Worker's Compensation FAQs

What is workers’ compensation?

Workers’ compensation is a system of laws whereby employees can recover from employers for injuries that arise out of an on-the-job injury. This system relieves employers of liability from common law suits involving negligence and the damages associated therewith in exchange for a relieve from the burden of proof on the employee. Specifically, in exchange for the relief from having to prove fault, employees’ damages recoveries are limited to the medical costs and lost wages resulting from on-the-job injuries.

What is a hearing?

The workers’ compensation commissioners conduct a hearing to resolve disputes between you and your employer’s representative. You may apply for a hearing if your employer does not report your accident, denies your injury by accident, or if you believe that you did not receive all your benefits.

What type of compensation is available through the Workers Compensation Act?

Workers’ compensation pays for necessary medical treatment, loss of wages during a period of disability, and compensation for permanent disability or disfigurement. If an employee is injured and unable to work for more than seven days, he or she is eligible to be compensated at the rate of 66 2/3% of the employee’s average weekly wage, limited to 100% of the State’s average weekly wage as established each year by the South Carolina Employment Security Commission. If the period of total disability exceeds 14 days, the employee is eligible for compensation beginning with the date of the accident.

The maximum award for total disability or death is limited by law to five hundred weeks of compensation. The rate of compensation is determined by the injured employee’s average weekly wage and cannot exceed 100% of the state’s average weekly wage. The loss of both hands, arms, feet, legs, or vision in both eyes, or a combination of two such losses, constitutes total and permanent disability. In addition, a commissioner can make other disability determinations based on the particular loss or impairment to the whole person.

There are exceptions for brain injury or paralysis which may entitle the claimant to lifetime disability benefits. Cases in which a finding of permanent and total disability is made generally result in lifetime medical care and treatment.

Who sends me my weekly pay check?

Your employer is required to have workers’ compensation insurance if they have four or more employees and the insurance carrier is responsible to pay compensation to you if you are out of work for more than seven days.

Do I get reimbursed for my travel expenses when I go to the doctor?

Yes, if the round trip distance is more than ten miles from your home. You should be reimbursed for the round trip mileage at the rate allowed state employees for mileage.

What changed with the recent workers comp reform?

There were a number of complex changes under South Carolina’s New Workers’ Comp Law that took effect beginning July 1, 2007. Here is a brief summary of a few of the changes:

  • In workers comp cases deemed “medically complex cases” by the Workers Compensation Commission, an employee must establish by medical evidence that the injury arose in the course of employment. “Medical evidence” means medical expert testimony is required to support the claims of an injured worker.
  • For “repetitive trauma injuries” (like carpal tunnel syndrome) also require medical evidence that establishes a specific causal connection between the injury and the repetitive activities that occurred while the employee was engaged in the regular duties of their employment. The statute of limitations in a repetitive trauma injury is from the time an employee discovered, or could have discovered by exercising reasonable diligence, that his/her condition is compensable. There is a caveat to this, however, and that is if reasonable excuse is made to the satisfaction of the Commission for not giving timely notice, and the Commission is satisfied that the employer has not been unduly prejudiced. An “occupational disease” is now defined as a disease arising out of and in the course of employment that is due to hazards in excess of those ordinarily incident to employment and is peculiar to the occupation in which the employee is engaged. Therefore disease is considered an “occupational disease” only if caused by a hazard recognized as peculiar to a particular trade, process, occupation, or employment as a direct result of continuous exposure to the normal working conditions of that particular trade, process, occupation, or employment.
  • Any health care provider who provides examination or treatment for which workers compensation is sought, may discuss or communicate an employee’s medical history, diagnosis, causation, course of treatment, prognosis, work restrictions, and impairments with the insurance carrier, employer, their respective attorneys or certified rehabilitation professionals, or the Commission without the employee’s consent without breaching any duty of confidentiality to the employee.
  • This summary does not, and is not intended to, cover all the 2007 changes, or substitute for competent legal advice. For specific questions about your potential claim, please contact us for a free consultation. What if I receive an impairment rating or have a scar?
  • When the doctor releases you with an impairment rating or if you have a non-surgical scar that can be seen at least eight feet away, the insurance carrier may request an informal conference/viewing. This is an opportunity for you to meet with a representative from the commission and the insurance carrier to determine the amount of compensation due, but you should seek legal advice to assure you obtain all benefits rightfully due.

What should I do if the doctor releases me to light duty?

You must accept light work if it is offered. If you do not accept, all compensation may cease as long as you refuse to return to work. You have a right to a hearing if you believe that you are not able to do the work assigned to you. If you return to light work before you are fully discharged by the doctor at a wage less than you were earning at the time of your original injury, you are entitled to weekly compensation at the rate of the sixty-six and two-thirds (66 2/3%) percent of the difference between your average weekly wage and your new wage.

When are my benefits terminated?

After the doctor releases you to return to work with or without restrictions, within 150 days of notification of the accident, you should receive two copies of Form 15 with Section II completed indicating that compensation has been stopped and for what reasons.

Will I get compensated for missing time from work because of my injury?

There is a seven-day waiting period before benefits can be paid. If you are out of work for more than seven days, payments will come from your employer’s insurance representative. If you are out of work for more than 14 days, you will receive compensation even for the first seven days.

