Workers’ Compensation FAQs

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Few situations bring about greater insecurity than an accident that threatens your livelihood. Workers’ compensation is designed to provide financial relief to workers injured on the job, but the system is controlled by complex laws that can be hard for most people to understand.

Joye Law Firm deals with South Carolina workers’ comp claims every day. We understand the system and are available to help you with your claim.

This page provides answers some questions we frequently hear from clients. To get specific answers to your individual questions, call Joye Law Firm now or contact us online to schedule a free case review.

Workers’ Compensation

Who is covered by workers’ compensation in South Carolina?

Virtually all employees are covered by workers’ comp, with a few notable exceptions. Workers who are determined to be independent contractors are not covered by workers’ comp – although just because your employer calls you an independent contractor doesn’t mean you are one.

One of the tests for separating employees from independent contractors is the degree of control an employer exercises over you. Factors such as whether you are salaried or provided with work equipment are also considered. Disputes over worker status are settled by the South Carolina Workers’ Compensation Commission.

Among other workers excluded from workers’ comp coverage are agricultural employees, railroad workers, federal employees and certain real estate salespeople. You may not be covered if you work for a small business that has fewer than four workers or a payroll of less than $3,000.

Most employers are required to carry workers’ compensation insurance to pay claims if employees get hurt. The general rule is that any employer with four or more full-time or part-time employees must have workers’ compensation insurance. Some of the same exceptions listed above also apply to the insurance requirement.

Our workers’ compensation lawyers at Joye Law Firm work with the system every day. We understand the complex laws and regulations regarding who is entitled to benefits and which employers are required to carry workers’ compensation insurance.

If you have questions about whether you are covered as an employee, Just Call Joye Law Firm. In a free claim analysis and consultation, our South Carolina workers’ compensation lawyers can review your situation and advise you about your legal right to workers’ comp benefits.

The consultation comes with no obligations, and no strings are attached. Since 1968 we have helped injured people like you recover not just the money they are entitled to, but also their lives. Let us help you, too. You can reach us by phone or fill out an online form for a free case review.

What types of injuries may qualify for workers’ compensation benefits?

Generally speaking, any injury you suffer while performing your normal work duties may entitle you to workers’ comp benefits. Some exceptions apply, such as if you were intoxicated when you were hurt and it is proven that your intoxication caused your work accident, or if you intentionally hurt yourself.

In addition to things we normally think of as “accidents,” you may also recover workers’ compensation benefits for occupational diseases (asbestos-related cancer, for example) and for work-related repetitive trauma injuries (such as carpal tunnel syndrome).

Although the workers’ compensation is intended to provide benefits to injured and ill employees with minimal complication, the reality often isn’t so simple. Many employers and their insurance companies try to protect their bottom lines by paying out as little as possible on claims. For example, they may challenge their obligation to pay benefits by raising such issues as alleged intoxication or arguing that an occupational disease or repetitive trauma injury was not work-related.

It is critical for injured workers to have their own advocates who can stand up for their right to workers’ compensation benefits. An attorney may work with medical experts, vocational experts and others to establish a claimant’s right to compensation and the full amount of benefits the claimant deserves under the law.

If your employer is balking at paying your workers’ compensation claim, get help from the attorneys at Joye Law Firm today. We are ready to review your situation and provide you with information about your legal rights and options.

Just call Joye Law Firm now or fill out our online contact form for a free consultation and claim review with one of our qualified South Carolina workers’ compensation lawyers.

How much of my medical expenses will workers’ compensation cover?

For those who qualify, the S.C. workers’ comp system will pay 100 percent of all “necessary medical treatment that is likely to lessen your disability.” Although you must go to the doctor your employer or its insurance carrier chooses, workers’ comp should pay for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. It even pays you for mileage if you travel more than 10 miles for treatment (57.5 cents per mile as of January 2015).

Although this sounds simple, employers and their insurance carriers often dispute medical expenses in workers’ compensation claims. For example, an employer may argue that an operation isn’t medically necessary or a procedure is not related to the workplace injury.

To make sure you get all of the medical benefits the law says you deserve, you should work with a qualified workers’ compensation attorney who will stand up for your rights. The lawyers at Joye Law Firm deal with the South Carolina workers’ compensation system every day. We are familiar with many of the tactics employers and insurance companies use in an effort to minimize what they pay out.

For legal help with your workers’ compensation claim, Just call Joye Law Firm now for a free consultation that comes with no strings attached. You can reach us by phone or fill out our online contact form.

Respect, compassion and care are what you can expect from our lawyers and staff from the first time you contact us until your case is resolved. It is one of our firm’s client commitments that we strive to return all our client’s phone calls within 24 hours or one business day.

What other benefits are available from the S.C. workers’ compensation system?

In addition to necessary medical treatment, workers’ compensation pays for loss of wages during a period of disability and compensation for permanent disability or disfigurement. Loss-of-wage compensation rates are based on 66.67 percent of your average weekly wage during the four quarters prior to your injury or illness. Benefits are capped at 100 percent of the statewide average weekly wage ($766.05 as of January 2015).

The maximum award for total disability or death is 500 weeks of compensation, unless your accident resulted in paraplegia, quadriplegia or a physical brain injury, in which case you may be eligible for lifetime benefits.

