workers compensation form or document

The South Carolina workers’ compensation system is a complex state-run program that serves most employees who are injured on the job or become ill because of working conditions in North Charleston.

Because of the vast number of employees and employers the system serves, the S.C. workers’ compensation program has become a bureaucracy governed by complicated rules and regulations. Some employers and insurance administrators try to use the rules to dispute valid workplace injury claims and deny benefits to injured employees.

A knowledgeable workers’ compensation lawyer in North Charleston can help you understand whether you are entitled to workers’ comp benefits after an on-the-job injury at a South Carolina workplace. Our personal injury attorneys at Joye Law Firm in North Charleston can assess your eligibility for workers’ compensation during a free consultation. We can explain the benefits you should receive and help you file a claim or appeal a denied claim if you are eligible for workers’ comp.

Contact us for help in North Charleston, SC today.

Injured Worker Must Be Classified as an Employee

In South Carolina, if a business has four or more employees it must carry workers’ compensation insurance. That count includes full-time employees, part-time employees, and family members.

According to the South Carolina Workers’ Compensation Law, “employee” means any full or part-time employee including undocumented workers engaged under any appointment, oral or written contract, or apprenticeship and also including minors, whether lawfully or unlawfully employed.

However, the law also allows several exemptions, including:

  • Employers who had a total annual payroll during the previous calendar year of less than $3,000, regardless of the number of persons employed
  • State and county fair associations
  • Casual employees, who are hired temporarily for tasks that are not part of the employer’s usual business, trade, profession, etc. (For example, a retail store may not have to provide workers’ comp coverage to members of a lawn care crew.)
  • Farmworkers
  • Individuals who sell agricultural products for a producer
  • Railroad employees
  • Federal employees
  • Licensed real estate salespersons who work for licensed real estate brokers on a straight commission basis or as independent contractors
  • Commercial truck drivers who own or lease their trucks and work as independent contractors

Independent contractors are not employees, and therefore there is no requirement to extend workers’ comp benefits to them. An independent contractor would generally be defined as someone who:

  • Operates under specific terms of a contract
  • Uses their own equipment and tools
  • Sets their own rates, work schedules, and payment

However, employees of a subcontractor are considered employees of a general contractor. A general contractor is liable for these employees in the event their subcontractors do not maintain their own workers’ compensation insurance coverage. But a general contractor may require their subcontractors to maintain workers’ compensation insurance to work on their jobs to avoid the liability of a workers’ compensation claim from an uninsured subcontractor.

Any employer may extend workers’ comp coverage to workers they are not legally required to cover. If you become injured and know you are an exempt employee, it may be worth asking whether any coverage is in place to assist you.

Employer Must Be Insuredcustomer are signing an insurance agreement with their insurance company

Most employers who are required to provide workers’ compensation insurance to their employees do so by contracting with a private insurance carrier. Companies pay premiums, and the benefits are managed by the private insurance company with oversight by the S.C. Workers’ Compensation Commission if there is a dispute.

Some companies may obtain insurance via the state’s assigned risk program, which is administered by the National Council on Compensation Insurance (NCCI). An assigned risk program is administered to extend coverage to companies that are required to provide protection but may not be able to obtain it in the general insurance market because of a poor safety or accident record.

Employers may also self-insure. Hundreds of employers in South Carolina do. To self-insure, an employer must meet certain financial requirements, and be approved by the South Carolina Workers’ Compensation Commission.

To ensure that coverage is in place, the South Carolina Workers’ Compensation Law requires employers to file certain documentation with the Workers’ Compensation Commission. If an employer does not file the appropriate documentation, they can be fined.

You can find an employer’s coverage information through this search engine.

Your Injury Must Be Work-Related

Workers’ comp wage-replacement benefits are paid if an employee is injured by an accident arising out of the course of employment and the injured employee is temporarily or permanently disabled. In other words, to be eligible, an employee must be injured while performing assigned job duties and be unable to return to work. However, medical benefits do not require disability.

Workers’ compensation is a no-fault system. Even if the employee was at fault for the workplace accident leading to the injury, he or she can still receive benefits for a qualifying injury.

Typical workplace injuries include those caused by:Young-afraid-woman-lifting-heavy-box-in-warehouse

Workers’ compensation typically does not cover Injuries due to horseplay, fighting (unless the fight is related to work activities), or being intoxicated while on the job because these actions are not a part of the employee’s job.

If you are injured during your commute or when you leave the workplace for lunch, you may not be eligible for workers’ compensation benefits. However, if driving to make work deliveries or to attend business meetings is part of your job, for example, an injury during the drive may be considered one “arising out of and in the course of employment.” If you are in a company car, or your employer pays for your gas, you are entitled to workers’ compensation benefits.

Wage-replacement benefits are also available to an employee who has contracted an occupational disease if the disease causes them to be unable to perform their job. A disease is considered an occupational disease only if it is caused by a hazard recognized as peculiar to a particular trade, occupation, or employment and was contracted as a result of exposure to the hazard under normal working conditions.

Communicable diseases, diseases associated with aging, and diseases of the cardiac, pulmonary, or circulatory systems may not be covered unless a link to unavoidable job or workplace conditions can be established.

What Workers’ Compensation Covers in South Carolina

South Carolina has several types of workers’ compensation benefits. Injured workers may be entitled to benefits for:

  • Medical expenses. South Carolina workers’ compensation covers the full cost of necessary medical treatments related to a qualifying workplace injury or illness. This starts with emergency care in response to an accident and continues through hospitalization, convalescence, and rehabilitation.
  • Lost wages. Once an injured or ill worker has missed seven days of work as a result of their condition, workers’ compensation provides income-replacement benefits. Under South Carolina law, workers are entitled to two-thirds of their average weekly wage for the last four quarters. However, a maximum weekly compensation rate is set each year, which could affect higher-income earners. For injuries arising on and after January 1, 2021, the limit was $903.40.
  • Long-term disability. In total permanent disability cases, benefits can last for up to 500 weeks, except in cases of physical brain injury or paralysis. In these cases, a worker may be entitled to lifetime benefits.
  • Death benefits. If a worker is killed in a workplace accident or dies from an occupational illness, dependent immediate family members may claim a death benefit. Death benefits are two-thirds of a deceased worker’s average weekly wage. They may be paid for up to 500 weeks. Workers’ compensation in South Carolina can also pay up to $12,000 for funeral and burial expenses.

Contact a South Carolina Workers’ Compensation Lawyer

If you suffered a serious injury or illness on the job in North Charleston or elsewhere in South Carolina or your loved one was killed in a workplace accident, it is important to understand the workers’ compensation benefits available to you. If your employer or the insurance administrator disputes your right to benefits or the amount of benefits, do not try to handle the issue on your own. You need experienced legal guidance.

An experienced workers’ compensation attorney at Joye Law Firm in North Charleston can help you pursue the full benefits South Carolina law provides. Joye Law Firm has proudly recovered benefits for injured workers in South Carolina for more than 50 years. We will meet with you to assess your claim and explain your rights at no charge. You will not owe a legal fee unless we recover a settlement for you.

Call us at (888) 324-3100 today or contact us online to arrange your free consultation.