Worker's Compensation FAQs
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.
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.
You can expect payments to be made directly to you and these should continue until the doctor releases you to return to work.
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.
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.
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.
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.
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.
We can help get payment for additional medical treatment under certain circumstances.
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.