If you’re accidentally injured or develop an occupational illness in the course and scope of performing your job duties in South Carolina, you’re generally entitled to file a claim for workers’ compensation benefits. Workers’ comp provides no-fault insurance coverage for SC workers hurt on the job. You need not prove that your employer did anything wrong to cause your injury or illness. Even if you caused your own accident, you may still file a claim, and you cannot be fired for doing so. If your claim is accepted, workers’ comp will Worker With TOS Holding His Neck and Shoulder | SC Workers' Compensation Lawyercover all your medical expenses and two-thirds of your lost wages. In some cases, vocational re-training is available to you if you cannot resume your old job after you’ve recovered.

If your injury is minor and clearly work-related and your medical bills are low, your employer might not dispute your claim, and you might not need an attorney to help you collect fair benefits. Occupational illnesses, like thoracic outlet syndrome (TOS), however, are harder to prove than accidental injuries because they can develop over time. Your employer is more likely to dispute such a condition, claiming perhaps that it’s really the result of a pre-existing condition and not work-related. In such a case, the services of an experienced workers’ comp attorney could be required to help you prove the causal connection between your work and your TOS.

What Is Thoracic Outlet Syndrome?

The thoracic outlet is a small opening between your first rib and your clavicle (collar bone). Through this outlet pass nerves and blood vessels that are crucial to the control of muscles in your upper body. Over time, work-related repetitive motions like heavy lifting, repeated arm elevation, or computer operation can result in TOS, which affects the bones around the thoracic outlet and causes compression of the vessels and nerves that pass through it. If you happen to have a “cervical rib,” which is an extra rib extending from your neck, you’re at greater risk of developing TOS. There are different subcategories of this condition:

Arterial TOS

In only one percent or so of cases, an artery is compressed. Symptoms include hand and arm pain suffered while performing overhead motions, coldness and paleness of the hand, blockage of an artery in the hand or arm (embolism), and a possible aneurysm of the subclavian artery

Venous TOS

In about five percent of cases, repeated overhead motions of the arms can cause a vein to be compressed, resulting in effort thrombosis (vessels blocked by blood clots) somewhere in the upper body. Symptoms include swelling, tingling, and a blue color in the hand and arm, as well as overly prominent veins in the hand, neck, and shoulder.

Neurogenic TOS

n approximately 90 percent of TOS cases, the brachial plexus that leads from the neck down to the arm is compressed, resulting in weakness, fatigue, tingling, and pain in the arm and shoulder.

Vascular TOS

Venous and arterial TOS can sometimes occur simultaneously.

The symptoms of TOS can also include reduced blood circulation and painful lumps in the collarbone area. Treatment usually involves a combination of rest, medication (pills or injections), physical therapy, and pain management. In some cases, surgery might be necessary to cut through muscles or remove a cervical rib that’s compressing your blood vessels.

If you ignore your symptoms and try to continue carrying out your job duties without treatment, you could suffer permanent nerve damage that might leave you unable to work at all in the future.

What to Do if You Experience TOS Symptoms

If you have a job that involves the kind of repetitive motions described above and become aware of one or more TOS symptoms, you should notify your supervisor immediately. If your employer does not file a claim for you with the South Carolina Workers’ Compensation Commission (SCWCC), you can do so yourself with Form 50, which is available on the SCWCC website. After filing your claim, you should visit a doctor certified by your employer’s insurance company (not your own doctor). Follow that doctor’s orders conscientiously, don’t miss any appointments, take all medication as prescribed, and keep a detailed daily journal of your treatment and recovery.

It's important to remember that your employer’s insurer generally certifies doctors who will diagnose you conservatively to save money for the insurance company. Doctors who cost the company money by diagnosing your injury as serious and expensive to treat might not get many more referrals from the insurer. You should contact a workers’ comp attorney immediately if:

  • You feel the certified doctor has not properly diagnosed or treated your TOS
  • You don’t feel that your condition is improving
  • The insurance company is slow to approve necessary medical treatments
  • Your claim is denied
  • You’re forced back to work before you’re ready
  • Any job restrictions given to you by the doctor are not honored
  • Your boss retaliates against you in any way for filing your claim

If your claim is denied on the basis of the report made by the insurance company’s chosen doctor, your lawyer can arrange for an independent medical exam with a different doctor and use that doctor’s report in a hearing before the SCWCC. If your claim is still denied, your attorney can appeal your claim to the SC Court of Appeals or the SC Supreme Court.

Workers’ Comp Exemptions and Exceptions

Nearly every SC employer with four or more employees is required by law to carry workers’ comp insurance, but some employers are exempt: businesses with an annual payroll of less than $3,000, county or state fair associations, railroads, and agricultural businesses. If your employer is not among the exempt businesses above, you’re probably eligible for workers’ comp benefits if you’re a salaried employee, but there are some exceptions. Those not covered by workers’ comp include federal employees of the state, independent contractors, casual employees working on an as-needed basis, sole proprietors or business partners, commissioned real estate agents working for brokers, and members of limited liability corporations (LLCs). If you’re not eligible for workers’ comp or your employer is exempt, a workers’ comp attorney can help you explore other sources of compensation for your work-related TOS, including a possible lawsuit against your employer.

Have You Been Injured On The Job In Florence?

If you've been hurt at your job in or around Florence, South Carolina, you can speak with a workers' compensation lawyer. Please contact us online or call our Florence personal injury office directly at 843.488.7540 to schedule your consultation. We are also able to meet clients at our CharlestonConwayMyrtle Beach, Murrells Inlet, Mt. PleasantNorth Myrtle Beach or North Charleston office locations.


Dirk J. Derrick
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South Carolina Lawyer Dirk Derrick helps victims recover from car accidents, personal injury & wrongful death.