Were you hurt in a workplace accident or diagnosed with an occupational illness? Workers’ compensation laws allow qualifying employees in the Carolinas to receive workers’ compensation benefits while they heal. However, the rules vary from state to state, so it’s important to reach out to an experienced workers’ compensation lawyer to learn how to access all of the benefits you’re entitled to.
Read on for answers or watch the video below for some of the most frequently asked questions from the experienced South Carolina workers’ comp attorneys at Stewart Law Offices.
What is Workers’ Compensation?
Workers’ compensation is a type of insurance that employers purchase to cover their employees’ medical expenses and lost wages if they suffer a work-related injury or become sick on the job. Disability benefits are also possible through workers’ comp.
What Types of Benefits Are Available to Me?
Workers’ compensation benefits in South Carolina and North Carolina can include:
- Medical expenses
- Partial wage replacement
- Disability benefits, including temporary total disability (TTD), temporary partial disability (TPD), permanent partial disability (PPD), and permanent total disability (PTD)
- Vocational rehabilitation
- Disfigurement
- Death benefits in a wrongful death case
How Do I Know if I am Covered?
A South Carolina business with four or more employees is generally required to carry workers’ comp insurance. That applies to companies with full-time and part-time employees. A few exceptions apply, such as if you are a railroad worker, agricultural employee, and employers with a low annual payroll.
In North Carolina, employers with three or more employees must purchase workers’ compensation insurance or qualify as self-insured employers for the purpose of paying workers’ comp benefits to their employees. Exceptions include railroad workers, casual employees, domestic servants directly employed by the household, certain agricultural workers, and N.C. federal government employees.
If you are unsure of whether you qualify for benefits, check with a workers’ compensation lawyer immediately.
Am I Covered If the Accident Was My Fault?
In South Carolina, workers’ compensation operates on a no-fault basis. This means that typically, your claim for benefits will not be prevented by your own negligence or carelessness, nor do you need to establish that your employer was at fault.
Coverage may only be denied in specific, narrow circumstances, and the burden of proving these exceptions falls on the employer or insurer. These exceptions are:
- If intoxication was the direct cause (proximate cause) of the accident.
- If the injury resulted from a wilful intent to harm yourself or others.
It is important to note that ordinary recklessness or violations of workplace rules generally do not bar coverage. If your claim is denied, it is strongly advised to consult a workers’ comp attorney.
What Should I Do If I’ve Been Hurt?
Report your work injury immediately to your employer and seek medical treatment promptly. There are a variety of workers’ compensation forms that must be completed to get the process underway, and many are subject to specific deadlines. A workers’ compensation lawyer can help you gather and submit the documentation you need.
Workers’ Compensation Deadlines in South Carolina and North Carolina
This is one of the most critical questions injured workers need to understand. Missing a deadline can cost you your right to benefits.
- South Carolina: Workers must report the injury to the employer within 90 days and file a claim with the South Carolina Workers’ Compensation Commission within 2 years. Death benefit claims must also be filed within 2 years, while occupational disease claims generally follow a 2‑year limit from diagnosis.
- North Carolina: Workers must report the injury to the employer within 30 days and file Form 18 with the North Carolina Industrial Commission within 2 years. Death benefit claims and occupational disease claims also carry a 2‑year deadline.
Acting promptly, keeping records in writing, and consulting a workers’ compensation attorney can help protect your rights and avoid disputes.
What Happens If a Claim is Denied?
Both states have an appeals process if your initial workers’ compensation claim is denied. Don’t be surprised if you are denied — many people are. Insurance companies work hard to avoid paying claims to workers, no matter how valid. A strong workers’ compensation attorney can help prepare your appeals and represent you in hearings before the S.C. Workers’ Compensation Commission or N.C. Industrial Commission, depending on your location.
What is Maximum Medical Improvement (MMI)?
MMI is reached when your doctor determines that your condition has stabilized and is unlikely to improve further with additional treatment. This is an important milestone in your case because it triggers the evaluation for permanent disability benefits. You should not sign any final settlement agreement until you have reached MMI and fully understand the long-term impact of your injuries.
Should I Accept the First Settlement Offer?
Not without consulting an attorney. Insurance companies often make early settlement offers that may not fully account for future medical care, long-term disability, or vocational retraining needs. Once you accept a settlement and it is approved by the Commission, you typically give up the right to further benefits for that injury. A workers’ comp attorney can evaluate whether any offer is fair and negotiate for a better outcome.
How Long Will a Workers’ Compensation Claim Take to Settle?
Where Can I Find a Good Workers’ Compensation Lawyer?
If you live in North Carolina or South Carolina, you can count on the workers’ compensation attorneys at Stewart Law Offices to represent you aggressively if you’ve been hurt. We understand how a job injury can bring on sudden hardships for employees, and we strive to resolve disputes efficiently and effectively so that you don’t have to worry while you recover.
To learn more, call or contact us today for a free consultation.