of insurance that provides financial benefits to employees who are injured on the job. In South Carolina, the first workers' compensation laws were enacted in 1935.
If you were injured on the job, you probably don't have time (or the desire) to read through the entire South Carolina Workers' Compensation Act. Fortunately, we've reviewed the relevant laws and prepared straightforward answers to some of the most common questions about workers' compensation in the Palmetto State.
Workers' compensation FAQs for injured employees
First, let's take a look at some of the most common questions injured employees have about workers' compensation in South Carolina:
Who oversees workers' compensation in South Carolina?
The South Carolina Workers' Compensation Commission is the primary agency overseeing workers' compensation claims in the Palmetto State.
The laws that govern workers' compensation can be found in Title 42 of the South Carolina Code.
In addition to the laws, there are administrative rules that govern workers' compensation. These rules can be found in Chapter 67 of the South Carolina Code of Regulations.
How do I know if my employer provides workers' compensation?
You can use the South Carolina Workers' Compensation Commission's free online tool to verify that your employer carries workers' compensation insurance.
Fortunately, most employers with 4 or more employees (part or full-time) are required to provide workers' compensation insurance coverage to their employees.
Is my injury covered by workers' compensation?
For your injury to be covered, it must "arise out of and in the course of" your employment.
To put it another way, an injury is NOT covered if it would have occurred even if you weren't working (e.g., a heart attack caused by high cholesterol).
South Carolina 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., a broken leg as a result of a fall from scaffolding)
- Occupational injuries occur over a period of time (e.g., arthritis from a repetitive movement)
What's the first thing I should do if I'm injured 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 done so, you need to provide written notice of your injury to your employer within 90 days of the accident. If you fail to do so, you may not receive benefits.
How do I file a workers' compensation claim?
In South Carolina, your employer is legally obligated to file your claim with the South Carolina Workers' Compensation Commission once you report your injuries.
What benefits can I receive?
If you're injured on the job in South Carolina, you can receive the following workers' compensation benefits:
- Reasonable and necessary medical expenses (doctor visits, surgeries, prescriptions, physical therapy, etc.)
- Income replacement benefits (if you're forced to miss time or take a lesser-paying job)
- Death benefits for certain dependents
The amount of income replacement benefits you can receive depends on whether your injury is considered a permanent total disability (PTD), permanent partial disability (PPD), temporary total disability (TTD), or temporary partial disability (TPD).
Can I choose my workers' compensation doctor?
Your employer has the right to choose the healthcare providers you see for your work-related injury. In most cases, you will NOT be reimbursed if you receive treatment from an unauthorized provider.
With that being said, there are 2 things to keep in mind:
- Emergency treatment will generally be covered regardless of whether or not the healthcare provider is authorized by your employer.
- If you're unhappy with a provider chosen by your employer, you can use Form 50 to request a hearing before the South Carolina Workers' Compensation Commission to address the issue.
What can I do if my workers' compensation claim is denied?
If your workers' compensation claim is denied, you have the right to request a hearing before the South Carolina Workers' Compensation Commission. To do so, you must complete and submit Form 50. When filling out the form, be sure to check box 13b (which states "I am requesting a hearing").
In most cases, your hearing will take place within 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.
Workers' compensation is considered an "exclusive remedy." This means you must file a workers' compensation claim in lieu of a personal injury lawsuit against your employer or colleague.
There are, however, a couple of exceptions. Most notably, you can sue your employer or a colleague if they intentionally cause your injury. Additionally, you may be able to file a third-party lawsuit if a third party (i.e., someone other than your employer or colleague) causes your work-related injury.
Can I hire an attorney to help with my claim?
You're allowed to hire an attorney to help you with your workers' compensation claim. In fact, we encourage you to do so as soon as possible. An experienced attorney can help develop medical evidence, negotiate and structure a settlement, represent you in a hearing or appeal, and explore third-party lawsuits and other legal options.
Workers' compensation FAQs for employers
Now, let's take a look at some of the most common questions employers have about workers' compensation in South Carolina:
Am I required to carry workers' compensation insurance for my employees?
In South Carolina, all employers with 4 or more employees (part or full-time) are required by law to provide workers' compensation insurance coverage to their employees. The only exceptions are as follows:
- 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
What if I'm a general contractor?
Under the South Carolina Workers' Compensation Act, employees of a subcontractor are considered employees of the general contractor. This means that the general contractor is required to provide coverage to subcontractors and their employees unless the subcontractors maintain workers' compensation for their own employees.
Where can I purchase workers' compensation insurance?
You can obtain workers' compensation insurance coverage through any commercial insurance carrier licensed in the state of South Carolina. You also have the option to self-insure, but there are strict financial requirements that must be met in order to do so.
If you have trouble finding affordable coverage, contact the National Council on Compensation Insurance (NCCI) and ask about receiving coverage through South Carolina's assigned risk program.
What happens if I don't carry workers' compensation insurance even though I'm supposed to?
If you don't have workers' compensation insurance and your employee gets injured, the state can take your business assets to cover the cost of the employee's claim. The South Carolina Workers' Compensation Commission may also assess additional fines.
What should I do if an employee is injured?
Do I have to file an employee's claim if I don't believe it's legitimate?
Yes. It's important to file an employee's claim regardless of whether or not you believe they suffered a legitimate work-related injury.
If you think your employee's workers' compensation claim is invalid, you can file a Form 51 requesting a hearing in response to Form 50. In most cases, this must be done within 30 days of filing Form 50.
Can I be sued in lieu of a workers' compensation claim?
Workers' compensation is considered an "exclusive remedy," which means your employee has to file a workers' compensation claim in lieu of a personal injury lawsuit provided that you didn't injure your employee intentionally.