What is Workers’ Compensation?
An employee who is injured on the job in South Carolina may be entitled to workers’ compensation benefits. The injured employee must report the accident to the employer no later than ninety (90) days after the accident, to be eligible for those benefits.
After notifying the employer of the accident and injury, to obtain benefits, an injured employee must file a claim with the Workers’ Compensation Commission within two (2) years from the date of the work accident.
In South Carolina, workers’ compensation provides three basic benefits to workers who have an accepted work-related injury. These benefits are summarized below:
Medical Treatment
In an accepted claim, an injured worker is entitled to treatment for a work-related injury. The employer has the right to choose which physician will treat the employee. That physician is called the “authorized treating physician.” If the injured employee chooses to be treated by a physician other than the “authorized treating physician,” the injured employee may be responsible for paying their chosen physician.
If an injured worker refuses medical treatment when offered by an employer, other workers’ compensation benefits could be terminated.
An injured worker should receive medical treatment for work-related injuries until the treating physician determines the employee has reached maximum medical improvement. Maximum medical improvement means the injured worker has reached a point in treatment when the condition will remain the same and is not likely to improve. Medical treatment may also be needed after reaching maximum medical improvement to maintain functioning at that level.
The employer, through the workers’ compensation insurance carrier, is required to pay for medications prescribed by the authorized treating physician for treatment of a work-related injury. If the carrier fails to pay for prescriptions, the injured employee should keep all receipts for prescriptions paid for out of pocket to be reimbursed.
An injured worker is entitled to reimbursement for mileage (at the approved rate), as well, if required to travel over ten miles, round-trip, to any injury-related doctor’s visit, treatment (such as physical therapy), diagnostic procedure (such as an MRI), pharmacy, or hospital.
Temporary Disability Payments
If an authorized treating physician instructs the injured worker to miss work because of the work-related injury for over seven (7) days, then the injured worker is entitled to weekly benefits beginning on the 8th day.
If out of work for longer than fourteen (14) days, the injured worker is entitled to receive weekly benefits from the first (1st) day the physician’s instruction to remain out of work.
Workers’ compensation will only pay for the days the treating physician authorizes the injured worker to be out of work. The injured worker will not be paid for any other workdays missed.
Temporary compensation is paid weekly. The compensation rate is equal to two/thirds of an employee’s average weekly wage (or gross weekly pay). The maximum monetary benefit any injured worker can receive is five hundred (500) weeks of temporary compensation, except where there is physical brain injury, paraplegia, or quadriplegia. In those cases, an injured worker is not limited to the five hundred-week maximum.
Settlement/Award
If left with any permanent disability caused by a work injury, after reaching maximum medical improvement, the injured worker may be entitled to a settlement or an award. This may be paid in one lump-sum check or in some circumstances, the Workers’ Compensation Commission may require that an award be paid in weekly checks.
The amount of a settlement or award will depend primarily on the degree of disability and the compensation rate, and, in some cases, the amount of weekly benefits the injured worker may have already received.
Causally related medical care may also be provided for the future, depending on the terms of the settlement agreement or the provisions of an award.
Do I need to hire an Attorney?
No. You can request a hearing by calling the Workers’ Compensation Commission at 803.737.5700.
Often an injured worker relies on his employer for information about workers’ compensation benefits but wonders if he or she is getting all of the benefits workers’ compensation provides.” If you do decide to consult with an attorney who practices in the field of workers’ compensation, you can find contact information for one of our attorneys here. Many will do a free case review for you.
Please note that it is unlawful for an attorney to accept any money directly from a client in a South Carolina workers’ compensation case. Any fee requested by a lawyer in a workers’ compensation claim must be approved by the Workers’ Compensation Commission, and if awarded it will be deducted from any additional benefits owed to you by the insurance carrier.