Workers’ Compensation

Workers’ Compensation Claim Process

There is a great deal we can do to protect your rights and determine the actual value of your claim. The insurance carrier wants to pay you as little as possible. That is their job. Our job is to protect you as you recover and make you aware of the actual value of your claim.

Please review this overview of the Claim Process and feel free to contact us with any questions or for a no cost confidential conference regarding your rights as an injured worker. (843) 971.0099 or [Click Here]

The injured worker should report his injury, condition or illness to his employer as soon as he knows he is hurt.

Definition of a Work Related Injury:

A work-related injury, illness or condition must have occurred during, arisen from or be causally related to the performance of one’s work duties.

Typically an immediate supervisor, plant nurse or safety manager is the first to receive notice of the injury and usually refers the injured worker to a selected medical provider for treatment. While the employer should provide medical treatment when the employee reports an injury, this is not always the case; however, the employee still has an obligation to care for his injuries.

The Employer should complete a report of injury to be submitted to the Workers’ Compensation insurance carrier.

The Workers’ Compensation insurance carrier then immediately begins their investigation of the claim.

Once the employer has turned in the report of injury, a claims processor or adjuster from the Workers’ Compensation carrier will usually contact the employee to find out how he or she is doing and may also obtain the employee’s statement if the investigation is still pending.

The adjuster will regularly obtain the medical records from any treatment that has been given the employee since his injury.

The adjuster also contacts the employer for the worker’s wage information in order to determine the proper amount to be paid to the injured employee if he is out of work.

The adjuster usually sends the checks out on a weekly basis, and continues to collect the worker’s medical records from his treating physicians after each visit.

Typically the worker will obtain a work excuse every time he goes to the doctor. The injured worker will be asked to continuously furnish the employer and carrier with documentation from the medical provider regarding his work restrictions that have created the wage loss.

If the medical provider takes the employee out of work or places such limitations on his activities that he is unable to perform his regular duties and has to work for a lesser amount or fewer hours thus creating a wage loss, then the employee would be entitled to compensation for his lost time.

Once the worker is released to return to work, the adjuster should stop sending the checks. If the checks continue to be sent, in error, the carrier will seek credit or a return of those funds.

If the employer does not have suitable work for the injured worker, the adjuster will need to keep sending the checks. The worker contacts his employer to return to work.

If the employer has suitable work for the employee, the worker goes back to work. If he is unable to do the work, the worker needs to advise his employer, and then get back in touch with his doctor for a revision of their work restrictions.

If the worker cannot continue the resumed work, then the adjuster will need to resume payment of the weekly checks.

Once the employee is released from medical treatment the insurance carrier will have the physician complete a statement which addresses the employee’s permanent impairment.

Fortunately, most people who experience a work-related injury are able to return to their regular duties at work after some medical treatment and perhaps some period of lost time for recovery, once they are released to do so by the authorized treating physician.

If the injured worker is not represented, with the permanent impairment information, the carrier usually requests that the South Carolina Workers’ Compensation Commission set the matter for an Informal Conference before a Commissioner or Deputy Commissioner who will assist the carrier’s representative and the injured worker in coming to an agreement on the amount of compensation to be paid to the worker.

If no agreement can be reached or in the opinion of the presiding South Carolina Workers’ Compensation Commission official there are other issues to be considered, the case will be set for Mediation or a Formal Hearing before a Hearing Commissioner.

The Insurance Carrier’s attorney will set a date and time for a deposition to determine the exact set of circumstances and degrees of impairment that has kept the worker from accepting compensation to satisfy the claim.

We hope this page has shown you the general sequence of a South Carolina Workers’ Compensation claim. Feel free to contact us for further direction and guidance. We are available to travel Statewide in order to meet and handle Workers’ Compensation Claims.

A knowledgeable and experienced Workers’ Compensation attorney can help to guide and direct this general sequence of events from the very beginning. We have only your best interests in mind.

There is a great deal we can do to protect your rights and determine the actual value of your claim. The insurance carrier wants to pay you as little as possible. That is their job. Our job is to protect you as you recover and make you aware of the actual value of your claim.

This is why you need to hire an experienced Workers’ Compensation attorney to handle your claim. Please feel free to e-mail us at Peterdavidbrown.com or call us at 843-971-0099. You can click here to reach us now and set up a no-cost conference to evaluate your claim.