SC is a "no-fault" workers' compensation state - which makes the worker's compensation system very different than the "tort system" in South Carolina.
What does "no-fault" mean, and how is it different from the "fault" system in civil court?
Even though SC has no-fault worker's compensation, your claim can still be denied - what are some of the more common reasons that workers' comp claims are denied?
What Does No-Fault Workers' Compensation in SC Mean?
When people think of lawsuits or compensation for injuries, car wrecks and negligence usually come to mind - workers' comp in SC is different, though.
You don't have to prove negligence to make a workers' compensation claim in SC - no-fault workers' compensation means that, if you are employed and you are injured on the job, you should be compensated.
No-Fault Workers' Compensation
Under SC's no-fault workers' compensation system, employees who are hurt on the job can be compensated for medical expenses, lost wages, and disability caused by any accident regardless of who's fault it was.
Drive a forklift into the wall? Even though you were negligent, and the accident was your fault, you are still covered by SC's no-fault workers' compensation system.
In exchange for providing no-fault workers' compensation to all employees, the legislature has protected employers by barring all lawsuits against employers for on-the-job injuries - if you are injured while working, your only remedy against your employer is to make a timely workers' compensation claim...
How are Tort Claims Different?
If you are involved in a car wreck, a slip and fall accident, or any other negligence-based tort claim in SC, you must prove that the other person was at fault.
If you are hurt because of someone else's negligence, gross negligence, or intentional act, they are responsible for all damages that you suffered. On the other hand, if you are responsible for the accident, you cannot recover damages and you may be sued yourself...
What if I was Injured on the Job by a Third Party?
If you are on the clock and you are injured because of someone's negligence, other than your employer, you may have both a worker's compensation claim and a civil lawsuit against the third party.
For example, you may be able to file suit against a negligent party when:
- You are involved in a car wreck while on the job;
- Your injuries are caused by a third party contractor at your workplace; or
- You are hurt by a defective product or tool at the workplace.
You may file one or both claims. Although you cannot be compensated twice for the same injuries, your civil lawsuit may cover some damages that workers' compensation does not:
- Pain and suffering;
- Property damage; and
- Punitive damages.
Does Comparative Negligence Apply to Workers' Comp Claims in SC?
In an ordinary civil lawsuit in SC, your recovery may be reduced or completely barred by comparative negligence - if you are more than 50% at fault you recover nothing. If jurors find that you are 50% or less at fault, your recovery can be reduced by the percentage of fault.
Because SC has a no-fault workers' compensation system, there is no comparative negligence - your recovery will not be barred or reduced even if you are 100% at fault for the accident.
Reasons No Fault Workers' Compensation May Be Denied in SC
Although SC has a no-fault workers' compensation system, that doesn't mean that your workers' comp claim will always get paid.
Workers' compensation is insurance. It is administered by insurance companies, who are in business to make profits. They make profits by paying out as little as possible, and they will deny or limit your workers' comp claim if they can...
What are some of the more common reasons that insurance companies deny workers' comp claims?
You must report your injury immediately.
If you do not immediately report your injury, your employer and the insurance company will use that to try to deny your claim.
Remember, if you are injured at home or anywhere when you are not on the clock, workers' compensation does not cover your injury. If you get hurt at work, don't tell anyone, go home, realize the injury is worse than you thought, then tell your boss the next morning, you are leaving yourself wide open for your boss or the insurance company to say you are lying and you hurt yourself at home.
Employers will often require a drug or alcohol test after an on-the-job injury, and they will use the results to attempt to deny your workers' compensation claim.
If there are discrepancies between what you told your employer after the accident, what you tell the insurance company, or what you tell your doctor or other medical providers, the insurance company will use this against you to deny or limit your claims.
Make sure that you are giving accurate and consistent information to everyone involved.
There are time limits for you to report your injury and file your workers' compensation claim. If you miss these deadlines, your claim may be automatically denied.
Get Help from a Workers' Compensation Attorney in Myrtle Beach
The biggest reason workers' compensation claims are denied may be because the applicants did not consult with a SC workers' comp attorney.
You attorney at Axelrod and Associates can help you to file your initial claim, make sure that you have complete medical records and documentation of your injuries, present your evidence to the workers' compensation commission, and appeal any denials of coverage for your injuries.
Call now and schedule a free consultation with a Myrtle Beach worker's compensation lawyer on the Axelrod team. Call us at (843) 916-9300 or message us online to speak with an Horry County worker's comp lawyer today.