You can expect payments to be made directly to you and these should continue until the doctor releases you to return to work.

How is my compensation rate determined?

You are entitled to compensation at the rate of 66 2/3% of your average weekly wage based on the four quarters prior to your injury, but no more than the maximum average weekly wage determined each year by the South Carolina Employment Security Commission. If you were working two or more jobs at the time of accident, those wages may be included as part of the average weekly wage and compensation rate.

Can I be fired for filing a Workers’ Comp claim?

NO! You are protected by South Carolina statutory law if you are legitimately injured and have a medical opinion saying so and are entitled to reinstatement and lost wages as damages for a retaliatory discharge.

How do I report an on-the-job injury?

Report all injuries at work to your employer immediately and request medical treatment, if needed. If you neglect to report the injury within 90 days of the accident you may lose your benefits.

Although you must report the injury within 90 days, you have up to two years to file a claim for benefits. If a worker dies because of work-related injuries, the worker’s dependents, or parents if there are no dependents, must file a claim within two years of the death to claim benefits.

Who is covered by the South Carolina Workers’ Compensation Act?

Every South Carolina employer and employee, with certain exceptions, is presumed to be covered by the State’s Workers’ Compensation Act. Exceptions to this provision include railroad and railway express companies and employees, certain casual employees, Federal employees in South Carolina, businesses with less than four employees, agricultural employees, and certain real estate salespersons, and, by election, corporate officers.

Employers covered by the provisions of the Act are required to maintain insurance sufficient for the payment of compensation, or they shall furnish the Workers Compensation Commission satisfactory proof of their ability to pay the compensation in the amount and manner due an injured employee. The Director of the South Carolina Department of Insurance is responsible for approving rates and classifications for all workers’ compensation insurers.

What are the objectives of the worker’s compensation system?

Historically, six basic objectives underlie the workers’ compensation laws:

  • Provide sure, prompt, and reasonable income and medical benefits to work-related accident victims, or income benefits to their dependents, regardless of fault;
  • Provide a single remedy and reduce court delays, costs, and judicial workloads arising out of personal injury litigation;
  • Relieve public and private charities of financial demands incident to uncompensated occupational accidents;
  • Minimize payment of fees to lawyers and witnesses as well as time-consuming trials and court appeals;
  • Encourage maximum employer interest in safety and rehabilitation through an appropriate experience-rating mechanism;
  • and, Promote frank study of the causes of accidents (rather than the concealment of fault) in an effort to reduce preventable accidents and human suffering.

What is the maximum weekly compensation rate?

The maximum compensation for 2008 is 2/3 of your average weekly wage, not to exceed $661.29. In terms of total disability for 500 weeks, the maximum commuted lump sum compensation award for 2008 is $270,001.80.

Generally, an individual must have earned $51,555 annually ($991.44 weekly) or more during the four quarters immediately preceding the quarter in which an accident occurs in order to be paid at the maximum compensation rate.

What if I aggravated a pre-existing injury?

In most cases, you are still covered by Workers’ Comp for a re-injury occurring in the workplace, even if the original injury was not work-related.

Do I have to see my employer’s doctor?

Yes. The law allows the employer to pick the treating physician but Hodge Law Firm often arranges independent medical evaluations to ensure objectivity and honest consultation for your case.

We can help get payment for additional medical treatment under certain circumstances.

Why was my Workers’ Comp claim denied?

Your workers compensation claim may have been denied for a legitimate reason or no reason at all because some workers compensation insurance carriers deny claims as a strategy to discourage claimants. Alternatively, the employer may dispute that the injury was job-related, even happened on the job, or claim that you failed to report it within the 90 day window following the accident, as required. The workers compensation attorneys at Hodge Law Firm will review and evaluate your case at no cost to you to determine whether or not you have a claim. This is for your and our benefit as we do not file frivolous or baseless claims.

Why shouldn’t you have a competent and experienced workers compensation attorney in your corner?

The workers compensation attorneys at Hodge Law firm have been in practice for many years and know how to counter vigorous defense representation with aggressiveness and an appreciation of the potential pitfalls a layperson is unlikely to appreciate that may cost them their case. This is increasingly the case given the numerous changes in the workers compensation system that took effect July 1, 2007. Thus, while you can file your own claim, you will likely find that the best results will come through claimants who are represented by an attorney.

Why should I get an attorney instead of filing my own claim?

First and foremost, the employer and the insurance company covering the employer will likely be represented by legal counsel. These attorneys have a duty to the employer and insurance company to vigorously represent their interests, which are by nature adverse to yours.

What constitutes a “work-related” injury in South Carolina?

Any injury you suffered while on the job is eligible for Workers’ Compensation benefits if it required medical treatment and prevents you from returning to your job (short term, long term, or permanently)

Examples include, but are not limited to: a back injury from a fall or from overexertion; an eye injury from a piece of scrap or a saw; a heart attack from unusual overexertion; a laceration or cut from a saw; a burn from a torch or welder; a ladder accident; an auto accident while in the course and scope of your duties (whether in your own car or a company car); workplace exposure to toxins; cumulative injury from everyday tasks (such as tendonitis or carpal tunnel from repetitive movements); or any number of other mishaps.

The workers compensation attorneys at Hodge Law Firm are familiar with all types of work injuries and the appropriate level of compensation associated with each.