1.Workers Compensation FAQ
The employee may be entitled to compensation, for a certain number of weeks, when certain parts of the body are permanently injured, even if the worker can still perform the job requirements. This type of compensation is called a “Scheduled” award and does not require any proof that the injury has caused a loss of earning capacity. For example, a worker who suffers a back injury on the job is entitled to compensation for the permanent back injury – even where there is only a partial loss of use and the injury does not keep the worker from returning to the job.
You are entitled to all necessary medical treatment that is likely to lessen your disability. Workers’ compensation 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. The employer has the right to designate the treating physician. The employee must accept the treatment provided or lose the right to receive compensation.
You are entitled to compensation at the rate of 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.
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.
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. If the insurance carrier stops your compensation, and if you disagree, complete Section III of the Form 15 and send it to the Commission’s Judicial Department. This is your way to request a hearing to be held in sixty days. If the Doctor releases you to return to work after the 150-day notification period, your employer or insurance representative will ask you to sign a Form 17, (receipt of compensation ) after you have been back to work for fifteen days.
You must accept light work if it’s 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 2/3 of the difference between your average weekly wage and your new wage.
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 will 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.
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.
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.
You can talk to the insurance carrier and see if he or she will allow you to go to another doctor, or you can request a hearing by completing Form 50 and have a Commissioner make a determination on the case.
Your employer is required to have workers’ compensation insurance if they have four or more employees and the insurance carrier will be responsible to pay compensation to you if you are out of work for more than seven days.
If an employee is hurt on the job, benefits provided by the laws are the worker’s sole remedy. Under most circumstances, employees cannot sue an employer for injuries received on the job. However, if a third party, such as the manufacturer of a defective machine, or a driver of a non-company vehicle, is responsible for the injury, then the employee can sue the third party and also file a workers’ compensation claim. But in the event of a recovery against the third party, the law requires that the workers’ compensation insurance company be reimbursed for any benefits the employee received.
Most attorneys will charge a contingent fee which is a percentage of, and paid only from, your award or settlement, and the fees must be approved by the South Carolina Workers’ Compensation Commission. Your attorney should explain his or her fees in detail and should have you sign a written fee agreement.