What To Expect In A Workmans Comp Claim

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Often times, a workers’ compensation client gets released from the treating physician with a low rating and wants me to settle their case for a substantial amount of money. They have certain expectations that the law unfortunately does not accommodate. They cite months of pain and suffering, mental anguish and fault as reasons for their expectations. Unfortunately, I have to break the news to my client, who has returned to work with little impairment that their case may not be worth what they were expecting. The truth is, Workers’ Compensation provides basically only three benefits – medical treatment, temporary weekly payments and permanent disability benefits.

What Medical Expenses Does Workers Comp Cover?

First, Workers’ Compensation Insurance Companies are responsible for paying all causally related medical expenses that reasonably tend to lesson ones impairment. When injured on the job, you should report the injury immediately to your supervisor and, if necessary, request medical treatment be provided by your employer. In South Carolina, the employer and its insurance carrier have the right to choose your medical providers. The logic there is that they are paying so they get to choose. If you simply go to a doctor on your own without prior authority from your employer, they may not be required to pay for that treatment. So, report the injury immediately and then ask your employer to send you to their doctor or emergency care provider. Medical treatment is usually the most important benefit provided by workers’ compensation and triggers the duties and benefits owed by the employer or its insurance carrier.

What Are Temporary Benefits?

Another benefit, is referred to as Temporary benefits. Sometimes it can be Temporary Total Disability benefits or Temporary Partial Disability benefits. This is essentially your weekly checks that covers your loss of earnings while you are written out of work by an authorized treating physician. These checks become owed to the injured worker who has been out of work for seven consecutive days. On the eighth day through the fourteenth day, the carrier only owes for those days. On the fifteenth day, the carrier must go back and pick up the first week. These weekly benefits are based on two thirds of your average weekly wage based on earnings in the 52 weeks leading up to your injury. If you are returned to work at reduced hours or reduced pay then the workers’ compensation insurance carrier owes two thirds of the difference in pay. Keep in mind that most employers do not want lost time injuries as it results in increased premiums. So there is a rush to get you back to work prematurely and often at the expense of being able to recover properly from your injury. Temporary benefits are owed until you have returned to regular duty or have been released from care.

What Else Is Consider in A Workmans Comp Case?

Finally, Workers’ Compensation takes into consideration any permanent impairment in calculating the third benefit known as Permanent Partial or Permanent Total Disability. After you have completed your treatment and the doctor states that you have reached what we call Maximum Medical Improvement, he or she will assign an impairment rating to the part or parts of your body that were injured. This number is critical and can make the difference between a fair settlement and an unjust one. In South Carolina, each body part has been assigned a number of weeks that our Legislature has previously and arbitrarily determined are the number of weeks one could expect to lose from the workplace in the future due to that injury. Many factors are to be taken into consideration when making the evaluation as to what Permanent Disability benefits an injured worker should receive. These include, age, occupation, job training and education. Settling a workers’ Compensation claim can be done leaving medical open for one year in the event of a change of condition or by providing the employer and carrier a full and final release.

Although this is a brief overview of the benefits available to someone who gets hurt on the job, there are many nuances and additional types of benefits and reimbursements that may be available. Unfortunately, workers’ Compensation benefits do not include compensation for pain and suffering, mental anguish or emotional distress.

If you or someone you know has been injured on the job, contact a workers’ compensation attorney at Schiller & Hamilton. Trying to handle a workers’ compensation claim without an attorney can be devastating. Please call us for a complimentary strategy session. It will not coast anything to see if we can help.

Let me put my 20 years of experience to work for you. At Schiller & Hamilton, we don’t want you to go it alone. Call us in Rock Hill, Lancaster, Beaufort, or. Bluffton South Carolina. We are here to help.

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