What is a Worker’s Compensation Claim in Rock Hill?

The advent of modern worker’s compensation laws at the beginning of the 20th century marked a significant change in the legal relationship between employees and bosses. Before these laws, employers were only liable for an injury if the employee could prove that the employer’s negligence caused their losses.

Worker’s compensation laws in Rock Hill now allow many employees to obtain medical care, temporary income, and payments for permanent disability after an on-the-job injury. However, obtaining these benefits can still be a difficult process.

A Rock Hill attorney could help to answer your questions concerning a worker’s compensation claim. Working together, an experienced attorney could fight to get you the benefits that you deserve after a workplace injury.

What Employers Need to Have Insurance?

State law requires employers with at least four workers to obtain a worker’s compensation insurance plan that covers every employee on their payroll. This includes part-time workers, seasonal workers, and temporary employees. Certain employees may not be covered under workers’ compensation, including:

  • Railroad workers
  • Dockyard workers
  • Federal employees

As a result, most injuries that occur at the workplace are the subject of worker’s compensation claims. However, many personal injury cases hinge on the question of whether the injury happened in the course of employment.

When is an Injury Work-Related?

The central question in many worker’s compensation disputes is whether the injury was the result of doing one’s job. Under South Carolina Code §42-1-160, an insurance policy must cover any injury that arises out of the course of one’s employment. This includes accidents that are the injured employee’s own fault. However, an insurance company may dispute whether the injury actually occurred at work, whether the worker’s own horseplay was the cause of the incident, or whether a claim for repetitive stress injuries is sufficiently connected to the employee’s work duties.

The Typical Legal Path for a Claim

Ideally, an injured employee notifies their boss of the injury. That employee then receives all necessary care under the insurance policy, eventually makes a full recovery, and receives cash benefits for all time missed at work. Unfortunately, such a perfect result is rare.

It is not uncommon for disputes to arise in worker’s compensation claims. This can result in an insurance company offering a reduced benefit package or denying the claim entirely. No matter the reason for a denial, all workers have the right to pursue an appeal.

The South Carolina Workers’ Compensation Commission receives all requests for appeals and coordinates all hearings before the Commission. However, not every appeal goes to a formal hearing. Both parties have the option to participate in informal mediation sessions in an attempt to settle their case without going to a full hearing. It is only if these sessions fail, or if the parties decline to mediate, that the case goes before a formal session.

During these hearings, both sides can present evidence in the form of medical records, incident reports from the workplace, and witness testimony. The Commission will consider the evidence and make a binding determination. Even if this hearing does not result in a positive outcome, workers can appeal. A Rock Hill attorney could provide more information about the worker’s compensation legal path.

Understanding a Rock Hill Worker’s Compensation Claim is Key to Obtaining Full Benefits

A successful workers’ compensation claim should not involve extensive paperwork, appeals, or court appearances. However, in situations where there is a dispute over the extent of an injury, or whether you qualify for benefits at all, it is vital to understand the legal processes behind worker’s compensation claims.

A worker’s compensation claim in Rock Hill can provide for your medical needs, result in the payment of temporary disability income, and even result in lump sum settlements for any permanent disability. However, it is sometimes necessary to appeal a denial from an insurance company to obtain the full benefits you deserve. A Rock Hill attorney may be able to help to provide more information about worker’s compensation claims and your legal rights. Contact Schiller & Hamilton today to explore your options.