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Answers to the Questions We Get Most About Workers’ Compensation Claims

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If you’ve been injured on the job in North Carolina or South Carolina, you probably have some questions about reporting your injury, seeking medical treatment, and filing a claim. At the Elrod Pope Law Firm, our workers’ compensation attorneys get a lot of questions every day about these issues. Below are some of the questions that we hear the most about workers’ compensation and the answers that you will need to move forward in the process of filing a workers’ comp claim.

How to Report a Work Related Injury

Most of the questions that we get about reporting work related injuries concern who you should report the injury to, how to report the injury, and how much time you have to report the injury. To begin with, you should report your injury to your immediate supervisor and/or another manager or supervisor at your place of employment. You should also fill out an incident report, which your employer should provide, or report the incident in a written and dated letter, if no incident report is provided. This will serve as evidence that you did report the injury and when you reported it. While you have up to 90 days to report the injury, you would be wise to do so right away.

Questions About Filing the Workers’ Compensation Claim

When it comes to filing your workers’ compensation claim, you may have questions about how much time you have to do this, how you go about filing the claim, and what to do if your employer won’t help you with the process. In North and South Carolina, you have up to two years to file your claim.

In most cases, your employer will initiate the claim by reporting your injury to their workers’ compensation insurance company. If your employer does not do this, then you can start the claim by yourself by contacting the South Carolina Workers’ Compensation Commission or the North Carolina Industrial Commission, depending on which state you’re dealing with, and requesting the appropriate forms.  You can also get these forms from the commission’s websites, wcc.sc.gov for South Carolina workers’ compensation claims, or ic.nc.gov for North Carolina workers’ compensation claims.

Questions About Receiving Medical Treatment

Many people also have questions about where they should go for medical treatment and what forms of medical treatment will be covered by workers’ compensation. If you are facing an emergency situation, then you can go to the nearest emergency room for your initial treatment. After this, or in cases that are not emergencies, you must go to an employer or insurance approved physician. Your employer should have a list of physicians for you to choose from.

When it comes to what forms of medical treatment are covered, you can expect all necessary and reasonable medical care that will reduce your level of disability to be covered. This includes surgeries, prescription medications, rehabilitation, hospital stays, and other medical needs.

Questions About Receiving Wage Benefits

The most common questions that we get about receiving wage benefits concern how the wage benefits are calculated, when you will start receiving wage benefits, and when those benefits will be terminated. Your wage benefits will be calculated at 2/3 of your average weekly wage. You will start receiving wage benefits after you have been out of work for more than seven days. If you are out of work for more than 14 days, then you will get benefits for the first seven days, too.

If your doctor releases you to return to work with restrictions and if your employer places you in a light duty position that pays less than your former position, then you will receive wage benefits at 2/3 the difference between your former wages and your current wages. If you were working more than one job at the time of your injury in South Carolina, then the income from both jobs will be taken into account when calculating the wage benefits at 2/3 of your former income.

You can receive benefits for up to 500 weeks, unless you are released to return to work. In such cases, you will receive notification that your benefits are going to be terminated along with the reason for this. If your medical condition prevents you from returning to work and you disagree with the decision to terminate, then you can request a hearing.

What are Workers’ Compensation Hearings

When it comes to workers’ compensation hearings, the most frequently asked questions involve what a hearing is for, how to request a hearing, and what can be accomplished at a hearing. You request a hearing with a Form 50 in South Carolina or a Form 18 in North Carolina. You do so when you disagree with the decision of your employer or their workers’ compensation insurance, when your claim is wrongfully denied, or when you do not believe you are medically capable of returning to work after being released to return to work. A hearing gives you the opportunity to argue your case and have it resolved before commission.

Questions About Employer and Insurance Approved Physicians 

We also hear a variety of questions concerning the expenses associated with going to the doctor and disagreements with the employer or insurance approved physician. For example, you may be wondering if you can recover compensation for the expenses associated with traveling. In cases where you must travel a distance greater than 10 miles in South Carolina or 20 miles in North Carolina (as of 1/1/17), round trip, then you can recover travel expenses by reporting your mileage. This will be reimbursed at the same rate that state employees receive for their mileage. In some cases, you may also be able to receive mileage reimbursement for traveling to the pharmacy.

When you disagree with what your physician says about your medical condition, or if you simply don’t feel comfortable with the physician or their evaluation, you do have the option of seeking a second opinion. However, you have to approach the workers’ compensation insurance provider to request permission to do so. If this doesn’t go the way you want it to, you can also request a hearing.

Other Workers’ Compensation Questions

If you have other questions about workers’ compensation that are not addressed here, or if you need to appeal a decision or request a hearing, contact the skilled South Carolina workers’ compensation lawyers at Elrod Pope Law Firm for more information.

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