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South Carolina law is supposed to entitle you to certain benefits when you have been hurt on the job. In reality, it is not always easy for you to qualify for workers’ compensation in South Carolina. Your case may have complicated issues, whether they arise at the time you file or while your benefits are being paid. You may not be heard by your employer or the insurance company.
It can be helpful to hire an attorney to help with your claim, either when you are filing, or after an issue arises. Contact the workers’ compensation attorneys at Schiller & Hamilton in Rock Hill to learn how we can help you.
Why Hire a Workers’ Compensation Lawyer?
When you have been injured on the job, your claim for workers’ compensation benefits is far from automatic. Both your employer and the insurance company may have a financial interest in you not being paid.
Denial rates for workers’ compensation claims have been increasing recently. Some estimates place the number of claims denied as high as 25%. The rate can be even higher for some injuries that may be deemed to be more subjective.
You should put your best foot forward when filing your initial claim. If your claim has been denied, you should certainly appeal. Most denied claims end up in litigation, and you need a lawyer to present your case effectively in the appeal forum. You may need to fight along the way, such as when you are being told to go back to work when you are not fully recovered.
Many workers’ compensation claims will end up in a settlement agreement. An experienced workers’ compensation attorney can negotiate your settlement agreement to get you the most possible money.
The workers’ compensation process is not always straightforward. You may need extra help at a time when you are already dealing with physical injuries.
What Is Workers’ Compensation Insurance?
Workers’ compensation insurance exists to protect employees when they have been hurt on the job. Public policy does not want workers to shy away from performing physical work or duties that could lead to injury. If they did, the overall economy would suffer.
Like every other state, South Carolina has its own workers’ compensation law. An employer is required to provide insurance when they employ four or more people. Usually, the employer will purchase coverage from an insurance company.
The price of the policy varies based on:
- The number of employees
- The total amount of payroll
- The risk of the job duties
- The employer’s prior claims record
If you have suffered a work-related injury, you would file a claim for benefits. If your claim is approved, you could be eligible for the following:
- Two-thirds of your average weekly wage, up to a statutory cap
- Reasonable medical expenses to treat your injury
- Vocational training to retrain you if necessary
What to Do After Being Injured on the Job
The most important thing that you must do after being hurt is give your employer timely notice of your injury. South Carolina law requires you to give notice to your job within 90 days. Otherwise, you could lose the right to claim workers’ compensation benefits altogether. Your notice should be to a supervisor or manager. Preferably, you should give notice in writing, so nobody can question you in the future. Your employer would then have ten days to report the injury to their insurance company.
In South Carolina, your employer has the right to select your medical provider. You may need to see a doctor of your choosing, who would then diagnose and treat your injuries. You can use the medical records that they have provided you as the basis of your claim.
You have two years to file a claim for workers’ compensation, although you should usually file well before then. To file for workers’ compensation benefits, you would submit a Form 50 to the Workers’ Compensation Commission, which would then forward everything to the relevant parties.
Types of Injuries that Qualify for Workers’ Compensation
Broadly speaking, you are eligible for workers’ compensation when you have suffered a work-related injury. Of course, being injured in a work accident should be sufficient to qualify you for benefits. Other injuries are included in this category.
In addition to accident-related injuries, you may be compensated for the following:
- Overuse injuries: The continuous use of a certain body part can result in an injury. For example, you could suffer tendonitis or bursitis in one of your joints due to the constant strain.
- Work-related illnesses: Exposure to a toxin or substance on the job could cause you to develop an illness, which can be connected to your job duties,
- Stress-induced injuries: The demands of your job could cause you to develop severe anxiety or emotional distress that keeps you from working
The insurance company is going to be more likely to challenge something that they consider to be subjective. They will not simply take your word for it. If you have suffered an injury that they cannot see on paper, you’d need extensive documentation of your treatment to have a chance to successfully challenge a denial.
What to Do if Your Workers’ Compensation Claim Is Denied
The insurance company does not get the last word about your claim. They may deny your benefits, but South Carolina law gives you the right to fight back. You can file an appeal that puts your case in front of an objective third-party commissioner from the South Carolina Workers Compensation Commission. They hear evidence about your claim and decide whether you deserve benefits.
Many people experience success when they try to appeal a denied workers’ compensation claim. Some statistics show that more than two-thirds of claims that are denied initially end up being converted to benefits, whether it is after a ruling or settlement agreement.
If you do not already have an attorney, you must contact one right after your claim has been denied. You have a limited amount of time to file an appeal, and you need the benefits that you may get if you win.
Your workers’ compensation attorney can do the following to help with your appeal:
- Review the denial letter to understand the exact reason why the insurance company would not pay your claim
- Gather the evidence that may be necessary to prove your case
- Request a hearing and file the necessary paperwork
- Present your evidence at the hearing in front of a Commissioner
- Negotiate a settlement agreement with the insurance company if that is what is in your best interest
Our Rock Hill injury attorneys could also represent you in appeals involving other workers’ compensation issues.
Contact a Rock Hill Workers’ Compensation Lawyer Today
The workers’ comp attorneys at Schiller & Hamilton are steadfast in their belief that you deserve justice under South Carolina law. We are here to stand up for you if the insurance company is trying to deny you what should be rightfully yours under the law. We are here to talk about your case in a free initial consultation, where we will listen and learn the facts. To speak to our workers’ comp lawyers in Rock Hill, you can send us a message online, or you can call us today at 803-902-4583.