If you’ve been hurt at work and wonder how South Carolina workers’ comp cases are handled, you’re in luck. I’m about to reveal the process our law firm uses to get workers’ compensation settlements for our clients.
I’m a Spartanburg, South Carolina workers’ compensation attorney who’s committed to helping injured workers make sense of South Carolina’s complicated workers’ compensation system and making the system work for you. As a service to folks like you, I’ve written a book about South Carolina workers’ compensation cases in normal, non-lawyer language to help educate folks about how South Carolina workers’ compensation works. You can DOWNLOAD IT FREE, right here.
Our Seven Point Process for Getting a South Carolina Workers’ Compensation Settlement
Maybe the first question to ask is, do I need a South Carolina workers’ compensation attorney in the first place? Let me answer that in a separate article I wrote, which also details the reasons WHY it’s critical to hire an experienced attorney if your case involves serious injuries or multiple body parts.
These are the typical tactics we employ to help you:
1. Understand How You Got Hurt
Here’s one myth we can bust right now: you don’t have to prove your employer was at fault in causing your injury. But there are some defenses we’ve got to be sure the insurance company can’t hammer you with.
It’s critical for us to understand exactly what body parts got hurt since multiple body parts can affect the amount of a South Carolina workers’ compensation settlement. We’ll be sure to include not just the body part that got directly hurt but the ones that are indirectly affected by it. For example, lifting a 50-pound box can directly injure your back. But if the injury is to a spinal disk, it can indirectly affect your legs and feet from lumbar radiculopathy—causing pain, numbness, and tingling. We need to be sure to include your legs and feet as injured.
And HOW you got hurt often explains WHY certain parts got hurt. It’s more likely you developed lumbar radiculopathy from lifting a 50-pound box than an empty fishbowl. Understanding this “mechanism of injury” can be vital in convincing an insurance company your injuries were caused by the work injury, resulting in them providing medical treatment and later a settlement. It’s even more important to have this understanding if the insurance company stubbornly refuses to do the right thing and we need to prove our case to a Commissioner to get you relief. That brings us to the next step.
Finally, if your injury is due to someone else's fault who's not associated with your employer, you might be able to recover an additional settlement from the wrongdoer. Typical examples include injuries from car accidents and defective work machines. This is called a "third party action." It gives you valuable additional rights, but the law's tricky, and if you do it wrong, you can lose your rights. That's why it pays to have a professional guide you through this complicated legal maze.
2. Request a Hearing
Do you need a workers’ compensation hearing? Insurance companies deny cases for any reason they can dream up. I’ve seen treatment denied without reason or explanation, only to be granted on the eve of a hearing we requested to get a Workers’ Compensation Commissioner to order it. Generally, treatment denials are a key reason for requesting a workers’ compensation hearing early or even later in the case.
Don’t be fooled: to win a hearing, you don’t just show up and ask for help. For example, there are technical legal requirements to get additional treatment, and if you don’t satisfy them, you lose your right to it. That’s a critical reason to get an experienced attorney involved in your South Carolina workers’ compensation case when the insurance company won’t provide the treatment the doctor says you need.
Other reasons we typically see hearings required include:
- The insurance company stops your weekly check for no reason.
- Sometimes you need a second opinion, but you’ve got to be careful in how you present that.
3. Obtain, Analyze, and Use Medical Evidence
A major part of your workers’ compensation case concerns medical evidence. Doctors’ records help prove the nature and extent of your injuries, including the treatment required now and in the future.
As you’ve detected by now, the doctor is one of the most vital witnesses in your case. They’re so important we often meet with them in serious cases to gain a better understanding of the clinical impact of your injuries and what they mean for your future. These meetings often lead us to create a questionnaire for the doctor. A medical questionnaire is a brief but vivid picture of the most important medical issues in your case that can be presented to an insurance company or a workers’ compensation commissioner to prove your right to benefits. It can become a central piece of evidence in your case.
4. Keep Up With Your Treatment
It’s vital for us to keep up with you—and it’s the right thing for us to do since you’re our client! We keep up with you as you navigate the medical portion in your case, so we can be aware of how your treatments are going and how you’re doing. It can also establish major points on your treatment timeline, especially when you’re about to be released. Knowing that helps us get ready for settlement ahead of time, so we can expedite the process to help you get a settlement faster.
Keeping up with you also helps us stay ahead of the insurance company and opposing counsel. If you get released, the insurance company has the right to request a “Form 21” hearing to decide the amount of your settlement. By law, the hearing has to be held within 60 days. While that sounds like they’re trying to help you get a settlement faster, you should know better by now. The 60-day limit makes it extremely hard to get all your medical records, meet with doctors if necessary, and send in the evidence by the hearing brief deadline set by the Workers’ Compensation Commission hearing process rules.
The insurance company’s overriding goal is to sneak attack you with a hearing request so you don’t have time to get all your evidence in. They want to strong-arm you into a cheap, unfair settlement.
Our process is designed to help prevent that.
5. Determine a Fair Settlement
We will evaluate with you what we should ask for in a settlement and develop a plan to get it. Here’s where we never forget who this case REALLY about—YOU!
Even a “simple” workers’ compensation settlement involves the determination of vital, complicated medical and legal rights. We consider all options to help you decide what’s best for your unique South Carolina workers’ compensation settlement. That involves going all over all your rights and the evidence to arrive at the settlement you should expect.
For especially serious cases that may involve South Carolina workers’ compensation total disability or wage loss, we’ll explore the need for a vocational evaluation to help prove your rights to these highly expensive workers’ compensation benefits the insurance company will fight tooth and nail against.
We give you a written settlement evaluation in clear, honest terms. Then we set a settlement goal and go for it!
6. Send a Demand Letter to the Insurance Company or Opposing Counsel
The demand letter lays out your case briefly, pinpointing why the insurance company should settle your workers’ compensation case in line with our goal. We overview your injury, treatment, ratings, restrictions, and physical limitations to justify a solid settlement.
7. Negotiations and the Next Step, if the Insurance Company Won’t Settle for a Fair Amount
During the negotiations process, we keep you updated with all offers and counteroffers as we move our strategy forward. We always want your input in this final step that’s hopefully the culmination of our efforts. Often, it ends with a settlement. But what if it doesn’t?
That means we request a hearing to get your case decided by a workers’ compensation commission. In serious cases, we might agree to mediation. In mediation, an experienced workers’ comp lawyer who’s not involved with the case works with both parties to get them to reach a settlement. It’s a totally voluntary process, so if we get no result from that, we can leave without repercussions. For some reason, it often works to generate a settlement even when it seems the insurance company has dug its heels in the ground. Maybe the best expression of what mediation can do came through from a distinguished lawyer I deeply respect: “I don’t know why mediation works, but it does.”
Put Our Process to Work for You
If you’re involved in a South Carolina workers’ compensation case, there’s really nothing simple or easy about it. If you’ve got a serious injury, you’re the only amateur in the room. You’ll find yourself cornered by a trained, skilled insurance adjuster who’s paid to shortchange you, along with the lawyer they hire to help them have their way with you.
You’ve got a lot at stake. Don’t risk it.
Get your questions answered and get guidance from a Spartanburg, South Carolina, workers’ compensation attorney before it’s too late. You can contact us with a live chat, fill out a Get Help Now form, or call toll-free at 888-230-1841.
Understanding every case is unique, and past results don’t guarantee future ones, you should see how our workers’ comp case handling process worked for others.