Almost all South Carolina companies and businesses with four or more employees are required by law to purchase workers’ compensation insurance, which covers the work-related injuries and occupational illnesses of their workers. If you sustain an accidental injury or develop a work-related illness in the course of performing your job duties for a company carrying workers’ comp insurance, you are entitled to file a claim for benefits.
If your claim is successful, workers’ comp will pay all your medical expenses and reimburse two-thirds of the wages you lose while off work due to your injury or illness. You don’t have to prove any negligence on your employer’s part, and you cannot be fired for filing a claim. If you lose a loved one to a work-related injury or illness, you may file a claim for workers’ comp death benefits.
What Happens After You Recover From Your Injury
When the doctor treating you for your work-related injury or illness determines that you’ve recovered to the fullest extent possible, you’ve reached the stage of maximum medical improvement (MMI). If you’ve recovered completely and are capable of resuming your previous duties, you’ll go back to work, your weekly wage benefits will stop, your medical bills will be paid, and that will be the end of your claim.
If, however, your injury or illness is a serious one that has resulted in the permanent loss of strength and/or range of motion in one or more body parts, you would be considered impaired, and your doctor must assign you an impairment rating. You still might be able to return to your job if your impairment doesn’t restrict or limit your ability to perform your necessary work activities. If your impairment does restrict that ability, you could be considered disabled and given a disability rating.
How Does an Impairment Rating Work?
Your doctor will typically rely on an American Medical Association guide or a similar publication to assign your impairment rating. Physical testing after you’ve reached MMI 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/or 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 possibly 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 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. Losing 20 percent of your shoulder function, for example, might render you completely unable to perform certain duties that require 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 a number of factors:
- 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 that 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 benefits you can receive for a permanent partial disability rating depend 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/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. Needless to say, PTD claims are the most expensive for your employer’s insurer and the most likely to be disputed, devalued, or denied.
Why You Need an Experienced Workers’ Comp Attorney
The services of a workers’ comp attorney are highly recommended for high-value disability claims. An experienced lawyer can work with your doctors, a vocational specialist, and other expert witnesses to help you get the disability benefits you deserve on the basis of your impairment rating. Your attorney may also fight your claim denial in the SC Court of Appeals if necessary.
Have You Been Injured on the Job in Charleston, South Carolina?
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, Florence or North Charleston office locations.