The Role of Telemedicine in Horry County Workers’ Compensation Cases

Eligibility for Worker’s Compensation Coverage In Horry County

Every South Carolina business or company with four or more employees is required to carry workers’ compensation insurance, which provides no-fault protection for employees who suffer work-related injuries or illnesses. If you’re hurt on the job, worker’s comp generally covers:

Your work injury related medical bills

Approximately two-thirds of wages you lose due to time off work for treatment/recovery

Disability benefits if you cannot return to your job

Vocational re-training (in some cases)

Death benefits (if you’ve lost a loved one due to a work-related injury or illness)

Reporting Your Accident and Filing Your Workers' Compensation Claim

In order to receive worker’s comp benefits for your work-related injury or illness, you must follow specific guidelines:

You have 90 days to report your injury or illness in writing to your employer or the claims representative at your workplace, but you should do so right away. Any delay on your part can be cited by your employer’s insurance company as proof that you’re not seriously hurt or ill.

If your employer disputes your report or does not file your claim with the South Carolina Workers’ Compensation Commission (SCWCC) within 10 days, do so yourself by using Form 50, which is available on the SCWCC website. You actually have two years to file a claim, but you should not wait.

See a doctor certified by the insurance company as soon as possible for examination and documentation of your injury or illness. You may not choose your own doctor.

Follow the doctor’s orders and treatment plans.

Consult a workers’ comp attorney if your claim is disputed/denied or if the insurance company is uncooperative.

Failure to follow these guidelines and deadlines can prevent you from collecting the workers’ comp benefits you deserve.

Telemedicine and Workers’ Compensation Benefits

According to the National Council on Compensation Insurance (NCCI), telemedicine has impacted the workers’ comp system around the country. Doctors can now use telehealth platforms to:

Quickly view, diagnose, and prescribe treatment for work-related injuries

Reduce the number of unnecessary trips to the hospital emergency room

Consult and collaborate about particular cases in real-time

Access medical data and records immediately

Take vital signs and monitor patients remotely

Help patients in remote/rural areas where there are few medical facilities

See patients quickly during times when the hospital/ER is not fully staffed

Treat patients whose injuries make travel difficult and/or painful

Reduce employers’ healthcare expenditures

The use of telemedicine can also help shorten recovery times and get workers back on the job sooner by making timely referrals to physical therapy providers and rehabilitation facilities easier. Even as the threat of COVID-19 declines, telemedicine is likely to play a larger role in workers’ comp cases than ever before.

Objections to Telemedicine for Workers’ Compensation

Of course, telemedicine is not appropriate for the diagnosis and treatment of all work-related injuries and illnesses. For especially serious and life-threatening conditions, personal contact with a physician is still necessary. Critics of telemedicine also point out other potential problems:

Language or culture barriers that might make virtual communication difficult
Security issues and privacy concerns
Increased possibility of improper diagnoses or incorrect treatment.
No established fee schedule for telehealth treatment
Technical malfunctions, loss of signal, and equipment failure in emergency situations

Nonetheless, telemedicine is probably here to stay and likely to play a growing role in workers’ compensation, especially in cases with minor injuries and minimal time off work.

Telemedicine and Insurance Companies

Most employees who file workers’ comp claims in Horry County would prefer to see their own doctors, rather than physicians certified by the insurance company, which generally exercises some control over the doctors it certifies. An insurance company-certified doctor could be more likely to:

Prescribe inexpensive treatment/medication to save the company money when more expensive remedies would be better for the patient
Claim a patient has reached maximum medical improvement (MMI) early and send that patient back to work too soon

It’s also possible that the insurance company might balk at reimbursing a patient for treatment via telemedicine or dispute the fee. The company might also recommend a doctor that does not provide telehealth care even though the employee’s injuries make leaving home for in-person treatment difficult or impossible.

If your claim is denied or the insurance company is slow or uncooperative about reimbursing you for covered expenses, a workers’ comp attorney may help you by taking the following actions if necessary:

Requesting an informal conference
Requesting a hearing before the SCWCC
Requesting a Commission Review
Appealing to the SC Court of Appeals
Appealing to the SC Supreme Court

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