What Formula is Used to Determine Wage Loss / Disability Benefits?
Calculation of disability for scheduled injuries is done according to a formula set out in the Workers' Compensation Act. Each body part is assigned a particular number of weeks in S.C. Code Ann. § 42-9-30. To determine the disability of an individual, the employee's compensation rate is multiplied by the number of weeks for the injured part set out by the statute and then multiply the resulting amount by the percentage of impairment that the doctor has given the claimant to determine the amount of disability benefits owed.
FORMULA: (Comp Rate X # weeks) X % impairment rating = Disability Benefits Owed
Example: Employee has a compensation rate of $100. He has suffered an injury to his leg. His doctor released him to go to work at Maximum Medical Improvement (MMI) and gave him a 10% impairment rating to the leg. The leg is valued at 195 weeks. Based on this information Claimant would be awarded $1950.00.
($100 X 195weeks) X .10 = $1950.00
Disability does not equal Impairment. Unlike some states, impairment is an "objective" finding by the medical provider. Disability is a "subjective" factual determination made by the Commission in South Carolina. Impairment is but one factor in the determination of disability. Age, physical condition, education, training, nature of the injury, and work experience are some of the other factors the Commission may take into consideration, as well as their subjective opinion. The AMA Guide is relied upon by the Commission in some, not all, situations. It is not unusual for the Commission to award an amount in excess of the claimant's impairment rating.
The kind of disability determinations can result in unpredictable awards. For instance, a 60 year- old, illiterate brick layer with a 20% impairment rating to his back and 15 pound lifting restriction may be given a permanent and total award because of his reduced ability to earn a living.
A Clincher Agreement is entered between an employee and the company to permanently resolve a claim without any additional liability. Once a Clincher Agreement has been entered, an employee cannot ever come back with complaints about the same injury and he/she has no claim for a change of condition.
Practice Note: In South Carolina, a Clincher Agreement involving a pro se claimant must be approved at an informal conference before a Commissioner. The Commission will not approve a Clincher Agreement with a pro se claimant unless the pro se claimant is receiving some amount in excess of his impairment, typically an additional 5%. For example, pro se claimant has a 10% impairment to the back, the Commission will require a Clincher amount equal to 15% or greater. The Commission's rationale for this is that the pro se claimant is giving up certain rights by entering a Clincher Agreement and may be getting a lower settlement than he would if represented by an attorney.
If a claimant is represented by an attorney and a settlement is reached, no informal conference is required.
MAY THE AMOUNT OF TEMPORARY TOTAL DISABILITY PAID BE CREDITED TOWARD THE AMOUNT ENTITLED FOR PERMEANT PARTIAL DISABILITY?
Typically, NO. However, it is credited in a permanent and total disability case.