Honest Answers About Worker's Compensation Law and Situations in South Carolina
When you’re faced with a major life event, you’re filled with questions and uncertainty. Get the straight answers you’re looking for from a South Carolina attorney.
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How do you get a workers’ comp settlement?
Settlement negotiations generally start after we issue our demand letter. That’s our official offer to the insurance company containing our analysis of your case with all the evidence that supports the money we’re asking the insurance company to pay.
The process doesn’t start in most cases until you reach maximum medical improvement, meaning the doctor decides you’re as good as you’re going to get.
After that, there’s a flurry of activity on your case, since the insurance company can request a hearing to decide your case that must be scheduled within 60 days. That’s not a lot of time to prepare. That’s why we prepare your case all along—so by the time you get released from treatment, we usually have only your last few medical records to gather before launching settlement negotiations.
Here’s our process to do it.
1. Get the Rest of Your Medical Records Analyzed
Two words should jump out at you here.
- “Rest.” That indicates that we already have some of your medical records, so there’s not as much to get. Preparing your case as it develops instead of waiting until the end relieves pressure on us. It gives us the luxury of taking time to make sure critical details get noticed, giving you and your case critical care when you need it most.
- “Analyzed.” Medical evidence is vital to your case. We don’t just collect your records; we make sure they are read and summarized to evaluate this crucial aspect—and use clinical evidence to support our case for a solid settlement.
2. Analyze Your Impairment Rating
Doctor impairment ratings often drive settlement value. They are based on a book, the AMA Guide to Permanent Impairment. I have it. When I get your rating, I compare it to the range of ratings given by the Guide. Based on that review, I determine if we can make arguments for a higher rating based on the Guide, or if we should get a second opinion for a more accurate rating.
3. Find Out Your Permanent Work Restrictions and Physical Limitations
Your doctor supplies your work restrictions. But your injuries affect not just work, but also your life. The physical limitations come from you. We’ve got a process allowing you to tell us how you can’t do things in life like you used to. We use that to assess your next step.
4. Develop a Strategy for the Highest Workers’ Compensation Disability Rating to Maximize Your Settlement
Based on the severity of your permanent injury, you may qualify for maximum financial and medical benefits such as workers’ comp total disability or wage loss. If so, strengthening our case for those may require me to refer you for a vocational evaluation.
But many settlements involve an injury to a single body part—resulting in a settlement centered around your impairment rating, work restrictions, and limitations. The workers’ compensation disability rating should be higher than the impairment rating because it measures the impact on your ability to work and live.
We create a strategy taking all this into account to help achieve your case goals.
5. Focus on the Goals of the Most Important Person in the Case—You
Before I issue the demand letter, I determine what you want to achieve, since workers’ compensation offers complex settlement options even in a typical case. A key consideration is often whether to keep your right to future care or “clinch” the case, meaning give up medical care for additional money.
6. Last Step Before the Demand Letter—a Written Settlement Evaluation
I give my folks a written settlement evaluation explaining your rights, the strengths and weaknesses of our case, and a range of amounts to settle for. I send it with the final draft of the demand letter, or with a copy of the demand you’ve already approved.
7. The Demand Letter
This formal letter to the insurance company, often sent to its lawyer, has one chief aim: justify a maximum settlement for your case. The letter summarizes your case, especially its strengths. It includes:
- A little background on you.
- A description of how you got hurt.
- An analysis of your medical records. If you’re seriously hurt and go forward without an attorney, you need to be able to do that. How else can you expect the insurance company to grasp how bad you’re hurt?
- A description of your injuries. Importantly, it describes your pain and permanent limitations in meaningful terms that I know the workers’ compensation commission bases its decisions on. You’ve got to prove to the insurance company and its lawyer you can prove your case in court before they’ll take you seriously.
Using all this ammunition, we justify the money amount we’re asking for.
Despite all my work, I never forget we’re a team and who’s the boss. We don’t issue the demand letter until you approve the draft. Once you do, I send it immediately, and settlement negotiations start.
8. Settlement Negotiations
As these go on, I keep you updated every step of the way. I notify you of insurance company counteroffers, and I have you approve any response. Many cases end in settlement. If so, our next step is minimizing how long it takes to get your settlement check.
