South Dakota'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 and sole proprietors.
Exemptions from coverage may apply to certain employees, including employees of very small employers, some agricultural workers, some part-time domestic employees and casual laborers.
Medical Benefits are provided to employees entitled to workers' compensation benefits, including coverage for necessary medical care.
The employee may choose the initial treating physician. Changes of physician are permitted with the permission of the employer or workers' compensation insurer. Second opinions may be obtained no more than once per month.
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, which are 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 the duration of the temporary disability.
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 Dakota PTD benefits are calculated based upon 2/3 of the injured worker's pre-injury wage, with a more generous formula applied to low wage earners. Some workers qualify for periodic adjustments for inflation. PTD benefits may continue for the duration of the disability. Offsets may apply for Social Security retirement benefits.
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 Dakota PPD benefits are determined based on a statutory schedule, or an assessment of the injured worker's functional impairment, and 2/3 of the worker's average weekly wage, subject to a cap. Benefits for unscheduled injuries may be payable for a maximum of 312 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 Dakota, TPD benefits are paid based upon 50% of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap.
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, 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 on 2/3 of the worker's average weekly wage, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 22 if the dependent is a student, or indefinitely in the event of disability. Spousal benefits end upon remarriage, at which time the spouse may receive a two year lump sum payment.
Dependent children may be eligible for a stipend toward expenses at a South Dakota state college.
Attorney fees are capped at 25% of the disputed amount in the event of a settlement, 30% of the recovery after a hearing, and 35% of the recovery if there are further appeals. Attorney fees are subject to review by the Department of Labor Relations.
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 Dakota Department of Labor and Regulation
Division of Labor & Management
700 Governors Dr., Kneip Bldg.
Pierre, SD 57501-2291