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Advisory Notice- Medical Service Provider Manual Updates.  To view the notice, click here. (3/24/2022)

Advisory Notice-Form 19.  To view the notice, click here. (3/23/2022)

 

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Injured Worker FAQ's

I was hurt at work. What should I do?

Report all injuries at work to your employer immediately. Be sure to tell an individual with a supervisory role at your company such as a manager, supervisor, or on-site nurse. Reporting your injury to another co-worker may not be considered notice of an injury.

Once you have notified your employer, ask to be seen by the employer’s recommended medical professional for an evaluation and treatment. If you have experienced a serious injury that requires emergency care, seek emergency care first and tell your employer about your injury at the earliest possible opportunity. Failure to report a work-related injury within 90 days of the accident may disqualify you from receiving benefits.

What else should I do to protect my right to benefits?

Often an employer’s representative will file a claim with the Commission after a workplace accident. However, the injured worker (or a dependent if the accident was fatal) must also file a claim within two years after the accident (or date of death) to protect his or her right to compensation. To file a claim, an injured worker (or dependent) must complete a Form 50 (workplace injury claim) or a Form 52 (workplace death claim) and submit it to the Commission prior to the 2- year deadline. There is no charge for filing a claim. The forms are available for download on our website. Questions about filing a claim may be directed to the Commission’s Claims Department at: claims@wcc.sc.gov.

What benefits am I entitled to receive?

There are three types of benefits available for work injuries: medical benefits; lost wages; and permanent disability. Unfortunately, there is no recovery for pain and suffering under the South Carolina Workers’ Compensation Act. The amount of benefits you receive depends on many factors including the average weekly wages you received from all employers prior to the injury, the extent of your injuries, and your ability to continue working.

Who provides my medical care if my injuries were caused by a work-related accident?

In South Carolina, your employer has the right to choose your treating doctor. Medical bills for your work-related injuries may not be paid by your employer’s representative if you receive treatment from any doctor you choose. Therefore, it is very important to ask your employer to send you to a doctor of their choosing. If your injury required emergency care and the emergency room refers you for follow-up treatment, do not assume the referral has been approved. Contact your employer or their representative before scheduling an appointment to make sure the additional treatment is authorized.

What should I expect during my first appointment?

At your initial appointment, be sure to tell the doctor about ALL injuries that were caused by the accident. This information could be important if you disagree about the medical care you are receiving and need to request a hearing. During the appointment, the doctor may ask you questions regarding prior injuries and pre-existing health conditions. Be prepared to answer those questions as clearly and completely as possible.

If your employer’s representative has determined that your injuries were work-related, it will generally pay for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. In addition, you are entitled to reimbursement for travel expenses to and from the doctor and the pharmacy. In addition to your treating doctor, an employer's representative may provide a nurse case manager (NCM) to help manage your care. 

If you are assigned a NCM, remember you may ask for a private examination with your doctor and ask that your NCM only discuss your examination and treatment with your doctor in your presence after the appointment.

However, by seeking treatment under the Workers’ Compensation Act, your are assumed to have agreed to the release of your work-injury-related treatment records to the insurance company, your employer, their attorneys, your nurse case manager, or the Commission. In addition, your authorized treating physicians may discuss your medical history, diagnosis, causation, course of treatment, prognosis, work restrictions, and impairment with those individuals provided you are given proper notice of the communication.

Can I get a second opinion if I am not happy with the doctor provided by the employer's representative?

You can ask to the employer's representative  if he or she will allow you to go to another doctor. If they deny your request, you may request a hearing and have the issue determined by a Workers' Compensation Commissioner. 

My Doctor has written me out of work or given me work restrictions. What happens next?

If your authorized treating doctor thinks that your injuries are severe enough to prevent you from returning to work or performing all of your regular job duties, he or she will give you a doctor's note stating the time period you should remain out of work. Give a copy of this note to your employer and your employer's representative and save a copy for your records.