If the insurance company won't do the right thing to settle it, we request a hearing for a workers’ compensation commissioner to decide it. Don’t worry. I’ll be ready, and so will you.
Yes, It’s Complicated. Get Help From a Professional.
Workers’ comp is confusing even when you’re not hurt and worried about paying your bills. That’s why I try to make it easy for everyone who needs my help. You can get free legal info without even leaving your chair—download my FREE BOOK on workers' comp cases.
What should I bring to my first meeting with a workers’ compensation attorney?
The best answer is any document or piece of evidence that might relate to your work injury, the medical treatment for it, documents from your employer about it, and any communication from an insurance company about it. I’ve got a list of more specific items below. If you don’t have some or even all these items, don’t worry—one of the most important things a good lawyer does is investigate to get all the information that you don’t have. We’ll get it for you.
But first, congratulations! You’ve made the right decision to take control of your work injury case and get some guidance from a professional on how to handle it. By the way, if you’re still a little anxious about how the meeting will work, you can relax. If it’s with me: just check out this article where I pull back the veil on what our first meeting is like—it’s a strategy session where the keywords are “free” and “easy.”
What You Might Bring
Again, if you don’t have all this, don’t let it stop you from the meeting:
- Any communication from the workers’ comp insurance company. This includes letters, emails, and texts. This helps us identify the adjuster we’ll be going against in your case. You may have already found out the hard way they’re really not on your side.
- Any medical records you have. You almost surely don’t have them all. And that’s okay. We’ll get them for you. But bring anything you have, since this helps us identify providers we need to get records from. Any notes you might have can give us an idea of the nature and extent of your injuries and your work restrictions, which helps us evaluate your case to determine how we can help you.
- A list of medical providers, summarizing your treatment. This streamlines our requesting the records. It’s especially important if you’ve waited a while to consider an attorney, and have received extensive treatment from several providers over a long time.
- Any medical bills workers’ comp didn’t pay. One of the primary benefits of workers’ compensation is free medical care related to your work injury. Sometimes the insurance company doesn’t do its job. We need to make sure they do so that you don’t get saddled with medical debt you should never have.
- A timeline of the work you’ve missed. This helps us protect your right to your weekly check if you’ve been shorted by the insurance company. They may be up to date on your checks. If not, bring any documentation you have of missed work, which might include paystubs showing the times you missed for the injury.
- Your photo ID, like a driver’s license. We may need a copy of this for your file, which can help identify you if that’s required.
- Accident report or documentation of the injury. This may come from your employer. But if you are involved in a car accident while working, it’s at least the form you got from the officer at the scene. You may even have a full crash report. Bring what you have.
- Pictures, if you have them. Most folks don’t have pictures of the scene of the injury because it happens at work where you don’t have a camera—and all you care about is getting to the hospital! But you might have pictures of gory wounds or broken bones, or how your wounds healed as time went on, such as removal of stitches or a cast. These can be useful to document the extent of your injuries. It’s sometimes especially helpful to document things that are hard to describe, like the extent of painful swelling to an ankle that’s “as good as it will get” but still balloons to the size of a grapefruit if you stand it for more than a half-hour.
- Contact info for any witnesses. Witnesses are often unnecessary in these cases because many accidents are admitted. And you don’t have to prove the injury was anyone’s fault. In fact, it can even be yours! Plus, as you might imagine, getting your co-workers to testify against your employer generally just doesn’t work. For what’s it worth, you’re very likely not going against your employer—your benefits usually get paid by an insurance company.
- A quick summary in your own words. IF YOU WANT TO GIVE YOUR LAWYER SOME BONUS INFO, type or write up a short statement summarizing your accident, injuries, and treatment. We cover all that in our first meeting.
- Additional relevant info. We might need a little more information if your injury got caused by someone else who doesn’t work for your employer. The classic example of this is if you drive for work and someone else causes a car crash. In that case, we can pursue the at-fault driver for additional compensation, called a “third-party case.” A third-party case complicates and improves your case at the same time. For a car crash, we will need information about the wreck.
Now you’re ready! If you really want to “wow” your potential lawyer, organize this stuff by category into a folder or file. This saves a tremendous amount of time, so I can hit the ground running in our strategy session and move it as fast as possible for you to get the answers you need.
