Columbia, SC Workers’ Compensation Attorneys
Workers’ Compensation insurance is provided by employers to help injured workers. If you were hurt at work, filing for Workers’ Compensation could be your best bet at recovering lost wages and medical expenses.
Filing with the help of an attorney can avoid denials and help ensure that the insurance company has enough information to pay your claim. If there are issues, your lawyers can also appeal the case and fight to get you the benefits you need.
For a free case review, call (803) 710-7729 to speak with the Workers’ Compensation lawyers at Burriss Ridgeway Injury Lawyers.
What is Workers’ Compensation Insurance in Columbia, SC?
Workers’ Compensation is an insurance system designed to cover injured workers by providing them with a portion of their lost wages and benefits to pay for medical bills. Suing an employer can be difficult as there are many laws and rules that get in the way – and often, an injury might not actually be your employer’s fault. Workers’ Compensation gives workers a route to compensation without needing to prove who was at fault, and it can even pay damages if you accidentally caused your own injuries.
Originally, before Workers’ Compensation systems were instituted, employees usually had no recourse for injuries except to either hope their employers paid for their injuries or to sue their employers. As mentioned, many accidents are not actually caused by an employer’s negligence at all, so the employer would not be liable in court for the employee’s injuries. Many accidents are also caused by the injured worker, and you cannot sue yourself for injury. Workers’ Compensation allows millions of workers who would otherwise have no recourse to still get payments for medical bills and lost wages in these situations.
Although medical bills and lost wages are covered, there are restrictions. Generally, all necessary medical care should be covered by Workers’ Compensation. Still, you will often need to get approval for the care and use a doctor approved by your employer or their insurance carrier. While medical bills are covered, they are not always paid at their full value, but the reduction in income is usually offset by the medical coverage.
Who Qualifies for Workers’ Compensation in Columbia, SC
Most employees within South Carolina should qualify for Workers’ Compensation coverage. The law requires most employers with four or more employees to provide their employees with Workers’ Compensation benefits.
Workers’ Compensation insurance is not necessary for certain industries or for certain types of workers. Anyone working for the federal government is not covered by a South Carolina Workers’ Compensation policy. Employers in South Carolina do not need Workers’ Compensation coverage for casual employees, agricultural workers, railroad workers, and other specific employees.
Additionally, owner-operator truckers, independent contractors, and owners of companies are typically not covered, and companies with a total payroll under $3,000 per year also do not need to cover employees.
Is Workers’ Compensation Required in Columbia, SC?
Employers following the requirements listed above must carry Workers’ Compensation for all qualifying workers. These workers are not required to pay anything into the Workers’ Compensation and should get coverage as a built-in part of their job. However, when Workers’ Compensation applies to you, you generally also lose your right to sue and must use Workers’ Compensation to recover damages; your right to sue is actually blocked.
Who Pays for Workers’ Compensation?
Workers’ Compensation is a required benefit that your employer should be paying for, not you. You should not have to make any additional payments or pay into a fund to get your benefits. Instead, your employer should be the one to cover the cost.
This is why Workers’ Compensation is often so fraught with issues: your employer (or their insurance carrier) will not want to pay, but you will need the benefits. Because of this, it is always a good idea to have a lawyer help you with your claim and fight to get the benefits you need rather than relying on your employer, your HR department, or even a union representative to get you the benefits you are entitled to.
When Can You Sue for Work Injuries in Columbia, SC?
As mentioned, Workers’ Compensation is the sole path to recovery for many injury victims because their accident was not the employer’s fault or they actually caused their accident. However, Workers’ Compensation is also legally known as the “sole remedy,” and covered workers are prohibited from suing their employers. That means that even if the accident that caused your injuries was indeed your employer’s fault, a lawsuit might be unavailable, and you will have to go through Workers’ Compensation instead of filing a lawsuit. But, like with many legal rules, there are exceptions.
Injured workers can often sue other parties other than their employer for workplace injuries. For example, a pizza delivery driver hit by a car might not be able to sue the pizza parlor they work for, but they can certainly sue the driver who hit them. The same kind of third-party liability can occur in many other employment situations, allowing injured workers to sue contractors, vendors, customers, clients, passers-by, and even the manufacturers of tools and products used in their line of work. Many injuries are caused by defective safety gear, tools, and appliances, and the producers of those items can often be held liable for the injuries their products cause, even in a work environment.
Common Workplace Injuries in Columbia, SC
Injuries at work can happen in many different ways, but the following are some of the most common injuries our Workers’ Compensation lawyers can help with:
Slip and Fall Injuries
Falls are common on slippery surfaces, rocky terrain, or floors covered with litter or other debris. Employers should work to keep job sites safe for employers, but slip and falls and trip and falls still happen in many different situations.
