work comp questions

Additional Workers' Compensation Information

Common Work Comp Questions | South Carolina Work Injury Lawyer

What are the scheduled parts worth?

Disability for scheduled parts are divided into two categories. If the specific part is covered under S.C. Code Ann. § 42-9-30, an award must be made pursuant to the statute. If the statute does not cover the specific part, reference should be made to the scheduled parts listed in the regulations. S.C. Code Ann. § 42-9-30(20); R. 67-1105. See attached chart.

What situation would place responsibility on the employer to pay claimant attorney fees?

In appeals to the Supreme Court or Court of Appeals, costs are taxed against the appellant when an appeal is dismissed or affirmed. When a judgment is reversed, costs are taxed against the respondent. Costs include attorney's fees of $750.00.

Frivolous Actions: While an uncharted area of South Carolina Law, the South Carolina Frivolous Civil Proceedings Sanctions Act applies to workers' compensation proceedings. S.C. Code Ann. §15-36-10.

Occupational Diseases

Occupational Diseases are also compensable, but are under a different set of criteria. The claimant must suffer from (1) a disease, (2) that arises out of and in the course of employment, (3) which is due to hazards in excess of those ordinarily incident to employment, (4) and is peculiar to the occupation in which the claimant was engaged. (5) It must be caused by a hazard recognized as peculiar to a particular trade, process, occupation, or employment, as a (6) direct results from the claimant's continuous exposure to the normal working conditions thereof. S.C. Code Ann. § 42-11-10. Ordinary diseases may be occupational if produced or aggravated by distinctive conditions of employment. The aggravation, acceleration, or lighting up of a pre- existing or latent infirmity or weakened physical condition may constitute a disability of such a character as to come within the meaning of workers' compensation acts, even though the accident would have caused no injury to a perfectly normal, healthy individual. Ferguson v. State Highway Department 197 S.C. 520, 15 S.E.2d 775 (S.C. 1941).

What is exposure to bad faith?

There is no cause of action for bad faith refusal to pay workers' compensation in South Carolina. Mack's Transfer & Storage v. Cook, 355 S.E.2d 861 (Ct. App. 1986). The Court of Appeals held that a worker who sustains injury covered by the Workers' Compensation Act may not bring separate action in courts for damages if employer and employer's insurance carrier allegedly act in bad faith in processing and paying his claim. However, if the Commission determines that an employer/carrier has withheld temporary benefits on an admitted claim in violation of S.C. Code Ann. § 42-9-260, then the employer/carrier may be subjected to a penalty of 25% of the amount improperly withheld.

Does the Claimant have to sustain a specific occurance or trauma in order to have a compensable claim?

NO. In Creech v. The Ducane Co. (467 S.E.2d 114, SC Ct. App. 1996) the Court of Appeals ruled that "In determining whether something constitutes "injury by accident" under workers' compensation law, no slip, fall or other fortuitous event or accident in cause of injury is required; unexpected result or industrial injury is itself considered the compensable accident." Id. Proof of the "causative event" is not required to establish "injury by accident" under workers' compensation law. The claimant had previously suffered a back injury and had been compensated. He later re-injured his back, when he bent over to lift an object weighing less than one pound, bringing about this case.

Can a claim be settled without court / commission approval?

Ordinarily NO, but if a claim is very minor it does not have to be reported to the Commission or the carrier. Additionally, if a claim is for "medicals only," the case may be closed by filing a WCC Form 12-M. When an injury requires less than $500 in medical treatment and does not cause more than one (1) lost work day or permanency, the employer may pay for the medical treatment. The employer is not required to make a written report to the employer's representative or to the Commission. When an injury requires less than $2,500 in medical treatment and does not result in compensable lost time or permanency, the employer's representative shall retain the Form 12-A (First Report of Injury) filed by the employer for two years. The employer's representative shall make a report of the injuries in this category on a Form 12-M to the Commission's Accident Reporting Division annually on April 1st. Those injuries which exceed $2,500 in medical treatment or result in compensable lost time or the possibility of permanency must be reported within ten business days after the occurrence or knowledge of the injury.

Are there any state requirements for vocational rehab?

NO. The South Carolina Vocational Rehabilitation system is usually free. The Commission has been known to recommend, but not require or order vocational rehabilitation.
S.C. Code Ann. §42-9-70, the statutory provision that used to cover this subject, has been repealed and no longer exists. However, the employer may face penalties under OSHA.

Which prosthetic devides are covered and for how long?

S.C. Code §42-15-60 grants lifetime replacement of prosthetic devices. All prosthetic devices which a doctor finds necessary in relation to the work injury are covered.

Is Subrogation available under Workers' Compensation?

S.C. Code Ann. §42-1-560 provides that an injured employee or his personal representative in the case of death may receive compensation benefits and enforce by "appropriate proceedings" his rights against a third party tortfeasor. The statute also states that "the carrier shall have a lien on the proceeds of any recovery from the third party, whether by judgment, settlement or otherwise South Carolina also recognizes an equitable lien in such matters.

No claim for compensation under this title shall be assignable and all compensation and claims therefore shall be exempt from all claims of creditors and from taxes. S.C. Code Ann. §42-9-360(A).