Most South Carolina businesses or companies with four or more employees are required by law to carry workers’ compensation insurance. Worker’s comp is no-fault protection that covers the medical bills and lost wages of workers who suffer job-related injuries or illnesses.
You don’t need to prove that your employer did anything wrong to cause your injury or illness. Even if it was your own fault, you could still collect workers’ comp benefits, and your boss may not fire you or retaliate against you for filing a claim.
Physical vs. Psychological Injury Following A Work Injury In Horry County
Most workers’ comp claims are filed for physical injuries that result from workplace accidents, dangerous conditions, or repetitive physical activity that leads to a medical condition over time. While it’s possible to collect benefits for work-related mental anguish or psychological problems, such claims are harder to prove and not as likely to succeed even when they’re completely valid.
According to the American Psychological Association (APA), workplace stress and tension can lead to any of the following physical conditions:
- High blood pressure
- Heart disease
- Muscle tension
- Lowered immunity
- Heart attack
The South Carolina Workers’ Compensation Act (SCWCA), however, allows benefits to be paid only for mental anguish resulting from extraordinary workplace conditions. The following conditions and events are not considered extraordinary:
- Work evaluations
- Salary reviews
- Disciplinary action
- Required overtime
Although such events might cause you stress or mental anguish, they’re normal in most job settings. You may not file a claim based on one of these events unless it occurs in an unusual or extraordinary way.
If, on the other hand, your stress or anguish is caused by a physical injury or non-standard conditions of employment, you might stand an improved chance of collecting benefits. Some examples of potentially successful claims are:
A serious physical injury or disability leads to diagnosed clinical depression, anxiety, or PTSD. If your employer tries to deny the causal connection, it must be documented by your physician, another authorized physician, or an authorized psychologist or psychiatrist.
A psychological condition brought on by extraordinary job circumstances causes a physical problem. Extreme verbal abuse or harassment from a supervisor or manager, for example, might lead to high blood pressure or an eating disorder.
A work-related event causes stress or mental anguish that leads to an ongoing psychological condition. For example, if you witnessed a co-worker’s severe injury or death on the job, the mental anguish of the experience might bring on diagnosed depression or anxiety.
Because psychological injuries are not as obvious or clear-cut as physical injuries, claims like these aren’t easy to win, especially on your own. The physical-mental claim is probably the one most likely to succeed because there is a verifiable physical injury you can cite as the basis for your psychological injury.
In any of the three, you must prove a causal connection between the workplace event and the resulting mental condition, which can be difficult, especially if there’s been a significant lapse of time between the event and the diagnosis of your condition. Most psychological workers’ comp claims require the services of an experienced attorney to succeed.
Other factors to consider include:
- Claims of mental stress due to abuse or sexual harassment by superiors might be readily paid by some employers in order to reduce such abusive behavior and avoid lawsuits.
- If you have been diagnosed with a pre-existing psychological condition like depression, addiction, anxiety, or bipolar disorder, the insurance company adjusters will know about it and try to claim that is the source of your current injury. You and your attorney must prove that work-related issues, not the pre-existing condition(s), are the primary cause of your condition.
Reporting and Filing A Workers' Compensation Claim In Horry County
To keep the time-lapse in a psychological claim as small as possible, you should follow strict reporting and filing guidelines. Although you have 90 days to report your psychological injury to your employer and two years to file a workers’ comp claim, it’s not a good idea to wait. You do not want to give the insurance company a chance to dispute your claim by saying you would have reported it earlier if your injuries were serious.
You should take the following steps as soon as you become aware of your psychological injury:
- Report your condition to your employer.
- If your employer doesn’t file a workers’ compensation claim on your behalf and/or disputes your report of a work-related illness, file your own claim with a form 50, available from the South Carolina Workers’ Compensation Commission (SCWCC).
- Even if your own doctor has diagnosed your condition, you still must see a doctor who is certified by the worker’s compensation insurance company.
- Follow the doctor’s recommendations carefully.
- Consult a workers’ compensation attorney if you experience problems getting your claim approved.
Steps in the Appeals Process For An Horry County Workers' Compensation Claim
You shouldn’t be surprised if your original claim is denied. A psychological claim is much more likely than a physical claim to be disputed, but South Carolina law gives you five opportunities to appeal a claim denial and present your evidence at increasingly higher levels:
- Informal conference
- SCWCC hearing request
- Commission Review
- SC Court of Appeals
- SC Supreme Court
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 Conway office directly at 843.248-7486 to schedule your consultation. We are also able to meet clients at our Florence, Myrtle Beach, Murrells Inlet, Mt. Pleasant, North Myrtle Beach or North Charleston office locations.