This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you are injured on the job, report the details of the accident to your employer as soon as possible, if not immediately. You must report the accident to your employer within ninety (90) days or risk your ability to receive payment for medical fees and lost wages.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
With some exceptions, almost every employer and employee is covered by the South Carolina Workers' Compensation Act. Under this Act, all covered employers are expected to provide sufficient insurance coverage for wage-compensation or establish proof of personal ability to pay out of pocket for potential wage-compensation claims.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
Timeliness is an essential element of the claims process. Make sure you keep track of the details surrounding your work-related accident, including dates, and report those details as soon as possible.
4. What benefits might I be eligible to receive?
Worker's compensation benefits can include payments for necessary medical treatment and expenses, loss of wages, and/or compensation for permanent disability or disfigurement.
Compensation for loss of wages usually begins after you have been absent for seven or more days from work as a result of your accident. Your wages will be paid to you at a reduced rate, approximately two-thirds (67%) of your average weekly wages. State law mandates that wage compensation may be paid for a maximum period of 500 weeks.
Payments for disability or disfigurement will depend on the extent of your injuries and the circumstances of your situation.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
Workers' compensation claims should be filed within two (2) years of your work-related accident. The claims process begins when you notify your employer. At that point, your employer or your employer's insurance provider has ten (10) days to report the accident to the Workers' Compensation Commission. This signals to the Commission to begin monitoring your claim (i.e., payments related to your medical treatment, lost-wages) with your employer and/or employer's insurance provider.
You may file an application for a hearing before a commissioner for one of the following reasons: if your employer does not report your accident, if your employer denies your injury is work-related, or if you believe you have not received all the benefits owed to you. Also, if you and your employer cannot reach an agreement regarding compensation you may file for a hearing within fourteen (14) days of notifying your employer of the work-related accident or the last payment of compensation.
A commissioner will render a determination about your dispute or issue. This determination may be appealed to Commission for review. When this happens, a panel of three to six commissioner is assembled to consider the circumstances surrounding your appeal.
6. If I am not happy with the determination, how do I appeal?
If you or your employer continue to be dissatisfied with the Commission's determinations you may appeal your claim subsequently to the Court of Common Pleas and the State Appellate Courts.