The short answer is no. You can’t be denied benefits for a new claim because you’ve received worker’s compensation benefits in the past.
Workers’ compensation is no-fault insurance that almost every South Carolina employer with four or more employees must carry. If you’re injured on the job or develop an illness from performing your duties, workers’ comp pays for:
- Medical expenses
- Two-thirds of lost wages
- Vocational rehabilitation
- Disability care
- Death benefits
It’s not necessary to prove your employer caused your accident or illness. If it occurred in the course of your work, you’re entitled to benefits—and you can’t be fired for filing a claim.
Common Work-Related Injuries and Illnesses
Workers’ comp covers a variety of common physical injuries and illnesses:
- Soft tissue strains/sprains
- Torn ligaments/pulled muscles
- Lung damage from toxic chemicals/fumes
- Carpal tunnel syndrome
- Dislocated joints
- Fractured/broken bones
- Shoulder injuries
- Spinal cord damage/paralysis
Although there are some exceptions, psychological/emotional issues like those below are not as likely to be covered by workers’ comp:
- Post-traumatic stress disorder (PTSD)
Other conditions are covered only if clearly connected to a work-related injury/illness:
- Heart attack
Report and File Soon
Technically, you have 90 days to report your workplace injury/illness to your employer and two years to file a workers’ compensation claim for benefits, but you definitely shouldn’t wait to do either. Any delay on your part gives the insurance company an opening to dispute your claim and allege you would have filed/reported sooner had you been seriously hurt or ill.
As soon as possible after your new accidental injury or diagnosis of your current illness, you should take the following steps:
- Provide a written report of your injury/illness to your employer or the claims administrator at your workplace.
- If your employer doesn’t file your claim with the SCWCC within 10 days, do so yourself with a form 50, available through the SCWCC website.
- See the doctor to whom your employer’s insurance company sends you.
- Follow all treatments prescribed by that doctor.
- Consult an experienced workers’ compensation attorney.
Multiple Injuries vs. Multiple Claims
If your work-related accident causes multiple injuries or you develop more than one occupational illness at the same time, you can file just one claim for all your injuries. An old injury for which you’ve already received benefits might also result in further unforeseen problems after you’ve reached maximum medical improvement (MMI). In that case, an attorney can help you petition your employer’s insurance company and/or the South Carolina Workers’ Compensation Commission (SCWCC) for additional treatments/allowances based on your original claim.
If, however, you suffer a new worked related accident or illness, you’re entitled to file a new workers’ comp claim for new benefits. There is no limit on the number of claims you may file for coverage of legitimate work-related injuries or illnesses.
Fighting the Insurance Company
Even though you’re permitted to file a new claim any time you sustain a new work-related injury, your second or third workers’ compensation claim against the same employer could encounter more resistance than your first did. The insurance company might accuse you of ignoring safety practices or hurting yourself intentionally. In such a case, your lawyer can increase your chances of success by:
- Presenting medical evidence to show your new injury or illness was unintentional and is unrelated to your previous claim
- Bringing in an expert witness/accident reconstruction worker if necessary
- Working with doctors to determine your future treatment/care costs
- Making sure any temporary/permanent disability is properly categorized
- Negotiating with the insurance company for fair benefits
- Possibly arranging for disability benefits to be paid in a lump sum
- Appealing at the following levels if your claim is denied:
- SCWCC hearing
- Commission review
- SC Appellate Court
- SC Supreme Court
If your current symptoms are actually unforeseen results of a previous injury for which you’ve already received benefits, your attorney will know how to petition the insurance company for additional allowances on that earlier claim, rather than file a new claim.
Have You Been Injured On The Job?
If you've been hurt at your job you need to speak with an experienced workers' compensation attorney as soon as possible. Please contact us online or call our Charleston, South Carolina office directly at 843.488.2359 to schedule your free consultation. We are also able to meet clients at our Conway, Myrtle Beach, Murrells Inlet, Mt. Pleasant, North Myrtle Beach or North Charleston office locations.