Workers’ compensation is no-fault insurance that covers employees’ work-related injuries and illnesses in South Carolina. An employer is generally required by law to carry workers’ comp if there are four or more people working for the business. If you suffer an accidental injury or develop an occupational disease in the course and scope of doing your job, you may file a workers’ comp claim to recover:
- Your medical expenses, including long-term disability care
- Two-thirds of your lost wages
- Vocational retraining in some cases
- Death benefits if you’ve lost a loved one to a work-related injury or illness
Your employer is not permitted to terminate you or take any action against you for filing a claim, and you don’t have to prove your company did anything negligent to cause your injury or illness. Even if you’re responsible for your own on-the-job accident, you may still file a claim for workers’ comp benefits.
The Coming and Going Rule
Most work-related injuries occur in the workplace. Although employees are sometimes injured while traveling to or from work, claims for injuries sustained while the worker is commuting are generally denied by the employer’s workers’ comp insurance company.
The coming and going rule holds that injuries suffered by an employee on the way to the workplace or on the way home are generally not compensable because the injured worker is not “on the clock” when the accidental injury takes place. There are, however, some exceptions to this rule. You might be able to claim workers’ comp benefits for an injury sustained while you’re going to or coming from work under any of the following circumstances:
Special errand exception.
You’re hurt while running an errand or performing some other service—like getting coffee or lunch for the office staff—requested by your boss. The special errand exception applies if:
- You’re not at your regular workplace when hurt.
- You’re on your way to carry out or going home after carrying out some duty incidental to your job.
- The incidental duty is not something you normally do and not for your own benefit.
Dangerous ingress/egress exception.
The only route by which you can get to your workplace is hazardous and causes an accident that injures you.
Continuing duty exception.
You still have work to complete on your way home from the workplace and are injured in the process of doing so. (Delivering company products to a customer/client after hours or picking up supplies to bring to work the next day are examples of continuing duty.)
Employer-provided transportation exception.
You’re hurt while driving to/from work in a company car, riding in a vehicle provided by your employer, and/or receiving compensation for your travel time.
Workplace proximity exception.
You’re injured while walking to/from the parking lot/structure, between buildings, or into the cafeteria in an area controlled or owned by the company.
You’re on call outside normal business hours, called into your workplace, and injured on the way there or back home.
The outcomes of workers’ comp claims based on the exceptions above depend on the facts of each situation and vary from case to case. The commissioners who serve on the Appellate Panel of the South Carolina Workers’ Compensation Commission (SCWCC) are sometimes in disagreement over the decisions in such cases.
If your claim is at first denied, your lawyer can request an SCWCC hearing. A professional, convincing presentation of evidence showing what you were doing when you sustained your injury can make all the difference in the outcome of your claim. For this reason, the services of an experienced workers’ comp attorney are highly recommended if you’re trying to prove an exception to the coming and going rule.
What to Do If You’re Injured Going to or Coming From Work
If you’re hurt on the way to or from work, you should follow the same procedure you would follow after an accident that occurs in the workplace. Taking the steps below will protect your claim and give your attorney the best chance of proving your case is an exception to the coming and going rule. As soon as possible after your accidental injury on the way to or from work:
- Submit a detailed report of your accident and injury to your employer or the company’s workers’ comp claims administrator if there is one. Your employer should then file your workers’ comp claim with the SCWCC.
- If your employer does not do so in 10 days, file your own claim with a form 50 (for injury/illness) or a form 52 (for the death of a loved one), both available from the SCWCC website.
- Immediately see the doctor certified and recommended by your employer’s insurance company. (You may not simply go to your own doctor; doing so could cause your claim to be denied.)
- Keep all medical appointments and follow all the recommended doctor’s advice, guidelines, and treatment plans to the letter.
- During each visit to a healthcare provider, make it clear that your treatment is for a work-related injury or illness for which you’ve filed a workers’ comp claim, and give the providers your claim number. They will then probably bill the insurer directly. This reduces the chance of billing errors.
- Keep all receipts and other documentation of your medical visits and treatments.
- Make note of any delayed approval or denials of treatment expenses by the insurance company.
Although South Carolina law technically gives you 90 days to report a work-related injury or illness and two years to file your actual workers’ comp claim, don’t wait. If you delay reporting your injury or filing your claim, you give the insurance company ammunition to use against you. It could try to deny your claim by contending:
- Your injury or illness occurred after your accident and is not really work-related.
- You would have reported, filed, and sought treatment sooner if you were as badly hurt as you say you are.
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.