If you drive around as part of your job, you are vulnerable to auto accidents. This could involve those who drive for a living, such as bus drivers and truck drivers. It can also involve people who drive from job site to job site or who have mobile operations. However, accidents during your commute to or from work are generally not covered.
Dropped tools and materials at a construction site, collapsing structures, boxes falling in a warehouse, or other falling materials can seriously injure workers. Depending on what fell on you, your injuries could even be life-threatening.
Repetitive Stress Injuries
Repetitive stress injuries are common in many different injuries. Tasks like typing, steering, or working on an assembly line are often responsible for many repetitive stress injuries that can interfere with your ability to work and require surgery, rehabilitation, and replacement wages.
Often, intentional acts of violence are not covered by Workers’ Compensation insurance. This might give you grounds to sue your employer instead of filing through this system. In any case, compensation should be available to you for instances of violence or abuse in the workplace.
Fires, Explosions, and Electrocutions
Fires can break out in any structure or office. On the other hand, explosions are rarer and are typically limited to factories, especially those dealing with hazardous chemicals. Electrocution is common on construction sites, but faulty wiring, dangerous electronics, and other electrocution hazards can appear at any job.
Occupational Illness (Physical or Mental Health)
Long-term health issues can arise from certain work, especially work involving exposure to chemicals and materials. Asbestos, silica, and other materials can lead to lung disease, while other chemicals can lead to cancer and other illness. Mental health issues can also arise in certain fields, especially if you witnessed a traumatic event or disaster at your job.
If a loved one was killed at work, Workers’ Compensation should provide for your family. There are special rules for these cases and what Workers’ Compensation insurance provides after a workplace death.
What to Do if You Are Hurt at Work in Columbia, SC
Taking steps to get yourself the medical care you need and to round up evidence for your potential case is important after a workplace accident. Follow the following steps:
Seek Medical Attention
Workers’ Compensation should cover emergency medical care for a work injury even if a later claim for benefits is rejected. If you were hurt at work, get to the hospital and get the care you need before returning to work. Your employer might prevent you from getting care or leaving the job site, but caring for yourself is vital. Call our attorneys if you have trouble getting emergency care.
Call a Lawyer
All of the remaining steps in the filing process require some level of legal understanding regarding what you should and should not say, who you can safely talk to about your injury, and what benefits you should get for your injuries. Our lawyers can help you at all steps throughout this process.
Report the Accident to Your Employer
Your employer accepts the report that starts your Workers’ Compensation claim, so it is vital to tell them about your accident. They should have forms for you to fill out detailing when the accident happened, how it happened, and what injuries you sustained. This is the first step in filing your case, so make sure you provide full information.
Your supervisor might have already reported the accident, but you need to report the accident as well in most cases to start the Workers’ Compensation process.
File for Workers’ Compensation Benefits
If your employer fails to file your claim or delays filing, contact a lawyer immediately and file your claim yourself with their help. You might also need to file additional documents and forms if your employer tries to reject your claim or deny that the accident happened.
Collect Evidence of the Accident
Getting evidence of how the accident happened, how you were injured, when the accident happened, and where it happened will be necessary to prove your claim. Getting the names and contact info of witnesses to the accident can also help you prove your case later. Any photos and physical evidence you have – e.g., the machinery or gear that injured you – will also be important. You will also need your medical records, so make sure to get copies of those to bring to your attorney.
What You Need to Prove for a Workers’ Compensation Claim in Columbia, SC
In an injury lawsuit, you need to show that the at-fault party breached some legal obligation to you and that you were injured because of it. In an employment context, some injuries happen even when safety regulations are followed. In any case, Workers’ Compensation is considered a “no-fault” system in that it much of a difference who was at fault or whether anyone violated any legal duties; you can get compensation for complete accidents as well as accidents that could be blamed on someone else. The only thing you cannot get compensation for is an accident caused by your own intoxication or intentional action.
To get compensation, you must prove that your injury was work-related. If the accident happened outside of work and you tried to pass it off as a work injury, it likely will not be covered. Similarly, injuries during your commute to or from work usually are not covered either. However, any injury or illness sustained because of your work tasks should be covered. That includes not only the physical injuries from manual labor but also repetitive stress injuries and injuries that form over time. You should also be entitled to Workers’ Compensation for work-related illnesses like asbestosis, mesothelioma, and cancer.
How a Workers’ Compensation Lawyer Can Help in Columbia, SC
Getting Workers’ Compensation is rarely as simple as it is supposed to be. Claims are supposed to be initiated through your employer and handled quickly so that you can safely stay home from work and still get the benefits and medical coverage you need to cover you while you are out of work. However, even when an employer is cooperative – which is rare – their insurance carrier might not be.
