Most employees in Horry County don’t think about workers’ compensation unless they’re hurt on the job and need to file a claim. Then, they want information fast. Unfortunately, the information they receive is not always accurate because there are many common misconceptions about workers' compensation.
Below, we’ve listed seven of these misconceptions and provided accurate information that you need if you’ve suffered a work-related injury or occupational illness in South Carolina. If you have any additional questions or concerns, we invite you to contact our office.
7 Misconceptions About Workers’ Compensation
Workers’ comp is no-fault insurance that covers employees who’ve been hurt or developed illnesses in the course of doing their jobs. The South Carolina Workers’ Compensation Commission (SCWCC) administers and oversees the program in Horry County. The SCWCC’s rules and regulations are complex and often difficult for the average person to understand, so you might need clarification of the misconceptions below if you’d like to file a claim.
Myth #1: Every Worker in South Carolina Is Covered by Workers’ Comp
Most workers in South Carolina are covered, but there are a few exceptions:
- Only official employees who receive W-2 tax statements are eligible; contractors who receive 1099s are not.
- If it can be proven that you were under the influence of alcohol or drugs at the time of your accident, you aren’t covered.
- If you injured yourself intentionally, you aren’t covered.
- If you were committing a crime at the time of your injury, you aren’t covered.
- Only businesses with four or more employees are required by law to carry workers’ comp insurance. If your company has three or fewer employees, you have to find out whether it participates in the program voluntarily.
If your employer does not carry workers’ compensation insurance, you might be able to file a lawsuit to recover damages or get help through South Carolina’s Uninsured Employer’s Fund. A workers’ comp attorney can help you look into either of these options.
Myth #2: You Have Two Years to Report Your Work-Related Injury or Illness
You actually have only 90 days to report your accident to your employer or workplace claims representative, who then has 10 days to file your claim with the SCWCC. If your employer does not file the claim, you can do it yourself with a Form 50, which is available through the SCWCC website. You have two years to file this form, but you shouldn’t wait to report or file.
Any delay on your part could be cited by your employer’s insurance company as evidence that your injury was not as serious as you claim it was. You should report your injury and file your claim as soon as possible. If you miss a deadline, you might not receive any benefits for your injury.
Myth #3: If You File on Time, You’ll Automatically Receive Benefits
Unfortunately, this is not true at all. Your claim is most likely to be approved if:
- Your injury is minor.
- Your medical expenses are low.
- You miss only a few days of work.
- You meet all reporting or filing deadlines.
- Your employer does not dispute your claim.
If, however, your injury or illness is serious—requiring surgery or referrals to multiple doctors and a long recovery or disability care—your claim will cost the insurance company a lot of money. It does not stay profitable by paying expensive claims, so its adjusters and lawyers will try to dispute, devalue, or deny your claim for any reason they can find:
- You had a pre-existing medical condition.
- Your accident was not really work-related.
- You went to the wrong doctor.
- You were impaired by drugs or alcohol.
If your claim is denied, you’re entitled to appeal the denial at five different levels:
- Informal conference
- SCWCC hearing request
- Commission review
- SC Court of Appeals
- SC Supreme Court
The appeals process is complicated and full of procedural rules and deadlines, so you should consult a workers’ compensation lawyer if you want to appeal a denied claim successfully.
Myth #4: You May Seek Treatment From the Doctor of Your Choice
No, you may not. You must see a doctor certified by your employer’s insurance company. You should do so as soon as possible and follow all medical advice and treatment guidelines for your injury or illness. If you see the wrong doctor, you might not receive benefits.
Myth #5: You Can’t Receive Workers’ Comp Benefits and File a Lawsuit for Damages
While it’s true that you may not file a lawsuit against your employer if you receive workers’ compensation benefits, you still might have a cause of action for a third-party lawsuit against a liable party other than your employer:
- A negligent driver who caused your accident while you were driving in the course of your work
- A manufacturer of defective equipment that caused your workplace injury
- A property owner whose negligence caused you to slip and fall while doing your job outside your workplace
While workers’ comp benefits cover only your medical expenses and two-thirds of your lost wages, a third-party lawsuit might allow you to recover:
- Compensation for pain and suffering (which workers’ comp does not pay)
- Punitive damages (if the defendant’s actions were intentional or reckless)
Myth #6: Your Employer Could Fire You If You File a Claim
Your employer cannot legally fire you or retaliate against you for filing a workers’ comp claim. The company is required to keep you on until you reach maximum medical improvement (MMI) and then make reasonable accommodations for any medical restrictions you have and/or offer you a light-duty job that you can do. If you suffer any retaliation from your employer, you should contact an attorney immediately.
Myth #7: The Insurance Company and Its Doctors Will Treat You Fairly
This is not necessarily true. In some cases, doctors who have relationships with the insurance company might make decisions that favor the company more than the patient. The insurance company’s duties are to those whom it insures, not to claimants like you. This is just one more reason to have a lawyer who will:
- Examine your medical evidence and evaluate your claim
- Call in witnesses
- Negotiate to get you a fair settlement
- File appeals, if necessary, to get you the benefits you deserve
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.