Am I Eligible for Workers' Compensation?
If you work for a South Carolina business or company with at least four employees, your employer is required to carry workers' compensation insurance. The workers' compensation system provides coverage for workers who are injured or become ill due to work-related accidents or conditions.
Because workers' comp is no-fault coverage, you don't have to prove that your employer was negligent or did anything wrong to cause your injury. Even if you were at fault and caused your own injury or illness, you may still file a claim with your employer's insurance company for your medical treatment and up to two-thirds of lost wages due to your work-related accident.
If your claim is approved, you'll start receiving weekly workers comp benefits equal to approximately two-thirds of your wages, and all your medical bills should be paid. The number of weeks for which you'll receive benefits depends on how long it takes you to recover. If you reach the stage of maximum medical improvement (MMI) and your doctor releases you to return to your previous job, your benefits will end. If you cannot return to the job you did before your injury, you might be given job restrictions and receive a disability rating.
What to Do After a Work Accident
If you are injured on the job, you have 90 days to report your injury to your employer, who should report it to the insurance company within ten days.
You have two years to file a workers' comp claim, but you should not wait. Waiting to report your injury or to file a claim could give the employer's insurance company a reason to dispute your claim. The insurer may argue that you would not have waited if your condition had been serious. To prevent this kind of dispute, you should do all of the following immediately after your accident:
- Report your accident and injury to your employer, preferably in writing
- If your employer does not file a workers' comp claim on your behalf or disputes your work-related injury report, file your claim with Form 50, available from the South Carolina Workers' Compensation Commission (SCWCC)
- See the doctor recommended by the insurance company
- Follow that doctor's orders and treatment recommendations carefully
- Consult a workers comp attorney if your employer or the insurance company disputes your claim or does not cooperate
South Carolina Workers' Compensation Benefits for Permanent Disabilities
Injured workers may receive workers' compensation benefits for a permanent total disability or a permanent partial disability.
Permanent Total Disability
If your permanent disability makes it impossible for you ever to return to your job, even on light duty, you're entitled to total permanent disability benefits. You are presumed to be permanently and totally disabled if you have lost the use of (or had amputated, in the case of limbs) any of the following:
- Both eyes
- Both hips
- Both legs
- Both feet
- Both shoulders
- Both arms
- 50% of the use of your back
- Two different body parts
For permanent total disability, you can collect two-thirds of your average weekly wage for up to 500 weeks, which is a little less than ten years. This time limit does not apply, however, if your injury has left you in any of the following conditions:
- Brain-damaged
- Paraplegic (legs paralyzed)
- Quadriplegic (legs and arms paralyzed)
With any of these three conditions, you can receive benefits for life.
Permanent Partial Disability
If your disability is permanent but only partial, the category of the disability determines how long you can receive lost-wage benefits:
- Loss of one eye or vision in one eye: 140 weeks
- Loss of up to 49% of the use of your back: 300 weeks
- Loss of one leg: 195 weeks
- Loss of one arm: 220 weeks
- Loss of one thumb: 65 weeks
- Loss of one big toe: 32 weeks
- Loss of one other toe: 10 weeks
Lost Earning Capacity
Workers' compensation claimants with permanent disabilities may choose to collect benefits according to the medical model outlined above or an economic model, which bases benefits on earnings lost due to permanent work-related injury or illness. If you choose to have your benefits calculated according to the economic model, you should receive either:
- Two-thirds of your pre-injury wages
- Two-thirds of the difference between your pre-injury wages and your current wages
If your injury is catastrophic but not permanent, you may still be eligible for other workers' compensation benefits.