Having a lawyer represent you can help you avoid any accidental disclosures that might be misinterpreted to say that the injury was not work-related or that you caused the injury intentionally. Additionally, when our Workers’ Compensation attorneys explain the injury to your employer and their insurance company, we can be sure to use language and terminology that is expected in this context to avoid any miscommunications or misunderstandings.
Our lawyers can also help you collect evidence and present a strong case to the insurance company. Often, insurance companies deny claims by insisting that they do not have enough information to make a determination on the claim, so it is important to produce all relevant evidence, doctor’s examinations, and other evidence of your condition and how the injury occurred. Doing this can potentially increase the chances of your claim getting accepted on the first try and avoid any delays from rejections or appeals.
If your claim is rejected, we can help you appeal it. We can also help alleviate any temporary freezes or pauses on benefits and fight terminations to help you continue getting the benefits you are entitled to for the full time you deserve them.
Our lawyers can also help you understand what your claim should be worth and help you avoid getting shortchanged. Suppose you are pursuing a lump sum settlement. In that case, we can also help you determine whether the settlement is sufficient to cover your needs or whether ongoing benefits might be better in your situation.
What to Do When Workers’ Compensation Claims are Denied in Columbia, SC
When you file your initial claim for Workers’ Compensation benefits with your employer and their insurance company, they might deny your claim. Often, this is done because they cannot verify that your accident was work-related, or they do not have enough information as part of the claim. Or at least, that is what they will tell you. Our Columbia Workers’ Compensation lawyers can help you appeal denials and get your claim paid.
Reasons for Denial
The reason that insurance companies and employers usually give for rejecting or denying a claim is that they have insufficient information to approve the claim. For them to approve the claim, they need proof that the injury was indeed work-related. If there are no medical records, if the injury was not reported, or if there is insufficient evidence, they will usually reject the claim.
In many cases, this denial is not justified. Injured workers can turn in medical records, make sure their managers made a report about the accident, report the accident themselves, and have witnesses ready to corroborate their stories. Even so, some employers and insurers will reject the claim anyway.
It is always best to have a lawyer review your claim so that you can make it as strong as possible and avoid turning in a claim that has holes in your story or missing information. This can make it harder for insurance to reject you without acting in bad faith.
How to Appeal a Denial
When an employer denies a claim, the injured worker can file an appeal with the South Carolina Workers’ Compensation Commission (SCWCC). The SCWCC is the first place you appeal your decision, turning over the decision on your case to experts with the commission instead of your employer and their insurance company.
This starts with a single commissioner hearing your appeal. Your lawyer will be able to present the evidence of what happened and what injuries resulted. If the commissioner finds that the accident was work-related, then they will order the insurance company to pay your claim. There is a limited time to make this first appeal, so act quickly.
If that single commissioner rules against you and you want a re-hearing, you have 14 days to appeal their decision to a panel of commissioners. When the panel hears your case, they will have a new hearing and potentially make a better decision, given that multiple people can rule in your favor instead of getting a single commissioner who seems skeptical of your claim.
If the full panel or a full commission rules against you, you have 30 days to take the case to court for an appeal. When you file your case in an appeals court, it will go before a judge to decide your case in open court. From there, additional appeals can be made up to the South Carolina Supreme Court if they still have not ruled in your favor. Most cases do not go this far through the appellate procedure, but you are entitled to press your case this way if they do not decide things in your favor.
Should I Appeal My Denial
If information or evidence is missing from your claim, you should appeal the denial. A successful appeal is going to be the best – and likely only – way to get your claim paid. If you wait too long to appeal your case, you will lose the chance, and the insurance company’s denial will become permanent.
If you go through your initial appeal with the commission and your case is still denied, our attorneys can reassess your case and help you determine whether further appeals make sense in your case. If you have a work-related injury, you deserve compensation for it, and we can fight your case for as long as it takes to help you get the benefits you deserve.
Fighting Terminations and Suspensions of Workers’ Compensation Benefits in Columbia, SC
If you were already successful in making a Workers’ Compensation claim and started receiving the benefits you deserve, it could be a shock to get a letter saying your benefits have been suspended or terminated. Again, as with denials, the most common reason for suspension or termination of benefits is lack of information.
Insurance companies often need ongoing information to show that you are still unable to work, you are still receiving treatment for your injuries, and you are still following through with all treatment plans. Sometimes, insurance will reach out to you, only for you to miss their calls or letters or delay returning the requested information. If this or some other event results in suspension or termination of benefits, our lawyers can help you find out what happened, correct any problems, and continue getting the benefits you deserve.
If your doctor has cleared you to return to work but they are wrong, and you still cannot work, then our lawyers can also help appeal that decision and fight any consequences that result from improper determinations.
Contact Our Columbia, SC Workers’ Compensation Lawyers Today
For a free review of your case, call the Workers’ Compensation lawyers at Burriss Ridgeway Injury Lawyers today at (803) 710-7729.