Take Control of Your Case
Even if you’re not ready to meet with an attorney, you still need your questions answered. You’re an injured amateur against a colossal insurance company, and you need help! We have a lot available for you, and not just on this website. Be sure to download my workers’ compensation book for free, which answers a lot of questions you are likely already asking—or should ask.
It won’t cost you a thing to meet with us, and it certainly won’t cost you anything but a little time to get your questions answered. Call toll-free at 888-230-1841 or fill out a Get Help Now form. We’ll get your questions answered and get you pointed in the right direction.
How can the Family and Medical Leave Act affect my South Carolina workers’ compensation case?
A severe workplace injury can bury you in confusing legal paperwork and complicated details. But one law you might need to know more about is the Family and Medical Leave Act—because it can impact your case.
What is the Family Medical Leave Act?
The Family & Medical Leave Act (FMLA) is a federal law giving eligible employees of certain employers up to 12 weeks of unpaid, job-protected leave in a 12-month period.
You don’t have to take all that time in a single block. It can be broken up over that 12-month period.
During that time, employers must also continue your health insurance coverage.
FMLA provides limited job protection. On return, most employees must be restored to the same or similar job with equivalent pay, benefits, and other employment terms and conditions.
To be eligible, an employee must:
- Work for the employer for at least 12 months
- Generally, have at least 1,250 hours of service in the 12 months before taking leave
- Work at a location where the employer has at least 50 employees within 75 miles of the employee’s worksite
How does FMLA impact a workers’ comp case?
One qualifying condition for FMLA is a legally-defined “serious health condition” that makes you unable to do your job. For a badly hurt employee, the question often becomes, “Can I take FMLA leave while I’m out on workers’ comp?”
The answer is yes. Whether it’s the right thing to do depends entirely on your unique circumstances. An experienced workers’ comp attorney can give some guidance here, but you may not have a choice.
Some injured employees are stunned to learn their employers can declare workers’ comp leave as FMLA leave. While it can be frustrating to lose FMLA rights when you’re covered by workers’ comp, it’s the law.
There’s another answer you might need to know.
Can my employer make me take FMLA Leave instead of workers’ comp?
One thing an employer cannot do is force you to take FMLA leave instead of fulfilling its legal duties owed to you under the South Carolina workers’ compensation law.
If your employer sidesteps this legal responsibility, don’t let them get away with it for a second. Call a workers’ comp attorney you trust.
Get Your Questions Answered and Fears Addressed
You’ve stepped unwillingly into the unknown. That’s why I wrote my free book on workers' comp cases—to help folks just like you.
To get your questions answered, fill out our Get Help Now form at the top of the page or call 888-230-1841 to schedule a free, no-pressure strategy session.
Don’t forget to see what people say about us!
The workers’ comp doctor told me I’m as good as I’ll get and he’ll release me, but I’m convinced I need more treatment. Is there anything I can do?
Few things in a work injury case can make you feel as frightened or helpless as the doctor releasing you when you’re convinced there’s more that can be done to make you better.
But just because that doctor gives up doesn’t mean you should. This is your only case to fix the only body you’ll ever get. It’s time to fight for it!
And yes, there’s a very good option you should use—a second opinion. However, you should be cautious and expect the insurance company to oppose it. After all, you’re telling the insurance company you want it to spend more—maybe tens of thousands more—to help you, right after it gets wind the doctor’s ready to close the book on you. Rest assured the insurance company won’t greet the request looking to lend a helping hand. But not only is it worth considering, it’s worth doing right the first time.
A second opinion can make a big difference in your case, but you should meet with an experienced workers’ comp attorney to help you make the best case to get it. You may end up fighting for it at a contested hearing. Don’t risk wrecking your case because you don’t know better.
Seek Help With A Workers’ Comp Second Opinion to Get More Medical Treatment
Fill out our Get Help Now form at the top of the page or call 888-230-1841 to get your questions answered by a skilled workers’ comp attorney. It could be the difference between restored health and a lifetime of regret.
What happens if I get hurt so bad on the job that my injuries keep me from working anymore?
