Yes, some family members may be eligible for workers’ compensation death benefits if a loved one dies due to a work-related injury or illness—as 4,000 to 5,000 Americans have annually for the past 10 years.
Workers’ Compensation Death Benefits
Every South Carolina business with four or more employees is required to carry workers’ compensation insurance, which provides no-fault coverage for employees’ work-related injuries and illnesses. When an employee dies as a result of a workplace injury or illness, death benefits are available to family members who were wholly financially dependent on the deceased:
- Minor children
- Adult children physically or mentally unable to support themselves
- Adult children under 23 who are full-time students
Adopted children, stepchildren, and illegitimate children are not considered completely dependent or eligible for death benefits unless they prove financial dependence on the deceased for more than 90 days before the time of death.
If your deceased loved one leaves behind no wholly dependent children, partial dependents may collect benefits according to their percentage of dependence. Any remaining benefits go to:
- Non-dependent children
- Surviving parents of the deceased
Collection of benefits can also be affected by exceptional circumstances:
- The deceased received workers’ comp benefits prior to death.
- The beneficiaries are non-resident aliens.
Due to the complexity of the distribution system, the services of a workers’ comp attorney are highly recommended for anyone trying to prove financial dependence.
What South Carolina Workers’ Comp Pays
The family of an employee who dies because of a work-related injury or illness should generally receive:
- Reimbursement for medical expenses incurred prior to death
- Approximately two-thirds of the deceased’s average weekly salary (up to a weekly cap that changes annually) for 500 weeks
- Funeral expenses up to $2,500
Reporting and Filing
Even though you’re mourning the loss of your loved one, it’s important to take the proper steps immediately after a work-related death:
- Report the death to the employer or workplace claims representative.
- File a Form 52 with the SCWCC.
- Keep all bills, receipts, and documentation for medical and funeral expenses.
- Consult an attorney.
Denials and the Appeals Process For A Charleston Area Workers' Compensation Claim
Workers’ comp death benefit claims are among the most expensive for your loved one’s employer’s insurance company to pay. If there was a significant period of time between the injury and the ensuing death, perhaps surgery or other expensive medical procedures took place. If so, the hospital bills are likely to be high. Nearly 10 years’ worth of lost wage reimbursement can also add up to hundreds of thousands of dollars.
The more expensive the claim, the more likely the insurance company is to look for ways to dispute or deny it to save money. Some common reasons for death benefit claim denials are:
- A pre-existing medical condition contributed to the on-the-job death.
- The employer maintains the deceased worker was not an employee but an independent contractor not eligible for workers’ comp benefits.
- The deceased employee’s injuries were self-inflicted/intentional.
- The employee was committing a crime or under the influence of drugs/alcohol when the fatal injury occurred.
- The employee’s fatal injury was not sustained in the course of work.
If your death benefit is denied, however, that is not the last word on your claim. The South Carolina Workers’ Compensation Commission (SCWCC) allows you to appeal the insurance company’s denial at five different levels:
- Informal conference
- SCWCC hearing request
- Commission review
- SC Court of Appeals
- SC Supreme Court
Your attorney can guide you through these difficult procedures and be sure you make no mistakes that might hurt your claim.
Have You Been Injured On The Job?
If you've been hurt at your job you can speak with a workers' compensation lawyer. Please contact us online or call our Charleston, South Carolina office directly at 843.488.2359 to schedule your 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.