Articles Posted in Workers’ Compensation

Some South Carolina workers’ compensation cases involve the issue of whether a particular injury was work-related or whether the employer has a valid defense against the employee’s claim. Sometimes, however, the real fight is not between the employer and employee, but between other parties. For instance, this can happen when a worker dies as a result of an on-the-job accident, and multiple parties seek death benefits.

Facts of the Case

The plaintiff in a recently decided appellate case was the brother and personal representative of the estate of a man who died when his boat capsized in a pond during a work-related accident in 2013. The plaintiff filed a Form 52 notice of a claim for death benefits a few months after the accident that took the worker’s life. A hearing was held, during which the plaintiff sought workers’ compensation benefits on behalf of the deceased worker’s mother, as next of kin under South Carolina Code § 42-9-140(B). Another claimant sought benefits for herself as the deceased worker’s alleged common law wife or, alternatively, as a dependent.

When someone is hurt at work and files a South Carolina workers’ compensation claim, one of the issues that must be determined is the claimant’s average weekly wage. Usually, this is fairly simple: just add up the worker’s earnings for the past year and divide that number by 52.

Of course, sometimes a worker has not been employed at a particular place long enough for there to be a meaningful accumulation of wage data (in which case a similarly situated worker’s earnings may possibly be used). Other issues can also arise, as was demonstrated in a case in which a worker held two jobs – one paid and one unpaid – and was hurt on the unpaid job.

Facts of the Case

In a recent (unreported) case from the South Carolina Court of Appeals, the plaintiff was a graduate student who worked both as an unpaid intern at a university hospital and as a regular employee at a fast food restaurant. He was hurt during his work as an intern and filed a workers’ compensation claim against the university’s accident fund. Continue reading

South Carolina workers’ compensation cases can sometimes drag on for years, especially if the injured worker allegedly suffers subsequent injuries to the same part of the body. Not all such litigation is pursued by the injured worker against his or her employer, however.

Sometimes, multiple insurance companies seek the courts’ direction as to which is responsible for payment of a workers’ claims. This can happen when the injuries happen at times in which a single employer had different workers’ compensation carriers or if the worker changes jobs and his or her employers are insured by different companies.

Facts of the Case

In a case appealed from the Richland County Circuit Court, the claimant was a man who allegedly hurt his back while working for a particular employer in 2002. The plaintiff was a workers’ compensation insurance company that paid benefits owed to the claimant as a result of this injury. The claimant reached maximum medical improvement in the summer of 2003 and, thereafter, began working for a different employer insured by the defendant workers’ compensation carrier. Continue reading

When an injured worker files a South Carolina workers’ compensation claim, he or she may be entitled to several kinds of benefits. These benefits may include paid medical care, temporary total disability, and/or permanent partial or permanent total disability payments.

The amount of money that the claimant ultimately receives is based in part upon his or her average weekly wage at the time of the accident or illness giving rise to the claim for benefits. Once a determination has been made that the worker is, in fact, entitled to workers’ compensation benefits, the worker may seek a lump sum payment of part (or all) of the benefits that the employer or its workers’ compensation insurance carrier is ordered to pay.

He or she is not automatically entitled to a lump sum payout, and such a request may be met with great resistance.

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Under the law of South Carolina, employers who do business in the state must provide a way for injured employees to receive the benefits to which they are entitled upon the filing of a South Carolina workers’ compensation claim.

There are generally two ways in which this can be accomplished. The employer may purchase a workers’ compensation liability insurance policy or it may qualify as a “self-insured” employer. With regard to the self-insured option, two or more employers in businesses of a similar nature may be allowed to enter into an agreement to pool their workers’ compensation liabilities for the purpose of qualifying as self-insurers.

Facts of the Case

In a case originating in the Richland County Circuit Court, the plaintiffs were members of a home builders’ association that, some years prior, had created a self-insurers’ fund  in order to fulfill their obligations under the law. After the defendant board of trustees announced their intent to wind down the fund and set up a new mutual insurance company, the plaintiffs filed a lawsuit seeking to challenge the board’s authority to use the fund’s assets in that manner. Continue reading

A South Carolina workers’ compensation case can be very challenging. Even though these laws were purportedly put in place to protect employees and their families against financial hardship due to a work-related injury or death, many workers’ compensation insurance companies will fight hard to avoid paying a claim.

