Does South Carolina Have “No-Fault” Workers’ Compensation?

In 2023, there were 2.5 million reported workplace injuries in South Carolina. If you’re hurt on the job, you may wonder if fault matters for a workers’ compensation claim. Do you have to prove that the employer is at fault?

Experienced Greenville workers’ compensation lawyer Bobby Jones explains.

Is the South Carolina Workers’ Compensation No Fault?

Yes, the South Carolina workers’ compensation is no fault. You do not have to prove the employer acted negligently or improperly to receive benefits.

There are still things that you must prove, and there are reasons that a claim may be denied. However, because South Carolina has workers’ compensation no fault, you don’t have to prove that the employer is responsible for your injury due to a wrongful act or omission.

How South Carolina’s No Fault System Protects Injured Workers

Unfair position—information in the hands of the employer

Because the South Carolina workers’ compensation system is no fault, you don’t have to prove employer fault to receive benefits. This is a good thing, as it favors the worker.

Generally, when a workplace accident occurs, the employer has better access to information, including business records and company information. Coworkers may be hesitant to speak for fear of retaliation.

If workers had to prove fault, they would have a challenging task. The no fault system helps workers by removing the requirement of proving fault against the employer.

Faster access to benefits

The no-fault system speeds up the process. Traditional personal injury claims can take months or even years. The parties must investigate what happened. They want to prove or disprove fault, and it takes time to interview witnesses, secure experts, and prepare exhibits for a case.

When someone is hurt at work, they don’t have months or years to wait for benefits.

They need medical care now. They’ve lost their income. With a no-fault system, what could be the most contested question, fault, is removed from the case. The parties can process the claim more quickly.

What Does “No Fault” Mean in Workers’ Compensation?

Workers’ comp no fault means that you do not need to prove the employer did something wrong to receive workers’ compensation. But that does not mean that your claim will automatically be approved. There are still things to prove.

You were an employee.
A workplace accident (or qualifying repetitive trauma or exposure) occurred.
This occurred in the course and scope of your employment.
This accident resulted in an injury.

A business employing four or more people is generally required to have workers’ compensation insurance, but there are exemptions. For example, businesses with an annual payroll of less than $3,000 are exempt from workers’ compensation insurance requirements.

Can You Still Be Denied Benefits in a No-Fault System?

Yes, you can still be denied benefits in a no-fault workers’ compensation system. There are criteria that must be met for a claim. You must report the workplace injury and file for benefits within the time limits. The time limit to file a workers’ compensation claim for benefits is 2 years from the date of injury or the date of diagnosis if it is an occupational disease.

You also must report the injury to your employer within 90 days.

Exceptions and Limitations in the SC Workers’ Comp System

Horseplay

You can’t claim workers’ compensation if you’re hurt because of horseplay. But if you’re an innocent bystander and you are injured because of someone else’s horseplay, you may still be covered. Whether this limitation applies is a fact-dependent question. If your claim is challenged, talk to a lawyer about your case.

Willful intoxication

An employee who is willfully intoxicated on the job cannot receive compensation. The employer has the burden of proof to prove that the worker was intoxicated.

Intentional injury

If you purposefully or intentionally harm yourself, you don’t qualify for workers’ compensation. In addition, fraud or exaggeration may exclude a claim.

Deliberate disregard of safety rules

Failure to comply with a safety rule, without cause, can be grounds for denial of workers’ compensation.

Not an employee

Independent contractors cannot receive workers’ compensation. However, when there are subcontractors, such as in construction, a lawyer can help you determine who is responsible for workers’ compensation coverage.

Injury not workplace related

For an injury to be covered, it must occur in the course and scope of employment.

Unrelated medical events are not covered. Job-related violence may be covered, but incidents unrelated to employment, such as domestic violence, may be excluded, unless the employer somehow contributed to the harmful event.

Fault other than the employer

Someone other than an employer may be at fault. Although workers’ compensation remedies are exclusive against the employer, you may have a claim against a third party. The right to workers’ comp is not affected by third-party liability. But there are special timelines and rules when you pursue both types of claims.

What To Do If Your Employer Challenges Your Claim

If your employer challenges your claim, you may request a hearing. A hearing officer can decide if you qualify. You must build the evidence, and you may have representation from an attorney.

I’m sure I can prove fault against my employer. Can I opt out of workers’ compensation in South Carolina?

No. The law says that employers and employees are presumed to have accepted workers’ compensation for the purpose of injury and death by accident arising out of and in the course of employment. As the employee, you are bound by it, even though you probably didn’t explicitly agree to it.

Benefits Covered Under South Carolina Workers’ Compensation

Replacement income for total temporary disability or partial disability
Permanent disability pay
Paid medical care, including medical supplies and physical therapy
Reimbursement for travel for medical care

Workers’ compensation doesn’t pay for pain and suffering. You may receive permanent disability pay for an injury that exists despite maximum medical improvement, but that isn’t the same as pain and suffering. While not having to prove fault is a protection for employees in the workers’ comp system, not having a pain and suffering award is unfavorable from the employee’s perspective.