Workers’ Compensation

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 rights to workers’ compensation 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.

You are entitled to all necessary medical treatment that is related to your work injury and is likely to lessen your disability. Workers’ compensation insurance companies generally pays for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. Keep in mind that in order to receive these benefits you must go to the doctor chosen by your employer or its insurance representative.

In short, probably not. Workers’ Compensation laws require the employer to pay for 100% of medical expenses related to the injury, but the law also allows the employer to choose which doctor provides the treatment. It’s possible that your employer will allow you to use your own physician, but it doesn’t happen often.

You are entitled to compensation at the rate of 66 2/3 percent 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.

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.

For many serious workplace injuries, medical treatment will include some level of physical therapy or specialized care, which may require regular travel and fuel costs. Workers’ Compensation will cover travel expenses for medical care related to your workplace illness or injury. SC Workers’ Compensation laws require the employer to reimburse an injured employee at the IRS mileage reimbursement rate for all travel to medical appointments more than 10 miles round trip. You can see the most recent mileage rate charts here on the South Carolina Workers’ Compensation Commission website.

Workers’ Compensation is designed to provide benefits to injured employees without a specific need to prove who was at fault for the accident or injury. While situations such as self-inflicted injuries or injuries that occur as a result of an employee’s intoxication will not be covered, most employees will not need to provide proof that they were not at fault when filing for Workers’ Compensation.

Not necessarily. South Carolina is an employment at will state. This means that, absent a collective bargaining agreement or contract, employment can be terminated at any time without reason, explanation, or warning as long as that reason is not against public policy and/or illegal. The FMLA, or Family Medical Leave Act, provides some limited protections for many South Carolina employees, but not all employees in the state of South Carolina are covered by the FMLA. You can learn more about FMLA eligibility and what is covered by it here.

If you are cleared to return to full work duties, or limited work, by a physician after your recovery, but find that the work is not provided by your employer, you may be entitled to additional temporary disability benefits. These situations are very dependent on specific facts in each unique case, and consultation with a Workers’ Compensation attorney is recommended to determine your best option moving forward.

You must accept light work if it is offered. If you do not accept the light duty offered to you, 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.

In most cases, Workers’ Compensation benefits are not taxable at either the federal or state level. The IRS generally exempts weekly payments, lump-sum settlements, medical reimbursements, and survivor benefits from income tax, so long as they are paid under a Workers’ Compensation Act for a work-related injury or illness.

Workers’ Compensation claims can be denied for a variety of reasons, such as a pre-existing condition, missed deadlines, or lack of medical documentation. If your claim is denied, the first step is to carefully review the denial letter to understand the reason behind the decision.

If you decide to appeal, it’s important to act quickly (strict deadlines apply) and consult with an experienced Workers’ Compensation attorney. A lawyer can help you navigate the appeal process, gather the necessary medical and vocational evidence, and improve your chances of securing the benefits you deserve.