There are several levels of review in such matters, beginning with the decision of a single commissioner and ending in the state supreme court. Most contested cases are settled or otherwise resolved somewhere along this lengthy process.

Facts of the Case

The plaintiff in a recent (unreported) case decided by the South Carolina Court of Appeals was the surviving spouse of a 58-year-old man who worked for the defendant county in its radio and telecommunications department. In September 2014, a criminal suspect barricaded himself in an apartment, leading to a nine-hour standoff that involved over 100 first responders. Two officers were shot during the altercation, and one died. The suspect also died as a result of a gunfire exchange with deputies. The decedent suffered an apparent heart attack while monitoring the county’s radio system during the standoff. He died a short time later.

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In a South Carolina workers’ compensation case, an injured employer has certain obligations that must be complied with before he or she can receive benefits from his or her employer or its insurance company. Among these requirements are a timely reporting of the injury and the filing of certain paperwork with the South Carolina Workers’ Compensation Commission (if the employer believes that he or she is entitled to other benefits in addition to those already paid by the employer or insurer).

If the employee is displeased with the determination of the commission in his or her case, he or she has a right to file an appeal. However, the burden of proof is on the employee to convince the reviewing tribunal that the commission’s decision was in error.

Facts of the Case

In an unpublished case recently considered on appeal, the plaintiff was a man who sought review of a decision of the Richland County Circuit Court with regard to his claim for workers’ compensation benefits he alleged were due him under South Carolina law. The trial court dismissed his suit for lack of subject matter jurisdiction and also held that the plaintiff had failed to state facts sufficient to constitute a viable cause of action against the defendant commission.

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Under South Carolina workers’ compensation law, a person who is hurt while performing his or her duties at job may file a claim for workers’ compensation benefits. While less generous than the personal injury damages potentially available to a person who is hurt by another’s negligence (in a car accident, for instance), these benefits can be very beneficial to the worker.

Some of the benefits that may be available in a successful workers’ compensation claim include temporary total disability benefits, permanent partial or permanent total disability benefits, and or paid medical treatment by an authorized physician.

Facts of the Case

In an (unreported) case recently considered by the South Carolina Court of Appeals, the plaintiff was a man who alleged that he was entitled to workers’ compensation benefits due to an injury he had suffered while working for the defendant employer. The Appellate Panel of the South Carolina Workers’ Compensation Commission found in favor of the employer and denied the employee’s request for benefits. The employee appealed, seeking review from the intermediate appellate court.

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In a South Carolina workers’ compensation case, the burden is on the injured worker to prove that he or she was injured or became ill due to his or her employment. Once this has been accomplished, the obligation then shifts to the employer to provide the benefits to which the plaintiff is entitled under the law.

Depending upon the situation, this may include temporary partial disability benefits, temporary total disability benefits, permanent partial disability benefits, and/or permanent total disability benefits. In most cases, the employer must also provide medical care to the injured worker at its own expense (or that of its workers’ compensation insurance carrier).

When the parties cannot agree on the benefits to which a particular worker is entitled, the state workers’ compensation commission and, if necessary, the courts, will make an adjudication.

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There was a time when an employee had to make out a case of negligence if he or she sought monetary compensation following an accidental injury at work. Nowadays, however, there is a workers’ compensation program in place that does not require proof of negligence or fault against the employer. However, the benefits that the worker receives are typically less than what would have been possible in a successful negligence action.

Even in this supposedly stream-lined process, many disputes still occur, and a significant number of workers’ compensation cases find their way into the appellate courts each year.

Facts of the Case

In a recent unreported South Carolina workers’ compensation case, the plaintiff was a man who alleged that he had been hurt during the course and scope of his employment with the defendant employer. The employer and its workers’ compensation insurance carrier disputed the plaintiff’s claim. A single administrative law judge of the South Carolina Workers’ Compensation Commission found that the plaintiff’s alleged clavicle injury was not compensable. Rather, the appellate panel found that the plaintiff’s injury was limited to his right shoulder and also ruled that he was prohibited from raising the issue of temporary partial disability on remand. The plaintiff appealed.

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