Employees injured on the job often turn to their company’s workers’ compensation insurance to pay medical bills and provide wage replacement benefits. However, it can be complicated and confusing to navigate through the claims process. Facing bills and medical costs while waiting for your benefits to start adds stress to an already frustrating time in your life.
To help you understand more about how this program works, here are some frequently asked questions (FAQs) about Charleston workers’ compensation.
WHAT IS THE PURPOSE OF WORKERS’ COMPENSATION?
Worker’s compensation is a kind of insurance that companies must provide for their employees in case of a work-related injury or illness. It has two main purposes:
- It provides critical benefits for workers if they are hurt while performing their jobs.
- It allows employers to avoid a lawsuit every time someone is injured.
The employer is not the only one who benefits from avoiding a lawsuit. Most workers just want to get better and get back to work. If you have to fight a court case to get the money you need to pay your medical bills, it could take a long time. Meanwhile, your condition could get worse if you are afraid to see the doctor without compensation.
Workers’ compensation takes care of your bills and pays you part of your wages. It lets you focus on your health and avoid worrying about how to support yourself. Your body and your health are crucial to a happy life. When you have been hurt doing your job, worker’s compensation can help you concentrate on overcoming your injury faster and getting back to your life.
WHO CAN FILE A WORKERS’ COMPENSATION CLAIM IN CHARLESTON, SC?
Nearly all employees in South Carolina are covered under the laws that oversee the Workers’ Compensation Act. If a company has more than four employees, they must carry coverage for their workers in the event of a work-related injury or illness. There are some exceptions, but most employees can claim benefits.
Many people believe workers’ compensation is only meant for employees in construction or other dangerous industries. However, no matter what kind of environment you work in, you are eligible. Provided their company meets the requirement to provide coverage, there are many employees who can file workers’ compensation claims, such as:
- Restaurant workers
- Retail employees
- Landscaping workers
- Cashiers
- Grocery store employees
- Salespeople
- Healthcare providers
Each of these workers puts their bodies on the line for their jobs, and they can all be eligible to receive benefits to help them heal after a work-related injury or illness.
WHAT BENEFITS DOES WORKERS’ COMP PAY IN CHARLESTON, SC?
Workers’ compensation for Charleston injury claims will pay benefits that include:
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Compensation for treatment: Provided your injury or illness is directly caused by something that happened at work, you are eligible for payment to cover your medications, therapy, surgery, and other care for the duration of your recovery.
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Partial wage replacement: Worker’s comp will pay two-thirds of your average weekly income when your condition is verified as work-related and causes you to miss at least seven days of work.
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Disability benefits: If you are unable to work for an extended period due to your injury or illness, you can qualify for temporary or permanent disability benefits.
Temporary disability benefits are paid until you are considered well enough to return to work. If you are permanently disabled, you will receive a disability rating from your doctor that indicates whether you are partially or totally disabled permanently.
With partial permanent disability, you may still qualify for light-duty work with your employer. This allows you to receive partial benefits from workers’ comp to supplement your light-duty salary, which may be less than your previous income. With total permanent disability, you can be eligible for lifetime medical payments and 500 weeks of partial wages.
HOW MUCH DOES WORKERS’ COMP PAY FOR MY WAGES?
Your workers’ comp insurance company will take your average weekly wage and pay you 66 and ⅔% of that for each week you are out of work. This amount changes each year and is calculated by the SC Workers’ Compensation Commission. As of January 1, 2023, the current maximum amount you can receive weekly is $1,035.78.
These partial wages allow you to focus your attention on getting better and recovering from your injury or illness. You can worry less about supporting yourself and your family. You also do not have to pay for your medical costs since workers’ compensation will ensure you get the care you need so you can return to better health.
WHAT SHOULD I DO IF I HAVE BEEN INJURED AT WORK?
When you suffer an injury or illness as a result of your job, you must first seek medical treatment. Once you are stable, state law requires you to report your accident to your supervisor or manager within 90 days. This protects your claim so you can receive benefits and defends against any arguments that your injury was not work-related.
It is important to not only notify your employer but also to file a Form 50 – Workplace Injury Form with the SC Workers’ Compensation Commission. Your company should do this on your behalf when you tell them about the injury or illness, but they may fail or refuse to do so. Filing the form yourself ensures your claim is established so you can receive your benefits.
If you suffer an illness from a communicable disease due to exposure at work, the 90-day rule is extended to up to two years after your diagnosis. However, any delay could prompt the insurance company to question the source of your injury or illness, so it is best to act quickly.
For example, if you work in an office, you could hurt yourself moving materials around or develop carpal tunnel syndrome from typing.
CAN I VISIT MY PERSONAL DOCTOR FOR TREATMENT AFTER A WORK-RELATED INJURY?
In the event of severe injury, you naturally can be taken for emergency care at a hospital without worrying about how it will affect your claim. However, if your accident is less serious, you should still get evaluated and treated right away to establish a connection to prove your injury is work-related. Workers’ comp in SC requires you to get care from a doctor who is authorized by your employer.
If you visit your personal doctor and they are not included in the list of authorized providers, the workers’ compensation insurance company could choose to deny your benefits. You must also follow the doctor’s orders and keep all your appointments for treatment.
HOW SOON SHOULD I FILE MY CLAIM FOR BENEFITS?
