Workers’ Compensation Lawyers
What is the workers’ compensation system?
Workers’ compensation, at its most basic level, is an insurance system where employers contribute payments to pay for harm that may occur to employees. Nearly all employers in South Carolina are required to participate in the workers’ comp system, meaning the vast majority of all workers in South Carolina receive workers’ comp protection. The insurance exists so that injured employees are able to recover pay for lost wages and have any medical bills paid related to workplace accidents paid. Without this important system, workers would be left to fend for themselves, likely filing expensive and time-consuming lawsuits against employers each and every time there was an on-the-job injury. The workers’ comp system streamlines this process and consolidates the claims, the goal being to make everything quicker and less expensive.
Are all employers required to maintain workers’ comp coverage?
The good news for worried employees is that nearly all employers in South Carolina are required to provide and maintain workers’ comp coverage. This ensures that the vast majority of employees in the state are covered should something happen at work leading to an illness or injury.
So what exactly does the law say? The law requires that any employer who regularly employs four or more people, either full or part-time, is required to maintain workers’ compensation insurance. The vast majority of businesses have four or more workers, meaning the vast majority of employees in the state are employed by businesses legally obligated to provide workers’ comp insurance benefits.
There are some exceptions to this general rule. For instance, agricultural employees, those employees of railroads and employees of companies with annual payroll of less than $3,000 are exempt from the worker’s compensation requirement.
What about independent contractors?
Another exception to the rule that nearly all workers in South Carolina have coverage concerns independent contractors. Workers’ compensation coverage exists to protect employees from on-the-job accidents or injuries. The key word in the previous sentence is “employees”. If you are not an employee, then the coverage provided by the employer will not apply to you. This can be problematic for workers who are deemed “independent contractors” and thus fall outside the workers’ compensation system. One important point to consider is that just because an employer claims that a worker is an independent contractor doesn’t make it true. In fact, employers often try and pass legitimate employees off as independent contractors, an attempt to lower their costs and reduce their liability. If you are an actual employee, but being treated as an independent contractor, the good news is that you can challenge this and fight to receive the workers’ comp coverage you deserve.
How to report a workplace injury
If you’ve been injured on the job or while conducting your work, it is crucial that you not only receive medical treatment, but that you report the incident to your employer quickly. Workers who delay reporting injuries to their supervisors or company management could put their entire claim at risk, potentially jeopardizing their ability to receive compensation for an otherwise valid workers’ comp case.
The law says that workers should report their injury as soon as possible, though the injury must be reported within 90 days of the accident which caused the injury. In the case of occupational disease, the requirement is that the issue must be reported within 90 days of the worker becoming aware of the illness or injury.
Though workers are required to report the injury to employers within 90 days, workers technically have up to two years to file a claim for benefits. If a worker is involved in an especially serious workplace accident and later dies, his or her family members have two years after the date of the accident to file a claim for death benefits.
How and why to file a workers compensation claim
Let’s say you were injured in a workplace accident and sought medical treatment. Since then, you’ve reported the accident to your employer, exactly as you were supposed to. So how do you go about filing a formal workers’ comp claim and why would you want to? The good news is that employees do not have to file such claims on their own. The reason is that employers are supposed to report the accident and handle and eventually pay your claim. However, this may not always happen. For one thing, employers may fail to report your claim as required. For another, your claim may be denied or you may believe the amount you were paid is incorrect or fails to compensate you properly for your injuries.
In each of these cases, it may make sense to file a claim on your own before the state Workers’ Compensation Commission. To do this, you will need to submit what’s known as a Form 50 or Form 52. This can be a complicated process and is thankfully something that a skilled Greenville, SC workers’ compensation attorney can assist with.
What workers comp benefits are you entitled to?
Those workers who are injured on the job are entitled to receive a range of benefits should their claims be approved. These benefits include payment for lost wages, payment for travel expenses to the doctor (if the roundtrip is more than 10 miles), payment of medical bills and, should the accident prove deadly, payment of death benefits to loved ones.
What medical treatment are you entitled to?
If you’ve been injured at work, you may understand that the workers’ compensation system will pay to cover your medical expenses. However, you may be curious about what exactly is deemed an approved medical expense. The law says that workers are entitled to receive payment for all necessary medical treatment that is likely to lessen your disability. That means that worker’s compensation coverage pays for things like surgery, anesthesia, hospitalization, medical supplies, prescription medications, rehabilitation and even prosthetic devices.
How are you compensated for time off work?
Injured workers are not only entitled to payment of medical expenses, but are also entitled compensation for time off work. In South Carolina, the rules say that before a worker can receive any payment for lost wages, he or she must first be out of work for seven days, this is known as a seven-day waiting period. This waiting period must first be exceeded before any lost wages will be repaid. For employees who have spent at least seven days out of work, payment will then begin and will be paid directly to the worker until the treating physician releases the employee to return to work. In serious cases where workers miss more than 14 days of work, they will then receive compensation for the first seven-day waiting period.
Many people understand that workers’ compensation insurance exists to cover workplace accidents and injuries. Something like slipping and falling or having a piece of machinery act up and cause an injury are two clear examples of when workers’ comp coverage kicks in. A less clear example concerns occupation disease. The law says that in addition to workplace accidents and injuries, workers’ comp coverage protects workers from expenses associated with occupational illness and disease.
What is an occupational disease? This is something that arises from conditions to which a worker is exposed. An example of this would be a worker who is exposed to asbestos and later develops lung problems. This exposure arises out of conditions to which the worker was exposed and will thus be covered by workers’ comp insurance, with the worker receiving benefits the same as for an on-the-job injury.
What is different and can be more complicated with occupational disease claims is the issue of causation. If a machine breaks down and cuts off someone’s finger, it is very easy to identify the cause of the injury and thus approve a workers’ comp claim. It is much more difficult to understand and investigate the potential causes of an illness or disease. Companies often challenge these claims, arguing that other factors may have led to the occupational illness. In these cases, it can be a relief to have a skilled Greenville, SC workers’ comp attorney fighting in your corner and clearly lay out your case for why benefits are deserved.
What does “no fault” mean?
The workers’ comp system in South Carolina operates on a “no fault” basis. What does that mean exactly? Good question. It means that it does not matter who was responsible for the accident occurring, no matter who is at fault the worker will receive benefits. This means that even if a worker is at fault, he or she will still be covered. This is a tremendous relief and different than most other personal injury cases where the victim must prove the accident is the fault of the defendant. In workers’ comp cases, the fact that the accident occurred at work is all that needs to be shown for the incident to be covered.
There are three exceptions to this otherwise generous rule. First, injuries that resulted from a worker’s intoxication, due to alcohol or drugs, will not be covered. Second, any injuries that occurred because a worker intentionally tried to cause harm to him or herself will not be covered. Third, injuries caused by horseplay can be excluded from workers compensation coverage also.
Another interesting aspect of the South Carolina workers’ comp system is that it is an exclusive remedy for injured workers. This means that workers must file claims within the workers’ comp system if they want to receive compensation for their injuries. Unlike other cases involving personal injury, workers are not allowed to file a civil claim for damages against their employer. Even if they don’t want to, injured workers must operate within the workers’ comp system and cannot file claims in court.
The only exception to this general rule concerns the actions of third parties. If someone other than your employer or a co-worker was responsible for causing your injuries you can sue that person in court. An example of this would be if someone from another company was visiting your office and broke a machine which then injured you. In this case, you could pursue a workers’ comp claim and you could also pursue the third party (the employee of an outside company) for damages in court.
Delay could cause you to lose your benefits and rights.