Do I Need a Workers Comp Lawyer?

Apr 2, 2019

What is Workers’ Compensation?

workers comp

Many of us are living paycheck to paycheck.  Now, imagine that you are severely injured at work.  You may have savings that you can utilize for a short while; however, it is likely that it will not sustain your family for long.  Therefore, we have Workers’ Compensation.  Workers’ Compensation is a benefit that is in place to protect individuals who are injured at work.  Workers’ Compensation provides medical and wage benefits to those who are injured at work or who become ill in the course of their work.

The basic requirement for Workers’ Compensation is for an injury or illness to have a direct tie to the workplace and/or job-related duties.  In general, an employee with a work-related illness or injury can get Workers’ Compensation benefits regardless of who was at fault, although there are some limits to this discussed in the coverage section below.

It is not a requirement for all employers to have Workers’ Compensation coverage. State laws vary, but an employer’s responsibility to provide coverage usually depends on how many employees it has, what type of business it is, and what type of work the employees are doing.  Certain types of employees are often excluded from Workers’ Compensation coverage, for example farm workers or seasonal workers do not often qualify for Workers’ Compensation coverage.  Also, independent contractors often do not qualify for Workers’ Compensation coverage.

workers comp lawyer

What does Worker’s Compensation cover?

Workers’ Compensation pays for medical treatment and loss of wages that result from a work-related injury or illness.  Here are some examples of what Workers’ Compensation does cover:

  • Injuries that occur while performing your line of work. Even if you are traveling for businesses and outside of your regular workplace, if you are traveling as a requirement for your work and injured then Workers’ Compensation benefits could apply.  The important factor here is if you were performing work-related duties.
  • Injuries that are caused by the aggravation of a pre-existing injury while performing work duties.
  • Injuries that are instigated from overuse or misuse of a body part at work over a long period of time, such as repetitive stress injuries or chronic back problems
  • Illness that occurs at work only if a medical expert confirms that the workplace did in fact cause the illness. Some examples of possible illnesses that are the gradual result of work conditions include heart conditions, lung disease, and stress-related digestive problems.
  • Mental stress caused by work only if the mental stress is directly linked to the workplace (i.e. extraordinary workplace conditions). It is very difficult to prove that the mental stress is directly linked to the workplace and as a result mental stress is the most difficult type of injury/illness for which employees receive compensation.

We have covered some of what Workers’ Compensation does cover, now here is a list of what Workers’ Compensation does not cover:

  • Injuries that occur because an employee is intoxicated or under the influence of illegal drugs
  • Self-inflicted injuries, including those caused by a person who starts a fight at the workplace
  • Injuries that occur while the employee is committing a crime
  • Injuries that occur while the employee is not working and is not engaged in work-related duties
  • Injuries that occur when an employee is in direct violation of company policy
  • Injuries that happen on the commute to or from work, when the employee is not performing any work-related duties

When Should I apply for Workers Compensation?

Speed is a necessity for any Workers’ Compensation issue.  If you are injured on the job you should notify you employer immediately; we recommend that you provide notice in person and in writing.  An employee has a limited number of days to report the injury and collect benefits.  If there is a delay in reporting the issue, then there will be a delay in filing for compensation benefits – a delay may create confusion over the legitimacy of the claim.

Reporting of the injury may be more difficult for cumulative injuries or illnesses.  In general, we recommend that you advise your supervisor of any short-term pains/illnesses that may be a result of work.  We recommend that you log these discussions.  Also, meet with your medical provider regularly to discuss your work-related concerns and any minor problems that they may be creating for your body.  Minor problems (such as wrist pains) can turn into major problems (such as carpal tunnel).

A typical Workers’ Compensation claims process is as follows:

  • Employee files a claim with the employer
  • Employee is referred to an approved physician for evaluation and treatment
  • Insurance company investigates and makes a determination of benefits

At this point, the employee should be notified of claims approval as well as the extent of medical and financial assistance available.  The employee has the right to dispute a Workers’ Compensation approval and can request a hearing.  This often occurs if an employee does not agree with the type, amount, or duration of benefits that were approved.  There are different avenues to explore if you do not agree with your Workers’ Compensation benefits, including mediation, hearings, and appeals.  It is advisable to speak with an attorney who will be able to determine which procedures apply to you.

Often, a Workers’ Compensation claim is stalled or denied.  This can create additional stress for the injured as there is no progress toward replacing lost wages that resulted from the workplace illness or injury.  Insurers may stall or deny a claim if:

  • Injury or illness did not occur on the job
  • Suspicion of fraud
  • Claim was not filed in a timely manner
  • Employee did not follow through with a physical examination in a timely manner
  • Insufficient evidence to tie the injury/illness to workplace duties

Do I Need a Workers Comp Lawyer?

The Workers’ Compensation law in South Carolina was revised on July 1, 2007. It is a comprehensive law that changes many of the previous statutes and common law. It may be particularly important to contact a Workers’ Compensation attorney about your Workers’ Compensation case due to the many new standards and proofs that must be met to successfully prevail in a Workers’ Compensation case.  Workers’ Compensation Attorneys help employees to navigate the laws; build their case; determine appropriate compensation; and then fight for that fair compensation.

If you are having problems getting Workers’ Compensation benefits, consult with an attorney who is experienced in disputing Workers’ Compensation claims and who will fight for your rights. A Workers’ Compensation attorney is best qualified to resolve the dispute and get you the medical and financial assistance that is lawfully yours.

If you have suffered any injury or illness as a result of work, please contact the South Carolina Workers’ Compensation lawyers at the Law Offices of F. Craig Wilkerson Jr.  Our expert knowledge in matters of Workers’ Compensation will help you receive all the benefits you are entitled to under the law.  Schedule a free consultation or call 803-324-7200.