If you’ve been hurt at work, what do you need to do about workers’ compensation benefits and what should you do next?
In this article, we will review the basics of what you need to know to get the ball rolling and begin collecting worker’s comp benefits after you’ve been hurt at work, including:
- When you are eligible for benefits,
- When you are not eligible for benefits,
- What to do after you are hurt at work,
- What compensation you are entitled to, and
- When your benefits will terminate.
Hurt at Work in SC: Are You Eligible for Benefits?
The first question after being hurt on the job in SC is whether your injuries are compensable – who is eligible for benefits, and are there situations where you are not eligible for benefits?
Who is Eligible for Benefits?
If you are hurt at work, you should be covered by workers’ compensation insurance, but there are some situations where you may not be covered.
Usually, if you 1) are an employee 2) who suffered an injury 3) during the course and scope of your employment, you should be covered by workers’ compensation.
Are You an Employee?
SC Code § 42-1-130 defines that an employee is any person engaged in any employment, contract of hire, or apprenticeship, expressed or implied.
Independent contractors are not covered by workers’ compensation insurance, although whether someone is an independent contractor is not always clear-cut. If you are not sure whether you should be classified as an employee or an independent contractor, call us for a free evaluation to determine whether you qualify for workers’ comp benefits.
In addition to independent contractors, SC Code § 42-1-360 lists additional employees and employers who are exempt from coverage, including:
- Casual employees,
- Employers with less than four employees or who have a total annual payroll of less than $3000,
- State or county fair associations,
- Agricultural employees,
- Railroad workers, ad
- Federal employees.
Did You Suffer an Injury?
Of course, injury has a specific meaning in SC workers’ compensation law.
SC Code § 42-1-160 defines “injury” as “only injury by accident arising out of and in the course of employment and shall not include a disease in any form, except when it results naturally and unavoidably from the accident and except such diseases as are compensable under the provisions of Chapter 11 of this title.”
Ordinarily, this means physical injuries caused by a sudden event, like a broken leg or a crushed hand, but SC workers’ compensation laws also define injury as including:
- Repetitive trauma injuries (like carpal tunnel syndrome or tendonitis),
- Occupational diseases when they are caused by your employment, and
- In some cases, heart attacks, strokes, mental injuries, or mental illness.
Did the Injury Happen in the Course and Scope of Your Employment?
This is an area that is often litigated by insurance defense lawyers – if you were doing anything that is required by your job duties when you were hurt at work, you should be covered.
For example, this could include:
- A fall from a roof, when your job is to install roofing,
- Carpal tunnel syndrome, when your job is to type on a computer,
- An auto accident, when your job is to deliver pizzas, or
- Electrocution from a loose wire, when your job is to work on the construction site where you encountered the wiring.
It would not include:
- A fistfight in the break room, because your coworker insulted your mother,
- An auto accident on your way to work in the morning (although there are some exceptions), or
- Lung cancer caused by smoking cigarettes during your work breaks.
What to do if You are Hurt at Work in SC
1. First, immediately report your injury to your employer. Although you have 90 days to report the injury before losing your right to claim workers’ comp benefits, you will have a more difficult time making your workers’ comp claim if you did not immediately inform your employer and document what happened.
2. Get medical attention – you are entitled to all necessary medical attention, and workers’ compensation will cover your medical expenses. Your employer or their insurance company has the right to choose your doctors initially, but you also have the right to seek a second opinion from an independent medical provider.
3. File a workers’ compensation claim. Your employer may help you to fill out the paperwork and file your claim. (You should complete an accident/incident report and explain how the injury occurred and what parts of your body were injured.) If your employer does not file a claim, then you can file the claim on your own or get help from a SC workers’ compensation lawyer.
If your claim is denied, if your employer did not report your injury, or if your employer denies that you were hurt at work, you or your attorney can request a hearing with the SC workers’ compensation commission.
What Compensation Are You Entitled to if You Are Hurt at Work?
The type and amount of compensation you receive when you are hurt at work may depend on:
- The degree of injury,
- Your average weekly wage,
- Your medical impairment rating, and
- Your disability rating.
You will not receive compensation for pain and suffering, punitive damages, or any other type of noneconomic damages that might be available in a civil lawsuit, but you can receive compensation for your medical costs and lost wages.
Your compensation rate is determined by your average weekly wage. For example, if you suffer a total disability, you can receive weekly compensation for lost wages at 66 and 2/3 the amount of your average weekly wage.
The compensation for lost wages is capped at $903.40 per week in 2021, but the caps are subject to change from year to year.
SC Code § 42-9-30 provides the maximum compensation available for the loss of use of various body parts, ranging from five weeks for the loss of part of a toe to 500 weeks for the loss of use of your back or other body parts or organs not listed in the statute.
Termination of Benefits
When do workers’ compensation benefits terminate?
The short answer is that your benefits end when your doctor releases you to return to work. If you are released to “light duty,” you must accept it, or your benefits will end.
If your benefits are terminated early, you can request a hearing with the workers’ compensation commission to present medical evidence showing why your benefits should not have been terminated or why you are unable to return to work.
Questions About What to Do If You Are Hurt at Work?
Your SC workers’ compensation attorney can increase your chances of success by helping you to gather your medical evidence, answering your questions, representing you before the SC workers’ compensation commission, and filing any necessary appeals on your behalf.
If you need help applying for workers’ compensation benefits, requesting a workers’ compensation hearing, or appealing an unfavorable decision, call the Law Office of Nicholas G. Callas, P.A. at 803-369-3968 or contact us through our website for a free consultation.
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