If your South Carolina work injury—or multiple injuries—are severe enough that your doctor or a vocational expert concludes you can’t work again, you may qualify for permanent and total disability benefits under workers’ comp. You can receive some major benefits:
- Free medical care for life. The workers' comp insurance company pays as long as the treatment relates to your work injury. You still have to pay for any other conditions or illnesses that aren’t related to your injury.
- Disability compensation. In most cases, disabled workers receive two-thirds of their average weekly wages for up to 500 weeks. But if you’re paralyzed or sustained a brain injury, you may qualify for that income for the rest of your life- see more on that below.
Two More Things You Should Know About These Benefits
- Being disabled under workers’ comp doesn't mean you're helpless. In fact, if you return to work, you keep the benefits. This encourages the severely injured to be as productive as possible.
- If you suffer total disability from a brain injury or paralysis, you might qualify for the maximum benefits under the law.
Protect Yourself Because Too Much Is at Stake
If your work injury case potentially involves total disability, your medical and financial futures are on the line. You likely need these benefits to prevent you and your family from falling into financial ruin as you waste away under untreated, disabling injuries. And you can rest assured the workers’ comp insurance company will fight you tooth and nail to save its precious dollars from your desperate need.
Hire an experienced workers’ comp attorney to build a convincing case for benefits to protect your future. This is the only chance you’ll get to do it.
If you’ve got questions about your case, start a live chat right where you are. An experienced South Carolina attorney will respond with answers.
What is a functional capacity evaluation (FCE), and why is it important in South Carolina workers' comp cases?
If your doctor wants guidance in assessing your accident injury for a permanent impairment rating or your work restrictions, he might send you for a functional capacity evaluation, or FCE.
Generally, it’s an exhaustive set of physical tests, usually given and scored by a physical therapist. Here’s what you need to know about FCEs.
Why FCEs Are Important
The doctor uses the results for two crucial reasons that can have a big impact on your South Carolina workers’ comp case:
- to give a more accurate rating,
- to set your permannent work restrictions.
The results can help determine if you’re eligible for extra financial benefits for permanent and total disability and wage loss. In the right case, restrictions from an FCE can be used to overcome low impairment ratings to secure a settlement for much higher benefits, if you've got a skilled workers' compensation atorney.
FCE Purpose From the Examiner’s Standpoint
There are generally three main purposes for the tester:
- Evaluate your ability to perform your job. The evaluator often has a copy of your job description from your employer.
- Define the physical level of work you qualify for under United States Department of Labor guidelines. Those provide 5 physical job demand categories: sitting, light, medium, heavy, and very heavy.
- Measure your loss of strength and motion from an injury.
Before moving on to the specific aspects of the test, there’s one vital thing you’ve got to remember.
Your Effort Counts—a Lot!
Exerting good effort is vital. These tests have built-in “lie detectors” that’ll expose deceptively low effort by you. Don’t try it. You’ll be smoked out, and it’ll ruin your case.
Now let’s turn to the tests and info used for the evaluation.
Physical Abilities Tests
The evaluator will test your ability to do the following, noting the maximum amount you can do:
- Lift from floor to shoulder, waist to shoulder, and a few inches off the floor to your waist.
- Push and pull.
- Basic motions including how much you can sit, stand, and walk (and whether you limp), climb stairs and ladders, reach overhead, and bend your knees to stoop, kneel, crouch, and crawl.
- Hand strength and coordination—you’ll be evaluated on your ability to handle objects and grasp with each hand.
This evaluates for things like:
- Whether you limp.
- Your posture and whether you can stand upright.
- Muscle tone—the tests measure tightness, tenderness, and muscle spasm.
- Joint and muscle flexibility.
- Range of motion and whether your ability to move your joints falls within normal limits.
You might even do a treadmill test. This checks your ability to walk for time and distance. The evaluator observes your posture and ability to walk without a limp. The test measures how long you’re able to do the task before it hurts too much or you run out of breath or energy.
You Get to Provide Some Input of Your Own
The evaluator also interviews you about important points in your injury like:
- How you got hurt.
- Your treatment history including the doctors you went to, what they did for you, and any therapy you had.
- Medications you take for your symptoms and other conditions.
- Your physical limitations, such as the ones we describe in this blog post.
