When an employee is hurt on the job in South Carolina, they may file a workers' compensation claim to pay for their medical care and recover income replacement benefits. However, many rules and procedures are associated with workers' compensation claims, which can be confusing and difficult to understand. A hurt employee may even miss out on the benefits they need if they do not understand how workers' compensation works. Am I Eligible for Workers' Compensation in South Carolina?
Almost all South Carolina companies and businesses with four or more employees are required by law to purchase workers' compensation insurance, which covers their workers' work-related injuries and occupational illnesses. If you sustain an accidental injury or develop a work-related illness while performing your job duties for a company carrying workers' comp insurance, you are entitled to file a claim for benefits.
What Workers' Compensation Benefits Are Available to Me if I Am Hurt at Work?
Some of the essential workers' compensation benefits allotted to injured workers include the following:
- Medical treatment and medical expenses
- Mileage for driving to appointments
- Lost weekly wages if specific criteria are met
Under South Carolina workers' compensation law, you are eligible to receive 66 2/3 percent of your weekly wage up to a set amount determined by the SC Department of Employment and Workforce while you are out of work. Your average weekly pay is based upon certain criteria.
Injured workers also receive paid medical benefits for necessary health care, including doctors' visits, physical therapy, surgeries, and other medical services or products needed. You may also be reimbursed for mileage to and from doctor appointments.
Many factors may determine a final settlement, including a value scale determined by the workers' compensation commission. An experienced workers' compensation lawyer will thoroughly evaluate your injuries and future needs before sending a demand to settle your case.
How Does an Impairment Rating Work?
Doctors typically rely on an American Medical Association guide or a similar publication to assign your impairment rating. After you reach maximum medical improvement (MMI), physical testing will indicate what percentage of function you've lost in a particular body part (20 percent of your shoulder function, for example).
If your impairment prevents you from returning to your old job, you could be given a light-duty job that complies with restrictions set by your doctor. Restrictions could include the following:
- The number of hours you may sit, stand, and walk on the job
- How much weight you may lift
- Your break times and mealtimes
- Your ability to use stairs or ramps
If you're given a light-duty job that accommodates your restrictions, you must show up and attempt to do that job. If it pays less than your previous job did, you could receive benefits, including up to two-thirds of the difference between the salaries of the two positions.
If your employer cannot offer a light-duty job that accommodates your medical restrictions or you cannot perform the light-duty job you're given, you could receive disability benefits.
If you refuse to attempt the light-duty job, you'll receive a Form 15 stating that your benefits have been terminated by the South Carolina Workers' Compensation Commission (SCWCC). If this happens and you disagree with the decision, you may complete Section III of Form 15 to request a hearing before the Commission. At the hearing, a Myrtle Beach workers' comp attorney can advise you, present your evidence, and stand up to the lawyers representing your employer's insurer, who will likely dispute your claim.
What Is a Disability Rating?
Your impairment rating is not necessarily the same as your disability rating. For example, losing 20 percent of your shoulder function might render you unable to perform specific duties requiring 100% shoulder strength. In such a case, you're effectively disabled. Because an employer, employee, and treating physician might disagree about the employee's capacity to work, the SCWCC will examine your medical evidence to determine how much your impairment permanently impacts your ability to carry out your former job duties and decide whether to award you disability benefits.
When making this determination, the Commission will consider several factors, including:
- Your age
- Your employment history
- Your education
- Your job duties
- Your impaired body part and its percentage of lost function
- Other factors specific to your case
If the SCWCC determines you're disabled, your disability will fall into one of four categories.
Temporary Partial Disability (TPD)
If you're able to go back to work at a position that accommodates your restrictions but pays less than your previous job did, TPD benefits will pay you two-thirds of the difference between your former and present salary for up to 340 weeks or until you can return to your previous job.
Temporary Total Disability (TTD)
You could be awarded TTD benefits if you cannot return to work even with your restrictions accommodated by a light-duty job. TTD benefits provide two-thirds of your previous salary for a maximum of 340 weeks or until you're able to work again.
Permanent Partial Disability (PPD)
The maximum permanent partial disability benefits you can receive depends on the body part that is disabled and whether you still have any function in that body part. Examples of the number of weeks for which you can receive up to two-thirds of your former salary are:
- One hand: 85 weeks
- One foot: 140 weeks
- One eye: 140 weeks
- One index finger: 40 weeks
- One shoulder: 300 weeks
Permanent Total Disability (PTD)
Loss of function in any of the body parts listed below (or amputation in the case of limbs) is considered permanent and total, preventing you from ever returning to work, even at a light-duty job:
- Both feet
- Both legs
- Both arms
- Both shoulders
- Both hips
- Both eyes
- Two different body parts (one arm and one leg, for example)
- 50 % or more of your back or spinal function
PTD benefits for the impairments above cover your medical expenses and two-thirds of your previous salary for up to 500 weeks. If, however, you've suffered paraplegia (paralysis of legs), quadriplegia (paralysis of arms and legs), or brain damage, you're entitled to medical care and wage benefits for life. PTD claims are the most expensive for your employer's insurer and the most likely to be disputed, devalued, or denied.
Is There Anything I Can Do to Hurt My Workers' Compensation Case?
There are mistakes that can be made that can or will ultimately hurt your workers' compensation claim. For example, it is essential to tell your supervisor that you are hurt as quickly as possible. The law says you have 90 days to report your injury. The longer you wait to tell your employer about your injury, the harder it becomes to prove your injury was work related.
A simple rule of thumb is always to tell the truth. Not being honest with your employer, doctors, or lawyer can damage your claim significantly. It is also important to tell your doctor of all your issues stemming from your injury at work.
Failure to share all of your injuries and disabilities from the accident can hurt you in the long run if the injuries were not initially reported.
Why Do I Need an Experienced Workers' Compensation Lawyer?
The services of a Myrtle Beach workers' compensation attorney are highly recommended if you are going to file a workers comp claim. Experienced lawyers can work with your doctors, a vocational specialist, and other expert witnesses to help you navigate the workers' compensation system and work to get you fair workers' compensation benefits on the basis of your impairment rating.