If you are written completely out of work for more than 7 days, you are entitled to temporary lost wages (or temporary compensation). You are eligible to begin receiving temporary compensation on the 8th calendar day following your inability to work. If you are written completely out of work for more than 14 days, you are eligible to receive benefits from the 1st day of incapacity. The employer's representative will send the compensation payments directly to you (or your guardian or dependent) on a weekly basis. The employer's representative will often send the check via US mail. However, you may ask if direct deposit is available. 

If your authorized treating physician thinks that you may return to work, but should not perform certain job functions while you are healing from your injury, you are eligible to receive temporary partial compensation. You are eligible to begin receiving temporary compensation on the 8th calendar day following your inability to work. If you are written completely out of work for more than 14 days, you are eligible to receive benefits from the 1st day of incapacity. In this instance you will receive payment from your employer for your hours worked and payment from the employer's representative on a weekly basis for a percentage of the difference between your post-injury wages and your pre-injury wages if you make less than your regular hourly rate after your accident.

I have been given light duty restrictions. Must I accept an offer of light duty work from my employer?

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.

How are my weekly benefits calculated?

If you are entitled to temporary total compensation you will receive 66 2/3% of your average weekly wages based on the four quarters prior to your injury but no more than the maximum average weekly wage determined yearly by the South Carolina Department of Employment and Workforce. If you were working more than one job at the time of the accident you may include those wages in calculating your average weekly wage.

If you are entitled to temporary partial compensation you will receive 66 2/3% of the difference between your average weekly wage prior to the accident and your average weekly wage after the accident. 

How long will I receive temporary benefits?

You should receive temporary compensation benefits until you are fully released back to work without any restrictions. If you are released back to work within 150 days of notification of the accident and your benefits are terminated, the employer's representative will send you two copies of a Form 15 with Section II completed notifying you that your payments have been stopped and why. If you disagree that your payments should stop, complete Section III of the form to request a hearing and return it to the Commission's Judicial Department.

If you are released back to work after 150 days of notification of the accident the employer's representative will ask you to sign a Form 17 agreeing that you are able to return to work once you have been back to work for 15 days. Again, if you disagree that you are able to return to work and that your benefits have been stopped, you may request a hearing.

Am I eligible for benefits after I am released by my doctor?

You may be eligible for benefits after you are released back to work. Your eligibility will depend on the specific facts of your claim. When you have completed your treatment, or if your doctor thinks that there is no other treatment that will tend to lessen your period of disability, you will be released from care and may be given an impairment rating if you sustained permanent disability because of the work accident.

The employer's representative may contact you to discuss settlement of your claim. The amount of permanent disability benefits you are entitled to will depend on severity of your injury and your average weekly wage. The employer's representative may make you a settlement offer based on the impairment rating provided by your doctor and the disability rating they think a Commissioner might award at a Hearing. This will be either a percentage of loss of use of a single body part or a percentage of permanent disability to the whole person multiplied by a statutorily determined number of weeks and your average weekly wage. 

Generally, there are two types of settlements for South Carolina Workers’ Compensation Claims. One option allows the employee to seek additional medical care within twelve months of the last payment of compensation if his or her condition worsens.  The other option finally resolves the entire claim including any payments for future medical care. The best settlement option for your claim will depend on the facts of your case and whether you need future medical care.

When should I file for a Hearing?

If your employer’s representative has not reported your claim, has denied your claim, or you believe that you are not receiving all the benefits you are entitled to, you may complete a Form 50 (workplace injury) or a Form 52 (workplace death) request for a hearing and submit it to the Commission’s Judicial Department along with a $50.00 fee. A South Carolina Workers’ Compensation Commissioner will hear testimony and receive evidence during the hearing and will decide whether and which benefits are due. If you have additional questions about how to file for a hearing, please contact the Commission’s Judicial Department at judicial@wcc.sc.gov.