It’s Just Another Piece of the Puzzle
With the exception of living with a permanent injury from an accident, your FCE may be the most difficult physical part of your case. But it’s only part of the challenge you face. If you’re severely injured enough to require an FCE, there’s a lot at stake for you legally too. Just as you got doctors to protect your body medically, it’s time to ask a lawyer about protecting your rights legally. You only get one chance at your case, so don’t risk ending it with regrets.
If you’ve got questions about your case, feel free to start a live chat right where you are so an experienced attorney can respond to your concerns.
If I file for workers’ comp, won’t my employer have to pay my medical bills?
Almost certainly not. We get this question more often than you might think. The majority of injured workers are loyal employees who might worry their employer will have to pay their medical bills. It discourages some employees from seeking vital benefits they need when they get seriously hurt on the job.
But before you forfeit important rights to income or to necessary medical care while you’re out of work, you should know this: In almost every case, your comp benefits get paid by an insurance company. That’s right! Your employer has paid thousands—maybe even millions—of dollars in premiums for years to provide coverage for people like you who get hurt on the job.
So if you’re worried your employer will personally pay your medical bills if you’re out, stop. It’s almost certainly an insurance company paying, and that insurer has plenty of money lying around to handle your claim.
And no, you can’t be fired for filing a workers’ comp claim. So if you haven't done this already, report the injury NOW, before the deadline runs out.
You Can Collect on Your Claim Without Hurting Anyone
Many of our clients are relieved to know that their claim for a job-related injury is not going to put their employer out of business. Even so, filing a claim can be uncomfortable for some workers who don’t want to deal with confrontation by co-workers or the sense from management they did something wrong by protecting their rights. And if you’re seriously hurt, the complexities and frustration of dealing with the insurance company can be overwhelming. Plus you’ve got important rights you need to protect, like future medical care. Just figuring out the right settlement can be complex.
All these are reasons why you should seek the advice of a professional who handles these cases for a living. If you’re worried about anything related to your work injury, fill out our Get Help Now section at the top of this page so you can get your questions answered.
After I settle my workers’ comp case, when do I get my check?
If you feel guilty about asking, stop. You’ve lost work and income. You may need the money to catch up on some bills. It’s the responsible thing to make plans and budget carefully when you receive money, and that includes a settlement.
That’s why we work to get you the money as quickly as we can.
But here’s the answer: it does take a little time to get your check, but it’s because workers’ compensation law imposes some requirements to protect you. Settlements must be filed with the Workers’ Compensation Commission and attorney fees and costs must be approved by the Commission.
The Workers' Comp Settlement Process
Here’s how it works ordinarily:
- We agree to settle the case with the workers’ compensation insurance company that handles your benefits.
- We get settlement documents laying out the agreement. We review them closely to protect your rights, especially since they can impact your ability to get free future medical care for your injuries, depending which settlement option you chose. If you’ve been declared permanently and totally disabled, you can bet we’ll be extra careful about preserving your rights to the most extensive benefits known in workers’ comp. If the documents aren’t right, we make changes to protect you.
- The check usually comes with the settlement documents. We deposit that in our trust account, a special account safeguarding your money.
- Once the documents are ready for you to sign, you sign. Naturally, we explain them to you beforehand, since they’re often incredibly complex “legalese”—which can be just plain ridiculous. We return them to opposing counsel to file with the Commission, or we file them ourselves.
- You also sign a Form 61. It’s an official form from the South Carolina Workers’ Compensation Commission. It details who gets paid from the settlement, including our fees and costs paid from the settlement check. We send that to a Commissioner with an order approving the fees and costs.
When we get the filed copies of the settlement documents, the form 61, and the order approving our fees and costs, it’s official! You get your check.
Workers Compensation Settlements Are Worth A Little Wait
While the process takes longer than we want—usually a few weeks—it’s to be sure no injured worker gets taken for a ride by an insurance company—or even a dishonest lawyer.
Naturally, if you’ve hired us, you’re not worried about that.
If you have questions about your potential comp settlement or any aspects of your comp case, feel free to email us right where you are to get them answered. We’re here to give you peace of mind and help you find your way in what’s often a hard, confusing time. You can also download our book The Hurt Worker's Toolkit to get valuable information to help you.
I got hurt at work due to an unsafe condition my supervisors knew about but didn’t fix. Can I sue the factory?
