work comp denials

As a South Carolina employee, you have the right to a workplace that is safe and secure. However, on-the-job accidents can happen in any workplace. When work-related injuries occur, it’s important to understand your rights.

If you were injured in a Summerville workplace accident, you may have significant pain and wonder how you will support yourself. You may have questions about workers’ compensation benefits. The good news is that your employer’s workers’ compensation insurance policy may pay for the medical care you need and cover a portion of your lost wages as you recover.

Joye Law Firm has helped thousands of workers in South Carolina overcome serious injuries and seek the benefits provided by law. The law firm had six attorneys recognized in the 2021 edition of The Best Lawyers in America in the practice area of workers’ compensation. If you have questions about workers’ compensation benefits, the experienced Summerville worker’s compensation attorneys at Joye Law Firm are ready to assist. Contact us today to learn more in a free initial consultation.

Workers’ Compensation in Summerville

Under South Carolina law, eligible employees who suffer on-the-job injuries are entitled to workers’ compensation benefits.

Importantly, South Carolina workers’ compensation benefits are no-fault benefits. Workers are not required to prove that anyone was at fault for their injuries to receive benefit payments. They are entitled to benefits regardless of who caused the workplace accident— even if they were at fault for causing their own work-related injuries.

If you were injured in a Summerville work-related accident, you can protect your legal rights and begin the process of claiming workers’ compensation benefits.

Follow these steps:

  • Report the injury to your employer – One of the most important steps in the workers’ compensation claims process is promptly notifying your employer of your work-related injury. If you fail to report your injuries to your employer within 90 days, you may lose your eligibility to claim benefits. It’s always best to notify your employer in writing and then save a copy for your records.
  • Seek prompt medical attention – South Carolina employers have the right to choose which doctors will treat their employees’ injuries, under workers’ compensation rules. However, there are exceptions if an injured worker needs emergency medical treatment. You have the right to seek treatment for a specific disability from the doctor of your choice, but the appointment will not be covered by workers’ comp insurance.
  • Make sure the SCWCC is notified – The South Carolina Workers’ Compensation Commission (SCWCC) oversees the benefits provided to injured workers. Employers in South Carolina are legally obligated to file workers’ comp claims on behalf of their employees. However, it’s a good idea to pay attention to be sure your employer files your claim on time. If your employer refuses or fails to file the claim, you can file the claim yourself by sending a completed Form 50 to the SCWCC.
  • Request a hearing – If your claim is disputed or denied by your employer or their insurance administrator, you have the right to ask the SCWCC for a hearing. During the hearing, you and your employer will be able to present relevant evidence about the claim, and a member of the Workers’ Compensation Commission will make a ruling on benefits.
  • File an appeal, if necessary – If you disagree with the commissioner’s ruling after the hearing, you have the right to file an appeal with the South Carolina Workers’ Compensation Commission within 14 days of the decision. If you disagree with the South Carolina Workers’ Compensation Commission’s decision, you can take your appeal all the way to the South Carolina Supreme Court for additional review.

Types of Workers Compensation Benefits in Summerville

If you are eligible for workers’ compensation benefits, you could receive the following types of compensation from your Summerville workers’ compensation settlement:

  • Medical care benefits – Workers’ comp insurance pays for any reasonable medical expenses for the treatment of work-related injuries. This includes expenses related to identifying, diagnosing, surgeries and treating the injury. Medical benefits cover things such as hospital stays, doctors’ visits, surgical treatments, prescription medications, and durable medical equipment.
  • Rehabilitation benefits – Rehabilitation benefits may pay for any medical, psychological, or occupational therapy you need to recover from your injuries and return to work. This includes physical rehabilitation, cognitive therapy, and vocational training needed to help you regain your work-related abilities.
  • Temporary partial disability – A temporary partial disability (TPD) prevents you from returning to your usual job for a limited period, even though you can still perform certain types of work. With TPD benefits, you can receive compensation to cover up to two-thirds of the difference between the average wages you earned before and after your injury until you recover.
  • Temporary total disability – A temporary total disability (TTD) prevents you from returning to work for a period of time. TTD benefits provide compensation that will cover up to two-thirds of your average pre-injury wages until you recover enough to go back to work.
  • Permanent partial disability – A permanent partial disability (PPD) leaves you with permanent damage that partially impacts your ability to do your job. PPD benefits provide compensation that covers any amount for the loss of use of the body parts affected.
  • Permanent total disability – A permanent total disability (PTD) leaves you with extensive, permanent damage that prevents you from returning to work. PTD benefits provide compensation that covers up to two-thirds of your average pre-disability wages for up to 500 weeks. In rare cases involving paraplegia, quadriplegia, or extensive brain damage, PTD benefits may be available for life.
  • Death benefits – If an employee dies as a result of a work-related injury or illness, their surviving family members may be entitled to death benefits on their behalf. Workers’ compensation death benefits pay for reasonable funeral expenses and provide their loved ones with a percentage of their average monthly earnings to make up for the loss of their financial support.

Who Is Eligible for Workers’ Compensation?

Most full-time and part-time employees in South Carolina are eligible to receive workers’ compensation benefits, if injured while performing their job duties. Businesses and non-profit organizations with four or more employees are required to purchase workers’ compensation insurance coverage for their workers.

General contractors are also required to cover subcontractors unless the subcontractors carry their own workers’ compensation insurance.

However, the following types of employers and employees may be exempt from state workers’ compensation requirements:

  • Employers who took in less than $3,000 in revenue the previous year
  • Business owners and partners in partnerships or sole proprietorships
  • Casual employees who work irregular hours on an as-needed basis
  • Agricultural, railroad, or railway express employees
  • Licensed real estate agents working under a real estate broker
  • Federal employees of the state of South Carolina

Independent contractors are not considered to be employees. Therefore, independent contractors are not covered by the workers’ compensation insurance of employers who contract them. However, some employees intentionally misclassify workers as independent contractors to avoid providing benefits to them.