If, when you’re ready to return to work, your physician reports that you have a percentage of permanent impairment from your injury, you may receive additional compensation. The amount of compensation is decided during a conference with the S.C. Workers’ Compensation Commission and it is based on the body part that is permanently impaired, as well as the percentage of disability assigned by the commission. Disfigurement and scarring may also qualify a worker for additional benefits, but typically only if “you have a non-surgical scar that can be seen at least eight feet away.”

If your case involves lost wages, it is very important to get help from a qualified workers’ compensation attorney who can protect your right to fair benefits. The stakes are often very high in cases that involve permanent disability – and particularly those in which lifetime benefits are a factor. Employers and their insurance companies are likely to dispute claims when so much money is on the line.

Joye Law Firm’s workers’ compensation attorneys deal with the system every day. We can help you fight for the full benefits the law says you deserve. Just call Joye Law Firm now for a free consultation about your workers’ compensation claim. You can reach us by phone or fill out our online contact form.

What are the deadlines for filing a workers’ compensation claim in South Carolina?

State law requires you to give notice to your employer “on the occurrence of an accident, or as soon thereafter as practicable,” but in any event, within 90 days after the accident. With repetitive trauma cases, you must give notice within 90 days of the date you discovered or should have discovered that you have a compensable condition.

There are some narrow exceptions to the 90-day notice rule, such as if a mental or physical incapacity prevented you from giving notice. An exception may also apply if you were prevented from giving notice due to the fraud or deceit of a third party.

Assuming that you give notice within the 90-day period, you then generally have two years to file your claim. Repetitive trauma cases require a filing within two years after “you knew or should have known” that you have a compensable injury, but no more than seven years after your “last date of injurious exposure.” Occupational disease claims must be filed within two years after you were definitively diagnosed with the condition and notified of it. None of these time limits apply to claimants who are mentally incompetent and have no guardian or trustee.

Because the South Carolina workers’ compensation system has strict notice requirements and filing deadlines, it is important to work with an attorney who understands the deadlines and how exceptions may apply. Joye Law Firm’s workers’ compensation attorneys deal with the system’s complex laws every day in their practice. Even if you think you may have waited too long to file a claim, you should still talk to an attorney to see if you may still be entitled to compensation.

Since 1968 we have helped injured people like you recover not just the money they are entitled to, but also their lives. Let us help you too. Just callJoye Law Firm now. You can reach us by phone or fill out an online form for a free case review.

Can’t I just use my own health insurance instead of claiming workers’ comp benefits?

South Carolina workers’ compensation provides significant benefits that are most likely not available through your health insurance. Unlike most private health insurance plans, workers’ compensation will pay for 100 percent of the medically necessary treatments that are related to your workplace injury. There are no deductibles, no co-payments and no lifetime caps.

If your on-the-job injury causes you to miss work, you could qualify for disability benefits – something that is unavailable under virtually all health insurance plans. Workers’ compensation will even reimburse you for mileage if you must travel more than 10 miles to appointments or the pharmacy.

Out of fear that a claim may make insurance premiums rise, an unscrupulous employer may encourage you to use your own health insurance instead of seeking benefits from the workers’ compensation system. It is illegal in South Carolina for an employer to require a qualified employee to pay for any medical treatment necessitated by a job-related injury.

You should not be discouraged from filing a workers’ compensation claim because you think it would be easier to rely on your health insurance. Joye Law Firm’s lawyers understand the complex laws and regulations and can guide you through the workers’ compensation process to ensure that you get the maximum benefits you deserve. Let us handle the bureaucracy while you focus on your health.

It costs you nothing to discuss your case with one of our lawyers. Joye Law Firm handles workers’ compensation claims on a contingency basis. That means you pay us no legal fees up front. We get paid a fee only if you recover benefits.

South Carolina law limits attorney fees to a third of the recovery amount in workers’ compensation cases. The South Carolina Workers’ Compensation Commission, however, must approve all fees a workers’ comp lawyer charges a client. In order to be approved, fees must be deemed “reasonable.”

If you have more questions or are ready to get started now, Just call Joye Law Firm or fill out our online contact form for a free claim review and consultation.

Can I file for workers’ compensation benefits and Social Security Disability Insurance (SSDI)?

It is possible to simultaneously file a claim for Social Security Disability and workers’ compensation, but if your claim for both is successful, your SSDI benefits may be partially offset by your workers’ comp benefits if the total amount of these benefits exceeds 80 percent of your average current earnings. This is referred to as a “workers’ compensation offset.”

Many people may not be aware of this quirk of workers’ compensation law. While that is completely understandable, it could also be very costly for someone who is disabled and in need of benefits to get by.

Workers’ compensation offsets are particularly critical for SSDI recipients when a workers’ comp award is made in a lump sum. The interplay between the complex rules for SSDI and the complex rules for workers’ compensation can cost families thousands of dollars if handled improperly.

Joye Law Firm’s attorneys work with both systems every day and understand issues that arise when someone is entitled to benefits under both SSDI and workers’ compensation. We have helped many clients structure their workers’ compensation awards in a way that will minimize the effect on their SSDI benefits.

A properly structured workers’ compensation award can help ensure that you do not give up too much money in an offset that applies to your SSDI benefits. To find out how our lawyers can help you recover the maximum benefits you deserve from SSDI and the South Carolina workers’ compensation system, Just call Joye Law Firm. You can reach us by phone or fill out an online form for a free case review and advice about your legal rights and options.

Sources:

  • South Carolina Workers’ Compensation Commission

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