Yes and no.
Yes, you can make a workers’ compensation claim against your employer, who likely has insurance to pay for your benefits.
No, you can’t file a lawsuit against your employer to recover money for damages, such as pain and suffering or punitive damages. EXCEPTION: If you got hurt at work as a result of someone besides your employer, you may be able to file a lawsuit called a “third party action.” But how you settle those cases is extremely important—if you do it wrong, it could cost you your workers’ comp benefits.
Why Can’t I Sue?
The reason you can’t sue your employer is that workers’ compensation is a bargain in the law made between employees and employers. Employees gave up the right to get more money from lawsuits for unsafe working conditions. But they gained the right to benefits related to work injuries, including free medical care, replacement of most income while they're out of work, and money for permanent disability.
Employers gave up the right to force injured employees prove employer fault in workplace injuries before paying benefits. This is why workers’ compensation is often called a “no-fault system.” You can often get benefits even if it’s your own fault you got hurt. In return, employers gained the ability to be free from potentially huge verdicts in unsafe workplace lawsuits.
In most cases, the system works pretty well. But that doesn’t mean it’s a cakewalk for injured employees. Despite less financial exposure, employer insurance companies tend to take a hard line on paying seriously hurt workers. While the system is designed to help employees, settlements can be complex, and insurance companies fight the hardest for the most expensive benefits for the most severely injured.
These are important rights to protect your health and your financial stability. Don’t give up rights you don’t know about…and don’t get run over by the workers’ compensation insurance company.
If you’ve got more questions about how workers’ compensation works, take advantage of the free info on our site. You can always open up a live chat for answers from an experienced workers’ compensation attorney. And you’re always free to come meet with us—there’s no pressure to hire us and it’s free!
The help we give in a single email, phone call, or sit down-chat can be the difference between peace of mind and heartbreak. Our phone number’s right there at the top of the screen. Make the call.
I got hurt bad on the job. The doctor says I can go back with restrictions. Do I have to go back to work if I’m worried I can’t do my job?
Yes, you must go back if your employer has work you can do within your restrictions. If you refuse to return to work at a job the doctor indicates you’re able to perform, you can be denied workers’ compensation benefits.
Few things inspire more anxiety for hurt workers than returning to work. Many are so anxious to get back to work it drives them crazy when the doctor won’t let them, or gives them restrictions their job can’t accommodate. And other folks worry they’re being released too early, that the work could worsen their condition, or that they just can’t do the job anymore. And returning to work after an injury can be a little awkward and even intimidating, even if it’s not your fault and you’re doing all you can to get back.
We’ve found information eases fears, so here’s some basics on how getting back to work goes.
The Doctor’s Work Restrictions Protect You
Here’s some important terms you might encounter:
Your doctor may allow you to do this type work while he’s still treating you. It means you’ve got restrictions keeping you from doing your normal work. So if you work in a warehouse but can’t lift due to a shoulder injury, light duty might mean you answer phones or sweep the floors. Hopefully, you’ll return to your prior job once you reach maximum medical improvement. If your employer has no light duty, you remain on temporary total disability, getting a weekly check.
When the doctor releases you, he gives these as your lifelong limitations from the injury. Once you have them, you should report to work to see if your employer has a job that can accommodate them. If so, congrats! You dodged a bullet by not having to look for a new job.
Some people aren’t so lucky. You may have a grave, complicated injury with lifelong consequences. You may count as totally disabled under workers’ compensation law, a term that doesn’t mean what you may think. If you don’t already have one, you need an experienced lawyer to get you the most permanent disability benefits possible to help protect your financial security.
What If I Try to Return to Work But Just Can’t Do It?
If you give work an honest try, but can’t do it, be honest about it. Report it to your supervisor. You may need more treatment, and you should ask to go back to the doctor for a reevaluation. For income, hurt employees who try working but can’t make it 15 days ordinarily qualify automatically for temporary total disability benefits.
The Cure for Legal Worries Is Professional Help
If you’re worried about going back to work or anything else related to your workers’ comp case, stop and take action. Email us your questions so we can answer them and start giving you guidance. Let us help give you peace of mind and get you the maximum available benefits you can obtain in your one-time chance to do right by yourself after a work injury.