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What you should know if you suffer a work injury in Richland County
Workers’ compensation claim denials are on the rise in Columbia, South Carolina. Find out what steps you need to take to give yourself the best chance of receiving the benefits you deserve.
Columbia, South Carolina, boasts a diverse and stable economy. Residents find jobs in local and state government, manufacturing, healthcare and technology. It’s not unusual to meet someone who provides services for the Fort Jackson Military Base or the University of South Carolina.
The top 10 employers in Columbia include:
- State of South Carolina
- Prisma Health
- BlueCross BlueShield of SC
- University of South Carolina
- United States Department of the Army
- Richland School District 1
- Richland School District 2
- Richland County
- City of Columbia
- AT&T South Carolina
Although we can all agree that having a diverse economy is a good thing, each occupation presents its own hazards for employees. Fortunately, most employers in Columbia carry workers’ compensation insurance in order to provide benefits to workers who are injured on the job.
Does your Columbia employer have workers’ compensation insurance?
Almost all employers with 4 or more employees (full or part-time) in Columbia are required to carry workers’ compensation insurance.
Those who are exempt from workers’ compensation coverage include:
- Employers with less than $3,000 in annual payroll in the previous year
- Agricultural employees
- Railroad or railway express company employees
- People selling agricultural products
- Casual employees (employees who don’t work regular hours and only work when needed)
- Licensed real estate agents working for a broker
- Federal employees of the state
To find out whether your Columbia employer carries workers’ compensation insurance, type the name of your employer into the “search” field on the South Carolina Workers’ Compensation Commission’s free online tool.
What injuries are covered by workers’ compensation?
Workers’ compensation insurance covers traumatic and occupational work injuries:
- Traumatic work injuries are those that result from a 1-time accident at work (e.g., amputation as a result of a machine accident).
- Occupational injuries occur over a period of time (e.g., repetitive movement injuries).
In order for your workplace injury to be covered by workers’ compensation insurance, it must “arise out of and in the course of” your employment.
Generally speaking, an injury does NOT arise out of and in the course of your employment if it was caused by a hazard or risk unrelated to your employment that you would have been equally exposed to outside of your employment.
For example, if you suffer a heart attack while teaching a class at the University of South Carolina due to high cholesterol, the injury won’t be covered because the injury was caused by a risk unrelated to your employment (high cholesterol), and the injury had an equal chance of occurring outside your employment (for example, at home or on a walk).
What happens if I’m injured while going to or coming home from work?
The general rule is you’re NOT covered by workers’ compensation insurance when you’re going to or coming home from work.
However, there are a number of exceptions to this general rule.
Most recently, the South Carolina Supreme Court held that when an employee crosses from one portion of their employer’s property to another by way of a reasonably necessary and direct route, the employee remains covered by workers’ compensation insurance even if the space they’re crossing is not part of the employer’s property.
The claimant in the case was a professor at the University of South Carolina. The claimant had been walking from the campus library to the campus parking lot. To reach the parking lot, she had to cross a public road. Tragically, she was struck by a car while crossing the road.
When the claimant filed a workers’ compensation claim, the claim was denied on the ground that she was not on her employer’s property at the time of the injury. The claimant appealed the denial, and the South Carolina Supreme Court ultimately overruled the denial.
What benefits does workers’ compensation provide?
Injured workers in Columbia can receive the following workers’ compensation benefits:
- Reasonable and necessary medical expenses (doctor’s visits, surgeries, prescriptions, physical therapy, etc.)
- Wage loss benefits
- Death benefits for certain dependents (in the event the worker is killed)
Wage loss benefits are two-thirds of your average weekly wage prior to the injury (subject to the maximum average weekly wage determined each year by the South Carolina Department of Employment and Workforce).
How long wage loss benefits last depends on the nature of your injury.
How do you file a workers’ compensation claim in Columbia?
You must report your work-related injury in writing to your employer within 90 days of the accident. If you fail to do so, you may not receive benefits.
There are 2 main exceptions to the notification requirement. You don’t need to report your work-related injuries to your employer if:
- Your employer already knows about the accident and injuries, or
- You’re physically or mentally incapable of reporting your injuries.
Once you report your injury, your employer is legally responsible for filing your claim with the South Carolina Workers’ Compensation Commission.
If your employer refuses or otherwise fails to file your claim, you can consult a Columbia workers’ compensation attorney or file your own claim by submitting Form 50 (if you’re injured) or Form 52 (if a family member is killed) to the Workers’ Compensation Commission.
What are your options if your claim is denied?
If your workers’ compensation claim is denied, you have the right to request a hearing before the Workers’ Compensation Commission. To do so, complete and submit Form 50. When filling out the form, be sure to check box 13b (which states “I am requesting a hearing”).
Your case will then be assigned to a commissioner who will hear your case in 3-5 months.
If you’re unhappy with the decision made at the hearing, you can appeal the decision to the circuit court and then, if necessary, to the South Carolina Supreme Court.
How to find a Columbia workers’ compensation attorney?
The decision to approve or deny your workers’ compensation claim might be the most important financial decision you’ll ever face.
To make things more stressful, the denial rate for workers’ compensation claims across all industries has increased over the last decade.
An experienced Columbia workers’ compensation attorney can make sure your claim is filed properly and can represent you should your claim be denied. What’s more, a Columbia workers’ compensation attorney can help you determine whether additional claims should be made (such as a 3rd-party lawsuit) and can help you deal with the legal implications of receiving workers’ compensation benefits and Social Security disability benefits.
To find an experienced Columbia workers’ compensation attorney, consider using our free online directory.
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