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Commonly Asked Questions about Filing a Workers’ Compensation Claim

Published on Aug 26, 2020 at 3:42 pm in Workers' Compensation.

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If you’ve been injured on the job, you’ll want to understand what your legal rights are to workers’ compensation benefits. Unfortunately, the system doesn’t always make it easy to understand what you’re entitled to and how you go about receiving those benefits. Because of that, let’s take a look at some of the frequently asked questions injured employees have in South Carolina.

According to the South Carolina Workers’ Compensation Commission, these are the most commonly asked questions about filing a workers’ compensation claim:

How do I report a work injury?

To report a work injury in South Carolina, you must immediately inform your supervisor of what’s happened. You also need to seek medical treatment, if needed. In the event you neglect to report the injury within 90 days, you may render yourself ineligible for workers’ compensation benefits. It’s important, however, to note that if a worker dies from work-related injuries, the workers’ dependents have two years to file a work injury claim.

What does the claims process look like?

In the event your employer does not report your accident, denies your injury by accident, or if you feel you have not received full benefits for your injury, you have the right to personally file a claim. To do so, you have to submit a Form 50 or Form 52 to the state Commission.

What medical treatment is available to me?

Any injured person is entitled to all necessary medical treatment that they need to lessen their injury. In general, workers’ compensation pays for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. In order to receive compensation for those expenses, however, you must go to a doctor chosen by your employer or insurance representative.

In the event I’m unhappy with the doctor referred to me by my insurance carrier, can I seek a second opinion?

When an employee is injured at work, their employer’s insurance carrier will recommend a doctor. In the event the employee wishes to seek a second opinion, they can talk to the insurance carrier to see if they will allow them to go to another doctor. There’s also the option of requesting a hearing by completing a Form 50 and having a Commissioner make a determination on the case.

What happens if I have a scar or receive an impairment rating?

In the event a doctor releases an employee with an impairment rating or a non-surgical scar that can be seen at least eight feet away, the insurance carrier will likely request an informal conference or viewing. That meeting will be an opportunity for the employee to meet with a representative from the Commission and the insurance carrier to determine the amount of compensation that’s due.

What happens if a doctor determines I can do light duty work?

If light duty is ordered, an injured employee is obligated to accept it. In the event they do not accept the order, all compensation may stop as long as they refuse to return to work. If an employee believes they are not able to do the work assigned to them, they have the right to request a hearing.

How is the amount of awarded compensation determined?

In South Carolina, those who are entitled to workers’ compensation benefits will receive 66 2/3% of their average weekly wage based on the four quarters prior to their injury. However, compensation will not exceed the maximum average weekly wage, which is determined by the South Carolina Department of Employment and Workforce on an annual basis.

Will lost wages be included in the compensation for my injury?

Prior to receiving benefits, injured employees have to go through a seven-day waiting period. In the event an employee is out of work for more than seven days, payments will come from their employer’s insurance representative. In the event a worker is off the job for more than 14 days, they will receive compensation for the first seven days. Payments can be expected to be made out directly to the employee until the doctor releases them to work again.

How do I receive my weekly benefits?

Once benefits are approved, the injured employee will receive a weekly check. Their employer is required to have workers’ compensation in the event they have four or more employees. The insurance carrier will be responsible for paying that compensation in the event an employee is out of work for more than seven days.

When do workers’ compensation benefits stop?

Once a doctor releases an injured worker to return to work with or without restrictions, the employee will receive two copies of Form 15 with Section II completed. This will indicate that compensation has been stopped and for what reasons. In the event the worker disagrees with that decision, they have the right to complete Section III on the form and send it to the Commission’s Judicial Department. A hearing will be held in sixty days to handle the dispute.

Learn More From Solomon Law Group

In the event you have more questions regarding your workers’ compensation eligibility or benefits, get in touch with the lawyers at Solomon Law Group. We’ll provide you with the legal advice you need to ensure you receive full and fair benefits for your work injury. Contact us today for more information.

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