Information For Employees/Injured Workers/Claimants
How do I report an on-the-job injury?
Report all injures at work to your employer immediately and request medical treatment, if needed. If you neglect to report the injury within 90 days of the accident you may lose your benefits. Although you must report the injury within 90 days, you have up to two years to file a claim for benefits. If a worker dies because of work-related injuries, the workers' dependents, or parents if there are no dependents, must file a claim within two years of the death to claim benefits.
How do I file a claim?
You may personally file a claim if your employer does not report your accident, denies your injury by accident, or if you believe you did not receive all of your benefits. To file a claim you must submit a Form 50 or Form 52 to the Commission. If you are unable to download these forms, email the Commission's Claims Department at firstname.lastname@example.org to request the forms be mailed to you. When filing a claim on a Form 50 or Form 52, mark the box 13a. which states, "I am filing a claim. I am not requesting a hearing at this time."
What medical treatment am I entitled to receive?
You are entitled to all necessary medical treatment that is likely to lessen your disability. Workers' compensation generally pays for surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. Keep in mind that in order to receive these benefits you must go to the doctor chosen by your employer or its insurance representative.
How is the compensation rate determined?
You are entitled to compensation at the rate of 66 2/3 percent of your average weekly wage based on the four quarters prior to your injury, but no more than the maximum average weekly wage determined each year by the South Carolina Department of Employment and Workforce. If you are working two or more jobs at the time of accident, those wages may be included as part of the average weekly wage and compensation rate.
Will I get compensated for missing time from work because of my injury?
There is a seven-day waiting period before benefits can be paid. If you are out of work for more than seven days, payments will come from your employer's insurance representative. If you are out of work for more than 14 days, you will receive compensation even for the first seven days. You can expect payments to be made directly to you and these should continue until the doctor releases you to return to work.
When are my benefits terminated?
After the doctor releases you to return to work with or without restrictions, within 150 days of notification of the accident, you should receive two copies of Form 15 with Section II completed indicating that compensation has been stopped and for what reasons. If the insurance carrier stops your compensation, and if you disagree, complete Section III of the Form 15 and send it to the Commission's Judicial Department. This is your way to request a hearing to be held in sixty days. If the doctor releases you to return to work after the 150-day notification period, your employer or insurance representative will ask you to sign a Form 17 (receipt of compensation) after you have been back to work for 15 days.
What if the doctor releases me to light duty?
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. If you return to light work before you are fully discharged by the doctor at a wage less than you were earning at the time of your original injury, you are entitled to weekly compensation at the rate of 66 2/3% of the difference between your average weekly wage and your new wage.
What if I receive an impairment rating or have a scar?
When the doctor releases you with an impairment rating or if you have a non-surgical scar that can be seen at least eight feet away, the insurance carrier will request an informal conference/viewing. This is an opportunity for you to meet with a representative from the Commission and the insurance carrier to determine the amount of compensation due.
What is a hearing?
The workers' compensation commissioners conduct a hearing to resolve disputes between you and your employer's representative. You may apply for a hearing if your employer does not report your accident, denies your injury by accident, or if you believe that you did not receive all your benefits. You may download the Form 50 from the website to request a hearing, or obtain the Form 50 by contacting the Commission's Judicial Department at email@example.com. Mark the box 13b. which states, "I am requesting a hearing." A $50 fee is required.
Do I get reimbursed for my travel expenses when I go to the doctor?
Yes, if the round trip distance is more than ten miles from your home. Effective August 23, 2004, Commission approved allowance for trips to a pharmacy if the round trip distance is more than ten miles from your home. You should be reimbursed for the round trip mileage at the rate allowed state employees for mileage.
Can I get a second opinion if I am not happy with the doctor to whom the insurance carrier refers me?
You can talk to the insurance carrier and see if he or she will allow you to go to another doctor, or you can request a hearing by completing a Form 50 and have a Commissioner make a determination on the case.
Who sends me my weekly check?
Your employer is required to have workers' compensation insurance if they have four or more employees and the insurance carrier will be responsible to pay compensation to you if you are out of work for more than seven days.
When is a Form 18 due?
Form 18 is due 6 months from the date of accident and each 6 months thereafter until the file is closed. The must be filed 10 days before or after the due date to avoid a fine.