Workplace accidents can result in many different types of workers’ compensation claims. The type of claim that you have can influence how to approach the claim and the benefits that you deserve.
Our experienced Greenville workers’ compensation lawyers at Bobby Jones Law explains the various types of workers’ compensation claims.
Overview of Workers’ Compensation in South Carolina
Workers’ compensation in South Carolina pays benefits for workplace injuries. The injured employee doesn’t have to prove that the employer is at fault for the injury, but they must prove that the injury is work-related. A claim goes through an administrative process, rather than directly to court.
The benefits you receive are based on the type of injury, the medical care required, and any permanent disability. In addition, the injured worker may claim wage replacement pay if the injury prevents them from working. South Carolina workers’ compensation laws address the types of injuries and what the person must prove to receive benefits.
Traumatic Injury Claims: Sudden Workplace Accidents
Workers’ compensation pays benefits for injuries that occur by accident, arising out of and in the course of employment. To receive benefits for a traumatic injury, you must report the workplace injury.
You can receive compensation for a wide variety of traumatic injuries, including:
- Traumatic brain injury
- Broken bones
- Burns, skin trauma, lacerations
- Organ damage, crushing injury, blunt force trauma
- Torn ligaments, tendons, and meniscus
- Back injury
- Hearing loss, vision loss
- Spinal cord trauma, paralysis
Traumatic injuries on the job vary in their nature and the treatment required. Common disputes include the extent of the injury and appropriate medical care, average weekly wages, returning to work, and disability compensation.
Preexisting conditions
When a claim involves a preexisting injury or condition, the employee must prove by a preponderance of the evidence that either the injury aggravated the pre-existing condition or that the pre-existing condition aggravated the injury.
Repetitive Stress Injuries and Cumulative Trauma
The recognized types of workers’ compensation claims in South Carolina include repetitive stress injuries and cumulative trauma. Repetitive trauma injuries occur gradually and are caused by the cumulative effects of repetitive traumatic stress.
The worker must prove causation of the repetitive activities to the injury and do so by a preponderance of the evidence. A direct causal relationship between the activity and the injury is required.
Occupational Illnesses and Toxic Exposure Cases
Disease may be compensated if it results naturally and unavoidably from a workplace accident. Alternatively, a disease may be compensated if it meets the requirements of an occupational disease as stated in S.C. Code Title 42, Chapter 11 – Occupational Diseases.
Qualifying occupational diseases are treated as “injury by accident” for workers’ compensation. To receive compensation for occupational disease, the employee must suffer a disability or incapacitation from performing the occupation that exposed them to the disease. Compensation payable for occupational disease, as a type of workers’ compensation claim, is the same as for injury.
An occupational disease arises out of and in the course of employment. To be compensable, it must result from hazards that are beyond what is incidental to employment. The hazard must be specific to the occupation and result from working conditions.
An illness that a person contracts from a contagious coworker is not compensable if the employee would have been equally exposed to the illness outside of work. Also, if the disease is one that the public is also generally exposed to, it is not compensable unless it’s a complication of an occupational disease.
If a person has both an occupational disease and an injury, they may claim the benefits payable for the malady that results in the longest period of disability.
Typically, the disease must have been contracted within one year of the last exposure to the hazard, but there are some exceptions.
For occupational disease claims, the workers’ compensation commission may refer medical questions to the medical board for an investigation and report. Questions may relate to the existence, cause, and duration of the disease, date of disability, percentage of disability, and other questions requiring experts.
Stress and Mental Injury
Stress and mental injury can be compensated under workers’ compensation claims. To qualify, the employment conditions that led to the injury must be extraordinary and unusual for that particular job. Additionally, medical evidence must show causation between work conditions and the resulting stress.
When a physical injury aggravates stress or mental injury, causation must be admitted by the employer, noted by the authorized physician or the employee’s physician, or verified by a psychologist or psychiatrist.
Death Benefits and Dependents’ Rights
Death benefits are a type of workers’ compensation claim. If death occurs because of a workplace accident, survivors may qualify for death benefits.
- Death must result within two years of the accident or within six years of the accident if the worker is on total disability status.
- Payment is 66 2/3% of average weekly wages, subject to minimum and maximum amounts.
- Payments are made for up to 500 weeks.
- Burial expenses are paid up to $12,000.
Who receives death benefits?
People wholly dependent on the victim at the time of death have the first right to benefits. The spouse and children under age 18 are presumed wholly dependent. If there are multiple people wholly dependent, they split the amount equally, but the spouse must receive at least half. If a child is 19 and a full-time student, benefits may continue to age 23 if full-time enrollment continues.
Partial dependents receive compensation only if there are no whole dependents. If there are partial dependents, they divide benefits in proportion to the support provided to them by the deceased employee. If a dependent child is mentally or physically incapable of self-support, they may collect benefits for the full 500 weeks, regardless of age.
There is a procedure for payment if the deceased employee leaves no dependents. The commuted amount is paid to surviving non-dependent children and, if none, then to parents.
Contact an Experienced Greenville Workers’ Compensation Lawyer
Workers’ compensation protects employees who are injured on the job. You can have help from an experienced Greenville workers’ compensation lawyer. Bobby Jones Law represents injured workers and their families. Contact us now.
