So, now what?
How can you get past this and have a normal, whole life again?
Since your injury is work-related, you may be eligible for workers’ compensation benefits.
Who’s Not Eligible for Benefits?
Although most workers in South Carolina are covered by workers’ compensation insurance, not everyone qualifies for workers’ comp benefits. Ineligible groups include:
- Agricultural workers
- Corporate officers
- Employees at small businesses with fewer than four employees
- Federal employees working in the state
- Railroad and railway express company employees
Report Your Injury
After your injury, report the incident as soon as possible to your employer and request medical treatment. It’s best to report your injury in writing, even if you’ve already spoken about it to your employer.
Workers’ comp law states that you must make your report within 90 days of the “accident” to qualify for benefits. Therefore, include the date of the incident and the date you’re submitting your report in your written notice. Alternatively, send your report via email, so you have timestamped proof that you made your report within the 90-day timeframe.
Seek Medical Attention
When you’re injured on the job, you’re entitled to all medical care necessary to treat your injury and lessen potential disability. You can even be reimbursed for travel expenses to and from your medical care appointments.
Workers’ compensation usually covers medical care including:
- Hospitalization
- Medical supplies
- Physical therapy
- Prescriptions
- Prosthetics
- Surgery
However, your employer—or your employer’s insurance carrier—gets to choose your doctor. You have the right to request a second opinion, but you must go through a medical practitioner approved by your employer’s insurance to do so. If you choose to seek care from a doctor different from the one provided to you, then your medical expenses won’t be covered by workers’ comp.
File a Claim
Employers will often help an employee file a workers’ compensation claim. You can also file the claim yourself.
To file a claim, you’ll need to complete and submit the correct form to the Workers’ Compensation Commission.
- Use Form 50 to file a workers’ comp claim for yourself
- Use Form 52 to file a workers’ comp claim for the work-related death of a family member
Get Compensation
Once your claim is filed and medical treatment has begun, you may get monetary compensation. The amount and types of compensation are determined by guidelines set by the state’s Workers’ Compensation Commission.
How the compensation rate is determined:
Your benefit is calculated at the rate of 66 ⅔ percent of your average weekly wages during the four quarters before your accident. If you had more than one job when you were injured, the salary from your other jobs could be factored into your average weekly wages and included in your compensation rate.
There’s a cap on compensation. You can’t receive more than the maximum average weekly wage ($806.92 as of January 1, 2017) determined annually by the South Carolina Employment Security Commission.
Missing time from work:
If you can’t return to work during your recovery, then you can get compensation for lost wages. Before your benefits can begin, there’s a seven-day waiting period from the time you stop working.
After the waiting period, you’ll receive payments from your employer’s insurance company for the time you miss after the first seven days. If you miss more than 14 days of work, then you’ll receive lost wages going back to the date you had to stop working, including the first seven days.
Types of compensation:
There are several kinds of benefit payments in workers’ comp cases. Which ones you receive will depend on your particular situation.
- Lost wages for work missed due to the work-related injury or illness
- Medical care necessary for the work-related injury or illness
- Permanent injury, such as loss of use of a limb
- Permanent partial disability, such as disfigurement
- Permanent total disability, such as loss of limbs or loss of sight in both eyes
Do I Need a Lawyer for my Workers’ Comp Case?
The process for workers’ compensation cases seems pretty straightforward—simply follow the steps above to report your accident, seek medical attention and file a claim. However, an insurance company reviewing your claim will deny benefits when they can, and your case can quickly get complicated, such as when:
- Your employer disputes your claim
- You aren’t satisfied with the settlement offer
- You are denied workers’ comp benefits
- You have pre-existing medical conditions
- Your work-related illness or injury causes permanent disability
An experienced workers’ compensation attorney can help you to submit your claim, review the facts of your case, fight for you to get a fair settlement in a hearing, and appeal adverse decisions on your behalf.
Coastal Law, LLC is on your side. We’re available to answer any questions about your workers’ compensation case in a free consultation. Contact us via our online form or call us at (843) 488-5000.
