After a work-related accident, injury, or illness, many injured workers and their families worry about how they will cover their expenses. Medical bills, rent or mortgage payments, and other living costs can quickly pile up, adding to the stress—especially when you’re unable to work and missing a paycheck.
The good news is that most workers in South Carolina are protected under the state’s workers’ compensation system. Any business with three or more employees is required to carry insurance to cover workplace injuries. As a no-fault system, workers’ compensation is meant to provide benefits quickly and efficiently—at least when the process goes smoothly.
In this article, we’ll share what workers’ compensation covers in South Carolina, how to access your benefits, and what to do if your claim is denied. If you have questions about your rights, don’t hesitate to reach out to an experienced Aiken workers’ compensation attorney at Johnson, Johnson, Whittle, Lancer, & Staggs for guidance.
Medical Expenses Covered by Workers’ Compensation
One of the most significant benefits of workers’ compensation is coverage for medical expenses related to your injury.
Here’s a breakdown of what’s typically included:
Emergency Medical Treatment
If you’re injured on the job and require immediate care, workers’ compensation will cover the cost of ambulance rides, emergency room visits, and initial treatment. This ensures you receive prompt medical attention without worrying about the bill.
Doctor Visits and Ongoing Medical Care
After the initial emergency care, workers’ compensation continues to cover follow-up appointments, specialist consultations, and routine checkups related to your injury. Whether you need to see an orthopedic surgeon, a physical therapist, or your primary care physician, these visits are typically covered.
Hospital Stays and Surgeries
If your injury requires hospitalization or surgery, workers’ compensation will cover these costs. This includes everything from overnight stays to complex surgical procedures necessary to make a full recovery.
Medications and Medical Equipment
Prescription drugs, physical therapy, and necessary medical devices like crutches, braces, or wheelchairs are also covered. These are essential for your recovery and long-term well-being.
Rehabilitation and Therapy
Workers’ compensation often includes coverage for physical therapy, occupational therapy, and other rehabilitation services. These programs help restore your function and mobility, allowing you to return to work as soon as possible.
Wage Replacement Benefits
When you’re unable to work due to a workplace injury, workers’ compensation provides wage replacement benefits to help you stay financially afloat.
Here’s how it works:
Temporary Total Disability (TTD) Benefits
If your injury prevents you from working entirely while you recover, you may be eligible for TTD benefits. These benefits typically replace a portion of your average weekly wage (usually two-thirds) until you can return to work.
Temporary Partial Disability (TPD) Benefits
If you can return to work in a limited capacity but earn less than before your injury, TPD benefits make up the difference. For example, if you’re working fewer hours or in a less demanding role, these benefits help bridge the gap.
Permanent Total Disability (PTD) Benefits
In severe cases where your injury prevents you from returning to any form of employment, PTD benefits provide ongoing financial support. These benefits are designed to help you maintain your quality of life despite your inability to work.
Permanent Partial Disability (PPD) Benefits
If you recover from your injury but are left with a permanent impairment that affects your ability to perform certain tasks, PPD benefits compensate you for the lasting impact on your earning capacity.
Vocational Rehabilitation Benefits
Sometimes, a workplace injury prevents you from returning to your previous job. In these cases, workers’ compensation may offer vocational rehabilitation benefits to help you transition into a new career.
Job Retraining Programs
If your injury prevents you from performing your old job, workers’ compensation may cover the cost of retraining programs to help you learn new skills.
Education Assistance
Whether you need to take courses or earn certifications to enter a new field, workers’ compensation can provide financial assistance to support your education.
Placement Assistance
Some programs also offer job placement services to help you find suitable employment after your recovery.
Death Benefits for Families
Tragically, some workplace injuries result in fatalities. In these cases, workers’ compensation provides death benefits to the surviving family members.
Compensation for Dependents
Spouses, children, and other dependents may receive financial support to help them cope with the loss of income.
Funeral and Burial Expenses
Workers’ compensation typically covers the cost of funeral and burial expenses, easing the financial burden on grieving families.
Lump-Sum Payments vs. Ongoing Benefits
Depending on the circumstances, death benefits may be paid as a lump sum or through ongoing payments. An attorney can help you understand which option is best for your family.
What Workers’ Compensation Does Not Cover
While workers’ compensation provides extensive coverage, there are some limitations. Here’s what’s typically not covered:
Injuries Outside the Scope of Employment
Injuries sustained while commuting to work, during off-the-clock activities, or while engaging in personal tasks are generally not covered.
Self-Inflicted Injuries or Misconduct
If your injury resulted from reckless behavior, intoxication, or intentional harm, you may be disqualified from receiving benefits.
Pain and Suffering
Workers’ compensation does not cover emotional distress, pain and suffering, or punitive damages. These are typically addressed through personal injury lawsuits, not workers’ comp claims.
What to Do if Your Workers’ Compensation Claim is Denied
Unfortunately, claims are sometimes denied. Here’s what you can do:
- Common Reasons for Denial
- Disputes over whether the injury is work-related.
- Missed deadlines for filing claims.
- Lack of sufficient medical evidence.
Steps to Appeal a Denied Claim
If your workers’ compensation claim is denied, taking the right steps—such as gathering additional evidence, filing an appeal, and seeking legal assistance—can help you secure the benefits you deserve.
- Gather additional documentation, such as medical records and witness statements.
- Consult a workers’ compensation attorney to guide you through the appeals process.
- File an appeal with the South Carolina Workers’ Compensation Commission.
Contact a Workers’ Compensation Attorney in Aiken, SC Today
Workers’ compensation is an essential safety net for employees injured on the job. It covers medical expenses, wage replacement, rehabilitation, and even death benefits for families. However, navigating the system can be complex, and claims are sometimes denied.
If you’ve been injured while at work, it’s important to understand your rights and take action to pursue the benefits you deserve. At JJWLS, our South Carolina personal injury lawyers are here to help. Contact our Aiken office today at (803) 649-5338 for a free consultation to discuss your case and ensure you receive the support you need.
