Reaching a Positive Conclusion of Your Workers’ Comp Claim
Workers' comp pays for medical expenses and lost wages for employees who become ill on the job or are injured at work. Employees working for a company with four or more employees in South Carolina must be covered by workers' compensation insurance. Under the South Carolina Workers’ Compensation Act, an injured employee can recover compensation for their medical costs, temporary compensation for the time they miss from work, and permanent or temporary disability benefits if needed. Although this coverage is mandatory, you may need help navigating the worker's comp process in order to be successful with your claim.
If I’m Injured, Can I Use My Own Doctor?
You can only be treated by doctors selected by your employer under South Carolina law. You are responsible for the cost of your medical care if you go to your own doctor without permission from your employer unless it is an emergency situation. You can pick the physician that evaluates you for a disability, but your employer doesn’t have to cover that expense.
What to Do After an Injury on the Job
The first thing a worker has to do is notify their boss or supervisor that they have been injured. They will then receive an injury claim form from their employer or supervisor. A worker's claim is filed with the state workers' compensation board once he or she completes and returns the form to their employer.
What if My Claim is Denied?
In South Carolina, claims can be denied for a number of reasons. However, you do have the right to appeal by filing a Form 50, and an SC workers’ comp lawyer can help you file and get the benefits you deserve. A request for a hearing is placed directly with the commissioner’s judicial department. In the appeals process, a hearing can be held for the following reasons:
- The employer did not report the injury or accident.
- The employer denied the claim.
- The employer said the injury was not work-related.
- The worker thinks they didn’t receive all the benefits they should have.
At the Commission Appeals Hearing
During the hearing, one commissioner for workers’ comp will listen to how you suffered an injury and decide whether you are entitled to benefits. If your claim is denied, you can still appeal the decision to the full commission within 14 days. To file this appeal costs around $150 but can be waived. If the commission still denies your claim, your case can be taken to the SC Supreme Court.
Because navigating the South Carolina workers’ compensation system can be complicated, being represented by a lawyer who is familiar with the ins and outs of the system is important. Claims can be refused for a number of reasons, including:
- You were injured outside the work area. However, if you were on company business, you would be covered.
- It is being argued that the injury was due to a preexisting condition.
- Your medical provider was not preapproved by your employer.
- Your claim was filed late.
A workers’ comp attorney can advise you, guide you and help with filing the necessary documents to avoid a denial. If your claim has already been denied, they can help you file an appeal and improve your chance of reaching a successful conclusion to get you the benefits you deserve.
Morris Law in South Carolina
If you are injured on the job, you may be able to file a workers’ comp claim. Call Morris Law at (843) 232-0944 or contact us online. We will be able to set up a free case review where we can examine your case, answer your questions and give you your options going forward.