The law allows up to two years from the date of your injury or illness to file your benefits claim. Ideally, you will file right away to take advantage of the full benefits you deserve. With accidents, most employees will begin their claim right away so they can have their medical bills paid and receive their partial wages. However, some injuries and illnesses can take time to appear.
For example, repetitive strain injuries (RSIs) such as carpal tunnel syndrome, tendonitis, back and neck strains, and shin splints may not get bad enough to prevent you from working for several months. When they finally require treatment, you may worry it is too late to apply for worker’s compensation.
In cases involving RSIs or illnesses, the filing window starts with the time you could have reasonably known about the injury or disease. This may be longer than two years, but the claim must be filed no later than seven years from the last time you were exposed to the disease or repetitive trauma.
CAN MY EMPLOYER FIRE OR DEMOTE ME IF I FILE A CLAIM?
Under SC 41-1-80, your employer cannot retaliate against you for filing a workers’ compensation claim. This does not protect you against losing your job or being demoted if you violate other company requirements. You are still subject to standard disciplinary procedures.
You should do your best to continue performing your duties after filing your claim. Your employer or its representatives cannot discourage you from making a claim or retaliate in any other way. If you feel you are being treated unfairly after filing your claim, speak with our qualified Charleston workers’ compensation attorneys to protect your rights.
SHOULD I ACCEPT LIGHT-DUTY WORK FROM MY EMPLOYER?
If your doctor has determined you can return to light-duty work and your employer offers it, you must accept the work. If you have been cleared for light-duty employment and you refuse, you could lose your workers’ compensation benefits.
If there is no work you can perform, you can still receive your benefits. However, if your employer refuses to make light-duty work available to you and claims you must stop receiving benefits, you should speak with an attorney right away.
HOW QUICKLY SHOULD I SETTLE MY WORKERS’ COMPENSATION CLAIM?
Every workers’ compensation case is unique because every person will recover at different rates. An injury or illness that takes a person in their 20s six weeks to overcome can leave an older worker with a permanent disability. It is critical that you have professional guidance when deciding when to settle your claim and for how much.
For example, repetitive strain injuries can affect your work and your personal life. Getting treatment to correct the problems may require multiple surgeries. You could need supplemental care for a few months or even years, which must be accounted for in your settlement. Having the right amount of compensation lets you put your energy into recovering and being your best on the job and at home.
It takes an experienced attorney to assess your situation and help you calculate a fair and appropriate settlement amount. Your lawyer may determine that your case is worth far more than what you have been offered. They can prevent an insurance company from taking advantage of you.
POTENTIAL VALUE OF EACH BODY PART IN A WORKERS’ COMP CLAIM
In South Carolina, state law describes the maximum number of weeks you can receive benefits for injuries to specific parts of the body. Knowing this can assist you in understanding just how valuable your claim could be. Injury to respective body parts will qualify for coverage as follows:
- Arm: 220 weeks
- Back: Up to 500 weeks
- Disfigurement: 50 weeks
- Eye: 140 weeks
- Foot: 140 weeks
- Hand: 185 weeks
- Hip: 280 weeks
- Leg: 195 weeks
- Shoulder: 300 weeks
- Thumb: 65 weeks
WHAT SHOULD I DO IF MY WORKERS’ COMPENSATION CLAIM IS DENIED?
Claims may be denied if you failed to follow the reporting procedure or did not use an approved physician. There are many other reasons the insurance company could deny your benefits, and understanding how to fight back can be confusing.
Your best option is to speak with an experienced workers’ comp attorney to help you determine how to appeal the denial and get your benefits back on track. There are several steps to the appeals process, and your lawyer can manage the paperwork and conversations for you. They will also appear with you at hearings and represent your interests.
WHY SHOULD I HIRE A WORKERS’ COMPENSATION ATTORNEY?
A workers’ comp attorney can take a lot of the burden off your shoulders when you file and appeal your claim. They ensure things work smoothly from start to finish by explaining how South Carolina workers’ compensation laws work and apply to your claim. They give you qualified legal advice and help you avoid mistakes that could jeopardize your claim.
A qualified workers’ compensation lawyer like Hirak Pati understands your concerns about recovering your health while protecting your rights. He listens compassionately to your story and will work to ensure you get the full benefits you deserve. Hirak educates clients so they can make informed decisions about their worker’s comp claims.
Your job may not require handling a lot of paperwork and managing forms. A skilled Charleston workers’ compensation attorney can take this burden off your shoulders by managing all aspects of your case on your behalf. We will negotiate with insurance representatives to maintain your benefits while you heal. If your case goes to court, we are prepared to fight fiercely to secure the settlement you need to get back to your life.
WHAT IF MY WORKERS’ COMPENSATION CASE GOES TO COURT?
Sometimes, the insurance company may argue that your injury is not work-related. You may need to provide additional information to support your claim. They might insist that you are ready to return to work, but you are still having pain that keeps you from performing your work duties. In situations like these, negotiations may break down, and it becomes time to take your case to court.
Pati Law Firm will develop a robust case on your behalf. We will present evidence we have gathered to demonstrate your claim is valid. We fight back against the workers’ comp insurance company, refuting their allegations and arguments, trying to reduce your settlement. We are not afraid of standing up to large insurers who are not concerned about your health and recovery.
Our team will stand by your side every step of the way to get the benefits and compensation you need to return to full health. Contact us today to schedule a consultation and learn more about how we can guide you through the workers’ compensation claim process.