Here is a list of the frequently asked questions about workers’ compensation laws that we receive from people who have been injured on the at work.
How do I report an on-the-job injury?
Report all injures at work to your employer immediately and request medical treatment, if needed. If you neglect to report the injury within 90 days of the accident you may lose your benefits. However, it is very important that the injury be reported as quickly as possible so that the employer does not claim that the injury did not occur. Although you must report the injury within 90 days, you have up to two years to file a claim for benefits. If a worker dies because of work-related injuries, the workers’ dependents, or parents if there are no dependents, must file a claim within two years of the death to claim benefits.
How do I file a claim?
You may personally file a claim if your employer does not report your accident, denies your injury by accident, or if you believe you did not receive all of your benefits. To file a claim you must submit a Form 50 or Form 52 to the Commission. When filing a claim on a Form 50 or Form 52, mark the box 13a. which states, “I am filing a claim. I am not requesting a hearing at this time.” However, if you believe that you are not receiving the benefits that you are entitled, you should contact an attorney immediately so that you can properly request a hearing
What medical treatment am I entitled to receive?
You are entitled to all necessary medical treatment that is likely to lessen your disability. Workers’ compensation generally pays for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. Keep in mind that in most circumstances in order to receive these benefits you must go to the doctor chosen by your employer or its insurance representative.
How is the compensation rate determined?
You are entitled to compensation at the rate of 66 2/3 percent of your average weekly wage based on the four quarters prior to your injury, but no more than the maximum average weekly wage determined each year by the South Carolina Department of Employment and Workforce. If you are working two or more jobs at the time of accident, those wages may be included as part of the average weekly wage and compensation rate.
Will I get compensated for missing time from work because of my injury?
The law requires a seven-day waiting period before benefits can be paid. If you are out of work for more than seven days, payments will come from your employer’s insurance representative. If you are out of work for more than 14 days, you will receive compensation even for the first seven days. You can expect payments to be made directly to you and these should continue until the doctor releases you to return to work.
When are my benefits terminated?
After the doctor releases you to return to work with or without restrictions, within 150 days of notification of the accident, you should receive two copies of Form 15 with Section II completed indicating that compensation has been stopped and for what reasons. If the insurance carrier stops your compensation, and if you disagree, complete Section III of the Form 15 and send it to the Commission’s Judicial Department. This is your way to request a hearing to be held in sixty (60) days. If the doctor releases you to return to work after the 150-day notification period, your employer or insurance representative will ask you to sign a Form 17 (receipt of compensation) after you have been back to work for 15 days.
What if the doctor releases me to light duty?
You must accept light work if it is ordered. If you do not accept, all compensation may cease as long as you refuse to return to work. You have a right to a hearing if you believe that you are not able to do the work assigned to you. If you return to light work before you are fully discharged by the doctor at a wage less than you were earning at the time of your original injury, you are entitled to weekly compensation at the rate of 66 2/3% of the difference between your average weekly wage and your new wage.
What if I receive an impairment rating?
If you receive an impairment rating, then you may be entitled to additional benefits under workers compensation. We strongly urge anyone who is injured to contact an attorney if their injury involves a surgery or a impairment to a body part. Without an attorney you may be required to have a hearing against the insurance company’s doctor. It has been our practice that insurance company never want to pay what you are entitled to receive based on the level of impairment or disability from your work related injury.
Do I get reimbursed for my travel expenses when I go to the doctor?
Yes, if the round trip distance is more than ten miles from your home. Effective August 23, 2004, Commission approved allowance for trips to a pharmacy if the round trip distance is more than ten miles from your home. You should be reimbursed for the round trip mileage at the rate allowed state employees for mileage.
Can I get a second opinion if I am not happy with the doctor to whom the insurance carrier refers me?
Under certain circumstances you can obtain a second opinion, but the insurance carrier will likely send you to another “insurance company doctor.” If you need a second opinion, we strongly urge you to contact our firm so that we can obtain a fair and impartial second opinion from a trusted physician.
Who sends me my weekly check?
Your employer is required to have workers’ compensation insurance if they have four or more employees and the insurance carrier will be responsible to pay compensation to you if you are out of work for more than seven days. If the insurance company has not started you checks, or if your checks are delayed or not timely coming to your address, you need to contact our office immediately to protect your rights.
If you or a loved one has a question about any worker’s compensation issue that you are facing, please do not hesitate to contact us today.
Often times a claim for workers compensation benefits can be tricky to navigate on your own, and the insurance companies can be notorious for my protecting the injured workers so that it can save money. Don’t put your financial benefits in the hands of a workers’ compensation insurance adjuster without first talking to a seasoned worker’s compensation attorney.
We are here to help, so call the Goings Law Firm today at (803) 350-9230.