If you’re a worker in South Carolina, you should probably know a bit about the workers’ compensation laws that protect you. Yet, most don’t know anything about South Carolina’s workers’ compensation laws. The law is boring, right? Well, not always.
Here are a few facts that have surprised my clients.
Fact 1: You Don’t (Technically) Have to Sue Anyone to Get South Carolina’s Workers’ Compensation Benefits
A workers’ compensation claim works just like a lawsuit in most ways, though it’s not technically a lawsuit. You’re fighting for your best interests against another entity that is, in turn, fighting for its own. Due to the complexity of the law and its interpretation, a workers’ comp lawyer is usually better equipped to handle it than someone handling a claim on their own.
You file a claim with your employer and their workers’ compensation policy, which is generally the source of the benefits you may receive. The amount and nature of those potential benefits are determined by guidelines established within the law. However, there can still be disagreements about whether an injury is covered, the amount of benefits, and many other points of contention.
Thus, a lawyer may still be necessary, and disagreements over benefits can still eventually end up in court. In general, though, it’s not required, and the vast majority of South Carolina workers’ compensation claims never get that far.
Fact 2: Your South Carolina Workers’ Compensation Dispute Typically Goes to the Commission, Not to a Court
If you have an issue or disagreement over your SC workers’ comp claim and that dispute usually does not go to court, then where does it go? As we’ve already established, the judicial system offloads a great deal of responsibility. To whom?
The South Carolina Workers’ Compensation Commission is the first – and usually last – authority you need to seek a ruling on your case. If your dispute requires you to appeal to the commission, it’s a good idea to consult with an attorney. If the decision still is not in your favor and your attorney believes you have a case, you can then file with the Court of Appeals. I’m simplifying here – a great deal more goes into appealing beyond the commission.
Fact 3: By Law, Your South Carolina Workplace Injury Is (Probably) No One’s Fault
South Carolina’s workers’ compensation system is “no-fault” by design. Your employer is, however, responsible and required in most cases to carry insurance to cover the claims of injured workers. The employer agrees to fund or supply benefits (usually through an insurance policy) in the event of a compensable injury.
While what constitutes a compensable injury is sometimes arguable, courts generally err on the employee’s side when rendering judgments in disputes. The law is designed to work this way, and broad interpretation with an “employee lean” is helpful because it means injured workers can receive medical care and wage replacement benefits while they recover. Meanwhile, it keeps mountains of work injury related lawsuits off busy court dockets.
There are exceptions, of course. You cannot reasonably expect to receive workers’ compensation benefits if you’re drunk at work and get hurt as a result, for example. Or if you’re injured racing forklifts or something similarly unprofessional. You may laugh, but I assure you this has happened before.
Fact 4: You Can’t Be Fired Simply for Filing for South Carolina Workers’ Compensation Benefits
South Carolina is a “right-to-work” state, which usually means an employer can fire you at any time for almost any reason, just as you can quit at any time for any reason. South Carolina workers’ compensation laws and regulations supersede this rule.
South Carolina workers’ compensation law prohibits an employer from firing an employee in retaliation for filing a workers’ compensation claim.
Fact 5: Most Employers Are Required to Have Workers’ Compensation Insurance
The state requires businesses with four or more employees to have workers’ compensation insurance. However, as with most things, there are exceptions to this rule. There are actually enough exceptions (and exceptions to the exceptions) that it’s difficult to definitively state them without tons of disclaimers.
Just know that most employers have to have workers’ compensation insurance, and worry about the exceptions if they come up!
If you’re hurt at work and denied workers’ compensation benefits, you should consult with a South Carolina workers’ compensation attorney before you give up.
Fact 6: There Is Arbitrary Math Involved in Your South Carolina Workers’ Compensation Benefits (And Discretionary Judgement, Too)
It’s no secret what the law covers. In South Carolina, injured workers may receive:
- Wage replacement benefits that pay them while they are unable to work due to an injury
- Medical benefits that cover the cost of medical care and necessary procedures
- Benefits due to permanent disability
However, did you know that the law sets out formulas for calculating these benefits? Wage replacement is based on a formula and maxes out at two-thirds of your average weekly wage. It’s not precisely “wage replacement” in that you aren’t making what you were before.
Also, permanent injuries and disabilities are assigned a “fixed” amount, expressed in weeks of wages. The so-called schedule of benefits is in Section 42-9-30. The law states, for example, that if you lose your big toe in a work-related injury, you can be paid two-thirds of your average weekly wages for thirty-five weeks. And if you have a complete loss of hearing in one ear, you could be entitled to two-thirds of your wages for eighty weeks.
Seems hopeless, huh? It’s not. In South Carolina, a workers’ compensation commissioner can increase the rating beyond that assigned by the doctor, largely at their discretion. This is where an experienced workers’ compensation lawyer may make a world of difference to an injured worker. If you just read the law without knowing the law, you wouldn’t think you’d need one.
Fact 7: Your Employer or the Insurance Company Chooses the Doctor Who Will Treat You
The law gives the employer or insurer control over your treatment. If you want to see your physician, you can. However, that cost generally is not covered under workers’ compensation benefits.
There are exceptions to this provision in the law, such as if you are being treated improperly, but you must follow a process if you want workers’ compensation to potentially pay.
Know the Facts, Know Your Rights
It’s more important than ever to know your rights as an employee. As the world changes in the wake of the pandemic, the risks to people at work have never been more in the public consciousness. I suggest you consult with a workers’ compensation lawyer to dive deeper into your rights, the law, and what you may be entitled to following a workplace injury.
And if you have questions or need help with your workers’ compensation claim, we’re here to help.