Being declared totally disabled from a work injury in
A South Carolina worker seriously injured at work can be declared totally disabled under workers’ comp rules in the following ways.
You are legally presumed totally disabled if you lose:
- Both hands, or both arms, or both feet, or both legs
- Vision in both eyes
- A combination of any of the two above
The law also presumes total disability if you lose 50 percent or more of your back.
Presumed disability extends to you if you suffer:
- paralysis, whether paraplegic (legs) or quadriplegic (all limbs), and
- physical (organic) brain damage.
Disability Proven by Lost Earning Ability
Injured workers who are not presumed disabled can prove they are by showing their injuries stripped them of virtually all their marketable job skills. For example, a construction worker who lost 35 percent of his back may look normal sitting in a lawn chair at a neighborhood get-together, but if his injury affects another part of his body, like his legs, and these combined injuries keep him from being able to lift or stand long enough to do the only job he’s trained and qualified for, he can be eligible for total disability benefits.
Note the important distinction here: to get benefits in this situation, you’ve got to prove your primary injury affects another body part. Our courts interpret “affect” to mean “impairs” or “injures” or causes some disability. It doesn’t have to be a direct injury. For our construction worker to qualify here, he’s got to prove his back injury, which got directly injured in the work accident, also caused some impairment, injury, or disability to his legs. If he’s got ruptured spinal disks in his low back that pinch the nerves leading to his legs, that can cause a condition called radiculopathy. Radiculopathy can cause weakness and pain in the legs, meaning the legs can be affected by that back injury.
If you think it’s a little complicated, you’re right. And it’s made worse by an insurance company straining to find any way to protect its precious dollars from falling into your needy hands. If you’ve got a serious back injury that might affect another body part, you can’t risk forfeiting these benefits. Medical evidence has got to be given the right way or you lose your rights. The insurance company knows that, but they make tons of money by not helping you. Get a skilled workers’ compensation attorney who knows how to present the medical evidence to protect your rights to these benefits.
Even assuming you’ve got the medical evidence, you’re nowhere near done proving your case. You’ve still got to prove these injuries disqualify you from working. At Holland & Usry, we often hire an expert—called a vocational consultant—for these cases. The vocational consultant evaluates you to determine whether you have any marketable skills unaffected by your injury, which can help the Commission decide total disability.
Total Disability Benefits
South Carolina injured workers who qualify for total disability under workers’ comp get the most benefits available under the law:
- Disability income. Most disabled workers get two-thirds of their average weekly wage for up to 500 weeks. Paralyzed workers or workers who sustained physical brain damage get that income for life.
- Medical treatment for life. This treatment only covers the injury that disabled the worker. The construction worker permanently disabled by a back injury can get free medical treatment for his back, but is on his own for everything else from the common cold to cancer.
To protect workers and encourage the disabled to be as productive as they can, an employer cannot cut off total disability benefits if the worker returns to work.
South Carolina workers’ comp total disability awards are often the most expensive for insurance companies, so they tend to fight them to the bitter end. If your work injuries are grave enough to qualify you for total disablement, expect a battle where the insurance company will do all it can to prevent from paying the long-term benefits you need. How hard will they fight? This hard.
Don’t let the insurance managers take advantage of your pain and fatigue to shortchange you on benefits; you only get one chance at securing the most income benefits you can legally get and the medical care you may need the rest of your life. Feel free to contact us by email or a live chat to discuss how we can build a case justifying these vital benefits for you and your family. You can also call us at 864.582.0416 or toll-free at 888.230.1841. If you’re too hurt to come to us, we will come to you.
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