Workers’ compensation is a system designed to provide medical care and wage replacement benefits to employees who suffer job-related injuries or illnesses. It is a no-fault insurance program that provides coverage to employees regardless of who was at fault for the injury.
However, there are some exceptions to this coverage, and one question that often arises is whether an employee can receive workers’ compensation benefits if they cause their own injury. The answer to this question is not always straightforward and depends on the circumstances surrounding the incident.
What is Workers’ Compensation in South Carolina?
Employers with four or more employees in South Carolina must carry workers’ compensation insurance. Workers’ compensation benefits include medical expenses, wage replacement benefits, and disability benefits for injured workers who are hurt on the job.
Medical expenses may include doctor’s visits, hospital stays, surgeries, and prescription medication. Wage replacement benefits are paid at a rate of two-thirds of the employee’s average weekly wage, up to the maximum amount set by law. Disability benefits are available for employees who have suffered a permanent loss of use or function of a body part or cannot return to work due to their injury.
To be eligible for workers’ compensation benefits in South Carolina, an employee must have suffered an injury or illness that arose during their employment. The injury must also have occurred due to a work-related activity or condition and the employee must have reported the incident to their employer within 90 days of the injury.
If You Cause Your Injury, Can You Still Receive Benefits?
Generally, benefits are available to employees regardless of who was at fault for the injury due to the program’s no-fault guidelines. For example, imagine you’re trained to operate machinery at work, but one day, you get momentarily distracted and mishandle the equipment, leading to a serious injury. Even though your negligence caused your damages, you may still receive workers’ compensation benefits because you were engaged in a work-related task.
When Might You Be Disqualified for Receiving Workers’ Comp?
In many cases, workers’ compensation benefits are available to employees who suffer work-related injuries or illnesses caused by their own actions. However, you could be disqualified under certain circumstances, including the following:
- Failure to report an injury: To be eligible for workers’ compensation benefits, you must notify your employer within 90 days of the accident. You will forfeit your right to benefits if you do not inform your employer within this timeframe.
- Intentional self-inflicted injury: Intentional self-inflicted injuries are generally not covered under workers’ compensation. If you purposefully harm yourself while at work, you cannot receive benefits for the resulting damages.
- Willful misconduct: If your intentional or reckless conduct caused your injury, you may be disqualified from receiving benefits. Examples of willful misconduct include fighting on the job or committing a crime at work.
- Intoxication or drug use: If you are intoxicated or under the influence of drugs at the time of the injury, you may not receive benefits. State law provides that if traces of a controlled substance or alcohol are found within an employee’s system within 8 hours and 4 hours, respectively, of the injury, they are disqualified from compensation. This also applies to legal substances that impair your ability to perform the job.
- Outside the scope of employment: If the injury occurred outside the scope of your employment, you may be ineligible for workers’ compensation benefits. For example, if you were injured while on a lunch break or commuting to or from work, you won’t be covered under workers’ compensation.
Make Sure You Receive the Compensation You Deserve
Navigating the workers’ compensation system can be challenging, which means having the right legal representation is essential to the outcome of your claim. Our South Carolina workers’ compensation attorneys at Joye Law Firm are dedicated to helping injured workers obtain the compensation they deserve.
If you have suffered a work-related injury or illness and are seeking workers’ compensation benefits, we can help you navigate the claims process. If you believe your employer may deny your claim or you’ve already received a rejection, we can help you file an accurate claim or appeal the insurer’s decision.
We will represent you at hearings and other legal proceedings, argue on your behalf, and present evidence to support your claim to get you the benefits you are entitled to.
Contact Joye Law Firm for a free consultation if you have suffered a work-related injury or illness. Our attorneys can evaluate your case, help you understand your legal options, and fight to ensure that you receive the compensation you’re owed.