South Carolina's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers.
Exemptions from coverage may apply to certain employees, including employees of very small employers, agricultural workers, domestic employees, professional athletes and casual labor.
Medical Benefits are provided to employees entitled to workers' compensation benefits, including coverage for necessary medical care.
The employer makes the initial choice of treating physician. The employee may change physicians with the approval of the workers' compensation division, the employer or the workers' compensation insurer.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 7 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than 14 days indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the injured worker's pre-injury wages, subject to a cap, and continue for up to 500 weeks. The employer may offer the injured worker continued salary instead of TDD benefits.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In South Carolina PTD benefits are calculated based upon 2/3 of the worker's pre-injury wages, subject to a cap. PTD benefits may continue for up to 500 weeks.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In South Carolina PPD benefits are determined based on a statutory schedule, with benefits based on the injured worker's actual wage losses. Benefits are calculated based upon 2/3 of the injured worker's average weekly wage, subject to a cap. For unscheduled injuries, PPD is based upon a functional impairment assessment of the injured worker, along with factors such as age, occupation and education, and benefits may be payable for a maximum of 340 weeks,
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In South Carolina, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap. Benefits may be payable for up to 340 weeks.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, disfigurement, mental stress and occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based the deceased worker's compensation rate, subject to a cap in amount and duration. Benefits may continue for minors until the vested benefit is received or, for dependents over the age of 19 who are students, until the child reaches the age of 23.
Attorney fees are limited by statute to more than 33% of the recovery, and are subject to review by the workers' compensation commission.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
South Carolina Workers' Compensation Commission
1333 Main Street, Suite 500
P. O. Box 1715
Columbia, SC 29202-1715