Who Qualifies for Workers’ Compensation?
April 23, 2024 – Paul Hammack
The South Carolina Bar states that any worker may qualify for workers’ compensation if they are injured while on the job, so long as their employer is required by law to insure their employees. Workers themselves are not the only people who may receive workers’ compensation, either. If your loved one passed away due to their on-the-job injury, you can apply for workers’ compensation, but only if you were financially dependent on the deceased.
Not all employers are required to carry this insurance, and there are circumstances under which employees can face a denial of benefits. This article will explain who qualifies for workers’ compensation and what you have to do to get your money.
Workplace Injuries Can Happen in any Industry
Every job comes with its own risks. Your employer is supposed to mitigate these risks as much as possible through proper instruction, training, and the use of safety equipment. The Occupational Safety and Health Administration (OSHA) provides standards and guidelines for multiple industries, for instance.
Unfortunately, workplace injuries still occur, especially in fields like construction. Depending on your occupation, you may encounter any or all of the following hazards on a daily basis:
- Falling objects
- Slip, trip, or fall hazards
- Falls from heights
- Electrocution
- Motor vehicle accidents
- Injuries caused by power tools
Due to the common presence of such hazards, many employers are required to maintain workers’ compensation insurance whether the industry they operate in is inherently dangerous or not.
Most Companies are Required to Carry Workers’ Compensation Insurance
According to the South Carolina Workers’ Compensation Commission (WCC), any company with four or more employees must have workers’ compensation insurance. This includes workers who are family members or who only work part-time.
It may also include subcontractors with any number of employees if the company that hires them requires the subcontractor to carry such insurance. It does not matter if a company is for-profit or not-for-profit—they must insure their employees.
That said, there are some exceptions. S.C. Ann. § 42-1-360 allows certain industries, such as agricultural or railway companies, to not carry workers’ compensation insurance. Therefore, workers in this industry are not entitled to these benefits.
Workers’ Compensation Covers a Wide Range of Injuries
You may be eligible for workers’ compensation for any number of physical injuries, such as:
- Head injuries/traumatic brain injuries (TBIs)
- Back strain
- Broken bones
- Burns from fire, electricity, or chemicals
- Cuts or lacerations
Some injuries may heal with time. If your injury is treatable, you may be eligible to receive temporary disability payments from workers’ compensation until you are well enough to go back to work. If your injuries result in a chronic condition or permanent disability, you might be able to collect permanent disability benefits.
How to get Workers’ Compensation Coverage
The WCC states that you must report your injury to your employer within 90 days. While this is the deadline, you should report your work injury to your supervisor immediately. Also, make sure they document the claim in writing. This can be through an injury report, but at a minimum through an email or text message.
Your employer may then file a workers’ compensation claim on your behalf. If they do not do so for any reason, you can file a claim yourself with the help of an attorney from our firm. It is critical that you ask the employer to provide treatment for your injuries as soon as possible.
If you must go to the ER or family doctor, do so, but report the treatment immediately and request that your employer provide follow-up treatment. All of the doctors you see under workers’ compensation will be chosen by the insurance company unless you get permission to see someone else or you pay for another doctor out of your own pocket.
Benefits You May Qualify to Receive
If your claim is approved, you will receive medical treatment deemed necessary to aid in your recovery and reduce the period of your disability. This may include:
- Doctor’s visits
- Surgery
- Medication
- Physical therapy
Workers’ compensation will also cover related mileage expenses to and from visits more than 10 miles. In addition, you will receive 66 2/3 percent of your average weekly wage every week until a doctor says you can return to work.
How Long Can You Receive Workers’ Compensation Benefits?
You can continue to collect workers’ compensation until you get the go-ahead to return to work. Since the doctors are selected and paid by the insurance company, they tend to be very conservative in their treatment. They have some incentive to attempt to return you to work before you may be fully recovered.
This is why you need to have an advocate as early in the process as possible, which our firm can offer you. If you disagree with the doctor’s decision to send you back to work, you can request a second opinion. If that gets denied, it is up to you and your lawyer to request a hearing before the WCC. You can also request a hearing if you receive an initial denial of your claim.
Workers’ Compensation Hearings
When you apply for a hearing, your case may go directly to a hearing or mediation, depending on the type of claim. As the WCC explains, mediation requires you and the other party (your employer or their insurance company) to sit down with a qualified mediator. The mediator will try to help you come to an agreement. Only if mediation fails does your case move on to a hearing.
At the hearing, you and your employer both get a chance to explain and submit evidence supporting your claims. A workers’ compensation commissioner will then decide.
What Our Law Firm Can do to Help
No matter what line of work you are in, you are entitled to a safe workplace environment. Our team can help you figure out if you are among those who qualify for workers’ compensation. If you do, we can help you through the process of getting your money.
We work on a contingency basis, meaning that we do not get paid until you do. Our team also firmly commits to serving every client with compassion and empathy, which is why we uphold our own Client Bill of Rights. You can view this information on our website, as well as some of our past results in workers’ compensation claims. Read what some of our past clients have had to say in our Google reviews:
- “I was very pleased with the quality of work and the outcome of my case. I felt they were genuinely wanting to do what was in my best interest.”
- “Professional and friendly…no glitzy stuff. Just honest people doing right by their clients.”
Reach Out to Our Team for Your Workers’ Compensation Case
We serve clients in communities throughout South Carolina in personal injury and workers’ compensation cases. Our office is located in Greenville on West Stone Avenue, but we take calls 24/7, so there is no need to visit for your complimentary case review.
Call our office at (864) 326-3333(864) 326-3333 to discuss your or your loved one’s workplace injuries.