In most cases, workers’ compensation claims are paid by insurance companies. Almost every employer in South Carolina carries workers’ compensation insurance to cover work-related injuries and illnesses. Employees hurt on the job sometimes hesitate to file workers’ comp claims, however, because they fear their employers will take action against them for costing the company money.
It’s important to remember that:
- The employer almost never bears the cost of a claim directly.
- Your employer may not legally fire you or retaliate against you for filing a claim.
Employees Covered by Workers’ Compensation
The South Carolina Workers’ Compensation Commission (SCWCC) requires essentially every company or business with four or more employers to participate in the workers’ compensation program. Almost all employees are covered, with a handful of exceptions:
- Casual employees working on an as-needed basis
- Agricultural employees
- Railroad employees
- Federal employees
- Independent contractors such as real estate agents working for brokers
- Employees of companies with annual payrolls of less than $3,000
- LLC members
- Partners in a business
- Sole proprietors
Workers’ Compensation Benefits In Charleston, South Carolina
If you suffer an accident and injury in the course of doing your job, you may file a workers’ comp claim for:
- All medical expenses related to your injury
- Wages lost due to time off work
- Temporary or permanent disability benefits if you’re unable to return to your job
- Vocational retraining for a different job in some cases
- Death benefits if a loved one dies as a result of a work-related injury or illness
Sources of Workers’ Compensation Benefits
There are three sources of workers’ compensation benefits: state programs, private insurance carriers, and self-insurance.
South Carolina employers can participate in workers’ comp through the state’s Assigned Risk Program, which is administered by the National Council on Compensation Insurance (NCCI). The employer pays NCCI a regular premium in return for coverage of work-related injuries. This option is chosen most often by:
- Small employers
- Employers unlikely to deal with many workplace injuries
Private Insurance Carriers
Employers may purchase workers’ comp insurance from private carriers and pay monthly premiums just as you do for your car, health, or home insurance. The carrier is then responsible for paying workers’ compensation benefits. This is the most common option for employers.
An employer with sufficient financial resources can request the self-insurance option, for which the SCWCC requires three years’ worth of audited financial statements showing the company meets an established financial standard. For this reason, self-insurance is the least common workers’ comp option for employers.
The SCWCC oversees self-insured companies more closely than it does any others to be sure they’re operating according to state law, following procedure, accepting legitimate claims, and paying benefits in a timely manner. A self-insured employer often handles workers’ comp claims through a third-party administrator who deals with:
- Claims processing
- Claim management
- Dispersing benefits
A self-insured employer has both a greater financial risk than others do in terms of workers’ compensation benefits and more financial resources to fight your claim. If you’ve filed a claim with a self-insured employer and have encountered disputes, denial, or slow payments, you might very well require the help of a workers’ comp attorney to get the settlement you deserve.
How to Report and File A Work Related Injury
In the great majority of cases, an employer pays monthly premiums to an insurance company that has plenty of resources to pay workers’ comp benefits, so you should not hesitate to file your claim. If you’ve been injured in a work-related injury or developed an illness due to workplace conditions, you should:
- Report your injury or illness to your employer and/or the workers’ comp claims administrator at your workplace.
- File your own claim by requesting a form 50 from the SCWCC if your employer does not immediately file a claim on your behalf.
- See a doctor certified by the insurance company.
- Follow all medical advice and treatment guidelines.
Although you have 90 days to report your injury and two years to file your claim, you should do both right away. Any delay on your part could be cited by the insurance company as evidence that your injury or illness is not serious. If your claim is disputed or denied or your employer retaliates against you, a workers’ compensation lawyer can guide you through the appeals process to get you the benefits you deserve.
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.