Workers get hurt on the job every day. Some injuries are long-lasting and debilitating, while others quickly heal. But every injury matters, because every employee matters.
As a South Carolina workers’ comp attorney, I have been involved in litigation on both the employee’s side and the insurance company’s side. And believe me, nothing beats the feeling of helping an injured worker fight for the benefits they may deserve.
Workers’ compensation is the no-fault insurance that most employers carry to protect their businesses when a worker is hurt or gets sick from a work-related cause. And workers’ comp can be very complicated. While there are many different stages of a workers’ compensation case, I will focus on the end game in this article – the settlement stage – for South Carolinians who have been injured at work.
Will My Workers’ Compensation Case Settle?
This is a great question because not all South Carolina workers’ comp cases settle. Sure, closure is great. But if you feel that your medical condition may worsen in the future, and the insurance company does not agree to pay future medical expenses, it may not be in your best interest to settle. Remember: settlements are final, and you can’t expect to go back to the insurance company at a later date and ask for additional compensation. You do not have to settle if it’s not in your best interest.
If you are fully recovered and the doctor has released you back to work, the insurance company will work to close your case so they can stop sending you compensation. At this point, if you have a permanent disability resulting from the injury, you can explore negotiating a settlement. Keep in mind that most insurance companies are for-profit businesses, and minimizing expenses can be a top priority — which means getting you to settle for as little as possible.
If you are not already working with an attorney who is experienced in South Carolina workers’ compensation settlements, I encourage you to seek one out for advice about settling your claim and to discuss the pros and cons. At my firm, we offer free case evaluations .
When Is the Right Time to Settle a Workers’ Compensation Claim?
While every case is different, a general rule-of-thumb is to wait until your doctor has declared that you have reached maximum medical improvement (MMI) before settling a workers’ comp claim. At this stage, the following has been established:
- Your physical condition is not likely to improve further with treatment
- How severe your injury is
- How your injury will impact your ability to work
If I’m Ready to Settle My Workers’ Comp Case, What Are My Options?
So now that you are ready to negotiate, there are three main types of South Carolina workers’ comp settlements to consider:
- Full and final clincher agreement – This agreement is designed to close out all further benefits (compensation and medical) and release the employer and insurance company from all future liability pertaining to the injury. Note: You generally cannot request additional compensation after signing a clincher agreement and must take on the responsibility for future medical treatment if needed.
- Indemnity-only clincher agreement – This agreement is a modified version of the clincher agreement and is intended to close out the compensation payment part of the claim only and leaves open the medical part of the claim, thus providing for ongoing medical treatment.
- Form 16A – This settlement agreement is for an award amount that also provides for further medical treatment recommended by the doctor. In addition to leaving open the medical portion of your claim, it allows you to file for additional potential disability compensation based on a worsening of your condition as long as you file the claim no later than one year from the date of the last payment of disability compensation.
You can benefit from having a lawyer to help you decide which type of settlement is optimal for your situation, and then to guide you through the negotiations with the insurance company. Typically, the final settlement is a compromise between the two parties that may take weeks or months of back-and-forth discussion.
What Happens if I Can’t Reach a Settlement With the Insurance Company?
If you and your employer’s insurance company cannot agree on a settlement amount, you can request a hearing in front of the South Carolina Workers’ Compensation Commission (SCWCC), where a judge will resolve it for you. At the court hearing, the judge will look at you, your evidence, and your situation to decide what you are potentially entitled to as a result of your permanent disability.
A lawyer at this stage can help you:
- Complete and submit a hearing request via Form 50
- Adhere to timelines
- Prepare and practice your testimony
- Gather facts and submit evidence
- Subpoena and interview any witnesses
- Present your case to the SCWCC
To try to increase your chances of obtaining a favorable result from the SCWCC hearing, I strongly advise you to enlist the aid of an attorney who is very familiar with how the SCWCC works.
How Much Will My SC Workers’ Comp Settlement Be?
While I can’t tell you how much your potential South Carolina workers’ comp settlement amount will be, I can tell you that the following factors should be considered when negotiating the amount:
- The nature of your injuries
- Balances on medical bills
- Unpaid benefits
- The likelihood and cost of future medical treatments, such as surgery or physical therapy
- The likelihood that your injury will prevent you from returning to work in some capacity
- Lost wages or future wage loss
- The extent of your permanent impairment
- Your weekly compensation rate, including overtime and bonuses
- The possibility of needing retraining and its cost, if necessary
- Prepare you for any depositions
While there is no specific workers’ comp settlement chart (South Carolina), there is published information that estimates the amount of workers’ comp benefits paid by state. The National Academy of Social Insurance (NASI) compiled a “Workers’ Compensation: Benefits, Costs, and Coverage” report that estimates the amount of workers’ comp benefits paid in each state in 2020.
According to this report, total workers’ comp benefits paid in 2020 in South Carolina were about $1,044,819,000. This was a 14.8% change from 2016-2020 – the second largest percentage increase over that period among all 50 states.
How Long Will It Take for Me to Receive a Settlement Check?
I wish I could provide an exact answer to this question, but the timing will vary based on the specifics of each case. Once a settlement has been negotiated, you will generally receive a check within one to two months. Rest assured that at my firm, our goal is to get you as much as possible, as quickly as possible. Our lawyers and paralegals understand the workers’ compensation system and will be in contact with your employer’s insurance company to try to move the process along because we understand how important it is for you to resolve your case.
When I work with clients who have been hurt at work, I often see firsthand how frustrating and difficult they find dealing with the insurance company. I listen carefully to their questions and concerns so that we can work towards a potential settlement that truly meets their needs. And what I hear often is that they are scared that they won’t be treated fairly in the settlement process.
That’s what drives me to be as thorough as possible when negotiating with the insurance company on a workers’ comp settlement. While it’s often just a dollars-and-cents exercise to the insurance company, the end result can make a real difference to my clients.