SC Worker’s Compensation Answers: I thought I was entitled to pay while I was out of work?
“I thought I was entitled to pay while I was out of work?”
Answer: It’s the 7/14 Rule
Every day we get asked… “I thought I was entitled to pay while I was out of work?” Our response is always the same “It’s an easy rule and I have no idea why the insurance carrier hasn’t paid you.” The reality is the Workers’ Compensation Act in South Carolina provides a very clear rule of law…injured workers are entitled to 2/3 of their gross pay (temporary total disability [TTD] benefits) while out of work from a work injury. I call it the 7/14 rule. South Carolina Coda Ann. 42-9-200 provides that once an injured worker has been out of work 7 days (does not have to be consecutive) they are entitled to start receiving 2/3 of their average weekly wages (gross). Starting the 8th day that worker is entitled to start receiving compensation from the insurance carrier.
If the injured worker is out of work the 8th through the 14th day they will receive benefits for each of those days. If the injured worker has not gotten better by the 15th day the insurance carrier has to go back and provide payment for those first 7 days that were not paid.
For the first 150 days from the reporting of the accident by the employee to the employer Weekly benefits will need to continue until the treating physician has released them to go back to work full duty (no restrictions) or they have been released to some type of light duty and the employer can accommodate those restrictions. If you have not been released or your employer cannot accommodate then the carrier has to continue to provide the payment of “timely benefits.”
The second 150 days is a crucial and often misunderstood or just blatantly ignored rule by insurance carriers as well. After 150 days has run on your claim and if you have not returned to work, the insurance carrier cannot turn stop off your benefits, even if they offer light duty or get their doctor to release you full duty (SC Code Ann. 42-9-260). Stoppage of your weekly benefits can only come by way of a signed Order by the Commissioner. As with the failure to start benefits we see often the same mistakes made by insurance carriers who fail to keep benefits running as required by the law.
Do you have Questions about Not Getting Paid by Workers Compensation for an On the Job Injury?
Let us help you navigate through and around some of the insurance carrier obstacles preventing you from receiving the full benefit of the law. If you need answers as to why you are not getting paid by the insurance carrier if you have been injured on the job, please contact the Goings Law Firm, LLC today and ask to speak with Workers Compensation Attorney Christian Boesl. The call is free to see if we can help you– workers compensation claims are tricky and you may need to hire an experienced lawyer in South Carolina to protect your legal rights.