Workers’ compensation is an insurance program. Like all insurers,
workers’ comp. insurance companies and their policyholders (your
employer) too often wants to pay as little as possible when claims are filed.
But you can
receive all of the workers’ compensation benefits you deserve if you follow the rules. Below are10 mistakes the workers’ compensation attorneys of George Sink, P.A. Injury
Lawyers see injured South Carolinians make when filing workers’
1. Failing to report your accident or illness.
South Carolina’s workers’ compensation law requires employees
who are injured and plan to seek workers’ compensation benefits
to report their injury or medical diagnosis to their employer as soon
as possible. Since some injuries are incapacitating, the law stipulates a
90-day deadline for notifying your employer in most cases (there are exceptions for extenuating circumstances). Failure
to meet the deadline could leave you unable to seek benefits.
NOTIFY YOUR EMPLOYER
in writing of any accident, injury or medical diagnosis as soon as possible after
you are hurt or are told of an illness. Get something on the record before
the 90-day deadline, even if it is an incomplete explanation of your situation.
State dates and times of the accident or other factors, and
the fact that you intend to seek workers’ compensation benefits. If you can, obtain any workplace policies for reporting accidents
/ injuries / illnesses and follow them as closely as possible.
SAVE COPIES of the notice and all subsequent documents connected to your accident, injury, illness and workers’ compensation claim.
2. Not filing a claim for benefits.
South Carolina differs from many other states in that it puts the
burden of filing a workers’ compensation claim on the injured employee. Your employer can and should file on your behalf, but may not, especially
if they intend to dispute your claim. Do not rely on your employer. Also,
do not delay in filing.
FILE A FORM 50 (available here; Form 52 is for death benefits) as soon as possible. By law, you have
two years from the date of an injury or illness diagnosis in most cases
to file a benefits claim. But the sooner you file, the sooner you can
begin to receive benefits. The form asks whether you want a hearing. It
also asks whether you are requesting mediation. Check the box that says,
“I am filing a claim. I am not requesting a hearing at this time.”
3. Not seeing the doctor your employer chooses.
Workers’ compensation law allows
your employer or the workers’ compensation insurer to choose the doctor who treats your injury or illness subject to a workers’ compensation
claim. You must see this doctor for assessment and treatment. His or her
reports will be the basis of your claim.
SEE THE APPOINTED DOCTOR. Failure to do so may be grounds for dismissing your claim. You may also
see your own doctor,
but not as substitute for seeing the doctor of record. If you are unhappy with the doctor you
are assigned, you may ask the workers’ compensation insurance carrier
for permission to see another doctor. If the insurer will not accommodate
you, you can complete a new Form 50 to request a hearing before a commissioner
to allow you to do so.
4. Not being open and/or honest about your condition.
||The workers’ compensation benefits you receive will be based on reports
from the doctor of record. He or she will know if you are exaggerating
your condition, but may not recognize problems you fail to explain.
ALWAYS BE TRUTHFUL about your accident, injuries, recovery and setbacks. Providing false
information at any point of the claims process, especially about the extent
of your injuries or illness, is grounds for denial.
5. Not following the doctor’s instructions.
The doctor of record on your claim will file reports with the Workers’
Compensation Commission about your treatment and recovery. If the Commission
learns that you are not trying to get better (by following doctor’s orders)
your claim could be denied or discontinued.
FOLLOW DOCTOR’S ORDERS. In particular, go to doctor appointments that are set for you, including
appointments for physical therapy.
Missing appointments is a common mistake which may cause problems with claims. If you or your personal doctor disagree
with the course of treatment prescribed by the doctor of record, you must
request a hearing with the commissioner for a ruling.
6. Not getting a second opinion.
||Though you must consult and follow the advice of the doctor assigned to
you by your employer or insurer, you should see your own doctor as well.
If your doctor’s opinion of your condition or treatment varies significantly
from the insurance company’s doctor, this may be brought to the
Commission and could have an impact on your claim settlement.
SEE A SECOND DOCTOR. If you do not have a doctor, and are a client of George Sink, P.A. Injury
Lawyers we may be able to point you to a doctor suitable for your injuries
who is familiar with workers’ compensation policies in South Carolina.
We can also help you obtain a hearing and present your case to the Commission.
7. Refusing work offered by your employer.
||The objective of workers’ compensation is to assist injured workers
while they cannot work, and to return them to the work force. But because
workers’ compensation insurance premiums may rise as the payouts
continue, employers may be often overanxious about injured workers returning
to work. Your employer may offer you limited or light duty, or even a
different job, to get you back to work, even at partial pay. If the doctor
of record says you are capable of the work your employer offers, you have
an obligation to take the offer. Refusing the work the doctor says you
can perform may cause benefits to cease.
REPORT FOR WORK and do the work the doctor says you are capable of doing. If you disagree
about your capabilities, you can request a hearing with the Workers’
Compensation Commission. You will need to be ready to prove you cannot
perform the work offered. This may require a second doctor’s opinion.
8. Returning to work too soon.
||Though you do have an obligation to accept work offered by your employer
if you are capable of performing it, you also have a right to your medical
safety. If you believe you are not ready to return to work, you have a
right to appeal the request to the Workers’ Compensation Commission.
REQUEST A JOB DESCRIPTION of the work your employer plans to assign to you. Advise your employer
in writing that you are not capable of returning to work and that you are
seeking a doctor’s review of the job description. Have both the doctor of record and your own doctor
review the job description. If you have a doctor’s written opinion
that supports you, the commissioner may want to see it.
9. Accepting a claim decision before returning to work.
Your objective should be to return to working for a living. However, you
may not be able to perform the work you once did. Because the workers’
compensation Commission also wants you to return to earning a living,
benefits available in the appropriate case include
money for occupational and vocational rehabilitation, and for education
and training. If you have not yet returned to work or been declared permanently disabled,
or resolved your claim, these additional benefits may be available.
ADVISE YOUR DOCTOR AND YOUR EMPLOYER of your interest in rehabilitation and/or education. An employer may refrain
from introducing a workers’ compensation recipient to the idea of
vocational and occupational rehabilitation or education. It costs them
money (indirectly) and likely means they are equipping an employee to
work elsewhere. But
you have a right to these benefits in the appropriate case include if they will help you. Advise your employer
and doctors in writing, and follow up with a hearing request to the Commission.
10. Accepting an incorrect disability rating.
Once the doctor of record on your case determines that you have recovered
as well as can be expected (Maximum Medical Improvement), he or she will
assign you a
disability rating. This rating is
an important component of your final workers’ compensation settlement. If your disability rating is too low, your benefit could be less than
Get Experienced Help and Advice about a Worker’s Compensation Claim
A South Carolina workers’ compensation attorney from George Sink,
P.A. Injury Lawyers can investigate your case and
pursue a fair settlement for you. We have helped thousands of working men and women throughout
obtain workers’ compensation benefits.
work with you from any point in a workers’ compensation claim, or represent you in appeals before the South Carolina Workers’
In some cases, we can reopen a workers’ compensation claim that has
been settled. If you have additional medical problems stemming from an
occupational injury or illness that were not covered by the settlement,
you may have a claim for additional benefits.
initial consultation is always FREE and our
objective is always maximum compensation for you. Call us now at 888-612-7001!