How do you get permanent disability benefits through workers’ compensation insurance if you have been severely injured on your job?
After reporting your injury to your employer and receiving emergency medical care, you should begin receiving temporary benefits from workers’ comp, unless your employer denies your claim, in which case you will need to request a formal hearing and present your medical evidence to the Workers’ Compensation Commission.
In this article, we will discuss when your temporary benefits become permanent disability benefits and what you should expect throughout the process, including:
- What permanent disability benefits are,
- The difference between permanent total and permanent partial disability benefits,
- The importance of your impairment rating and disability rating,
- How much permanent disability benefits pay, and
- How long permanent disability benefits last.
What are Permanent Disability Benefits?
In many workers’ compensation cases, temporary benefits are all a person needs to get them through the rough patch after they are injured on the job. Once a person has recovered from an injury, their doctor will clear them to return to work, and their benefits end.
In other cases, however, the employee’s injuries may be severe, resulting in a lifelong disability where the employee is unable to return to work. What then?
Depending on the medical opinions provided by their doctors, a person may be entitled to permanent total disability benefits or permanent partial disability benefits, and they can continue to collect insurance payments each month (or negotiate a lump-sum settlement, depending on the facts of the case).
Permanent Total Disability Benefits
SC Code Section 42-9-10 defines total and permanent disability as “the loss of both hands, arms, shoulders, feet, legs, hip, or vision in both eyes, or any two thereof.”
You should qualify for total permanent disability benefits if you have lost two of any of the body parts listed above, or any combination of two body parts listed above.
What if you did not lose two body parts, but your injuries have still resulted in a disability that prevents you from working or that prevents you from working the same type of job you previously had?
Permanent Partial Disability Benefits
Permanent disability benefits, whether they are total or partial, do not begin until you have reached maximum medical improvement – if you are still disabled at this point, it is no longer temporary and you are entitled to begin permanent disability benefits (or negotiate a lump-sum settlement).
Permanent disability doesn’t necessarily prevent you from working and earning an income, however. First, your doctor will assign an “impairment rating” that estimates your ability to use the affected body parts.
More importantly, you will then be assigned a “disability rating” that estimates your ability to perform your job taking into consideration your impairment rating and the loss of functioning caused by the injury.
It is the disability rating that determines the amount of compensation you will receive as your permanent partial disability benefits, and you should keep in mind that a high impairment rating doesn’t always translate to a high disability rating – for purposes of permanent disability benefits, the question is to what extent the injuries will prevent you from earning future income.
How Much Do Permanent Disability Benefits Pay in SC?
The amount paid by your permanent disability benefits or settlement will depend on the nature of the injury, whether the disability is total and permanent, whether the disability is partial and permanent, and your impairment rating.
- Your medical expenses should be covered as part of any settlement, including “Dodge medicals” if you need continuing care that would reduce your disability,
- If your disability is total and permanent, SC Code Section 42-9-30 caps the number of weeks that you will be paid 2/3 of your average weekly wage, ranging from ten weeks for the loss of a toe to 500 weeks for the most serious injuries,
- For permanent partial disability, your total payments may be reduced based on the percentage of disability assigned to you in your disability rating, or
- For extreme injuries resulting in quadriplegia, paraplegia, or brain damage, workers’ compensation should pay 2/3 of the average weekly wage for the rest of the person’s life.
In cases where a person is entitled to receive lifetime benefits, SC law does not permit the person to negotiate a lump-sum settlement instead of receiving lifetime benefits.
For many, it is a long road before a person gets to the point where they begin receiving permanent disability benefits, involving:
- Injury and treatment,
- Temporary disability benefits,
- Once the person has reached maximum medical improvement, they receive a disability rating, and
- Permanent disability benefits begin or a lump sum settlement is negotiated based on the body parts affected and the person’s disability rating.
Questions about permanent disability benefits through workers’ compensation?
Contact a SC workers’ comp attorney as soon as possible – your workers’ comp attorney on the Axelrod team will help you to gather and present the medical evidence that is needed to maximize your recovery and to appeal any adverse decisions by the Commission.