Finally, to be entitled to workers’ compensation benefits in South Carolina, your injury must be a work-related injury. A work-related injury is any injury or condition you sustain while you are on the job and performing duties related to work for the benefit of your employer. This includes certain occupational illnesses as well as injuries caused by long-term repetitive strain.

Common Workplace Injuries in Summerville

Common workplace injuries in Summerville include:

  • Back and neck injuries – Many types of work-related accidents and accumulated trauma can result in back and neck injuries such as herniated discs, whiplash, and spinal cord injuries.
  • Sprains, strains, and tears – Sprains, strains, and tears to soft tissues such as muscles, ligaments, and tendons. These injuries are commonly caused by overexertion, overuse, or improper techniques.
  • Lacerations and puncture wounds – Deep cuts and punctures may be caused by falls onto sharp objects, equipment malfunctions, or even workplace violence.
  • Repetitive strain injuries – These injuries occur due to repetitive motions or activities that cause wear and tear over time. Common examples include carpal tunnel syndrome and tennis elbow.
  • Slip and fall injuries – Slip and falls can occur in a variety of different workplaces as a result of slick surfaces, obstructed walkways, faulty steps or ladders, or lack of proper handrails.
  • Broken and dislocated bones – Fractures and dislocations can be serious and painful injuries that result in significant time away from work. These injuries may be caused by slip-and-falls, equipment malfunctions, or falling objects.
  • Traumatic brain injuries – Traumatic brain injuries (TBIs) can range from mild concussions to severe penetrative head injuries and may have life-altering consequences.
  • Electrocutions and burns – Workers who handle complex machinery or open circuitry are at risk of electrocution injuries. Employees who work with caustic chemicals or flammable substances may sustain on-the-job burns.

Frequently Asked Questions

Summerville Workers Comp Lawyer

How long can you stay on workers’ comp in South Carolina?

Under South Carolina’s workers’ compensation system, an injured worker may be eligible for workers’ compensation benefits for up to 500 weeks. If a worker suffers paralysis or a permanent brain injury due to a work-related accident, the worker may qualify to receive benefits for life. The length of time you can receive benefits will depend on the severity of your injury, your ability to work, and your medical needs.

Can you be fired while on workers’ comp in South Carolina?

South Carolina law makes it illegal for an employer to terminate an injured worker in retaliation for seeking workers’ compensation benefits or to prevent them from filing a claim. However, you can be fired for disciplinary reasons related to events that occurred before filing for workers’ comp benefits or because your employer is reducing its workforce.

If your company fires you because you are physically unable to perform your job due to your workplace injury or illness, they must still send you weekly workers’ compensation checks until a doctor says you have reached maximum medical improvement, meaning further treatment will not improve the condition.

How much does South Carolina workers’ comp pay?

Under South Carolina law, the maximum weekly compensation rate for wage replacement benefits is two-thirds of the injured employee’s average weekly wage prior to the injury or illness, not to exceed the average weekly wage in South Carolina the previous fiscal year. The average weekly wage in the state is certified by the South Carolina Department of Employment and Workforce. The cap increases every year to account for inflation.

If you have a permanent impairment rating after reaching maximum medical improvement following your work-related injury, you may qualify for a permanent disability award based on the type and severity of your impairment and your average weekly wage prior to your injury or illness.

Can you sue your employer in South Carolina?

Generally, workers’ compensation coverage bars an injured worker from suing their employer for their work-related injury or illness. That’s because workers’ compensation provides injured workers with no-fault benefits. As an injured worker, you may collect benefits after a workplace accident regardless of who is responsible for the accident that led to the injury or illness.

However, if your workplace injury or illness was caused by the negligent or reckless actions of a party unaffiliated with your employer, you may be able to file a personal injury lawsuit against the at-fault party. You can file a personal injury suit against a third party and also claim workers’ compensation.

What is the highest impairment rating?

An impairment resulting from an injury or illness can affect the way a person’s body functions. Impairment ratings are expressed as a percentage between zero and 100 and give employers and insurers an idea of how much the impairment will impact a person’s ability to work. Once an injured worker reaches maximum medical improvement, meaning further treatment will not improve their condition, a medical professional may conduct an impairment rating evaluation (IRE) to determine whether the injured employee has a partial or total disability. Typically, a person who receives a rating above 50 percent is considered to have a total disability and may be able to receive substantial benefits. However, you need to consult with an experienced workers’ comp attorney in South Carolina to get exact numbers.

What is the longest you can be on workers’ comp?

An injured employee can receive temporary wage replacement benefits for up to 500 weeks following a workplace injury or illness. If the injury or illness results in permanent disability or impairment, an injured employee can continue to receive benefits based on the type and severity of their impairment. If an employee suffers a total and permanent disability from a work-related injury or illness that prevents them from pursuing gainful employment, they may be eligible to receive disability benefits for life.

Summerville Workers’ Compensation Attorneys

It’s important to act quickly after a Summerville workplace injury. You have a limited amount of time to notify your employer and file a claim. If you fail to take action before the relevant deadlines, you could lose your ability to claim your benefits.

The Summerville Injury Lawyers of Joye Law Firm can help you establish a strong claim and file an appeal on your behalf if your employer is disputing your right to benefits. Contact us today to discuss the details of your Summerville workers’ comp case with a knowledgeable attorney.

Joye Law Firm Summerville Office Location

1731 N Main St Suite A-1
Summerville, SC 29483
(854) 220-9905