If you were injured on the job, you will need to report your work injury directly to your employer. South Carolina workers’ compensation law permits employees 90 days to report a work accident or injury to employers. Waiting longer may result in a denial of benefits. Your employer’s workers’ compensation insurance company will handle your claim, from investigating the incident surrounding your injuries to processing medical claims to ensure you receive the treatment you need.

In this blog, our Greenville workers’ compensation attorneys discuss the process of reporting a work injury and how a lawyer can help you receive maximum compensation on your claim.

The Insurance Company Sets Strict Time Limits to File a Claim

Whether it be tripping on an exposed wire, hurting your back while lifting a heavy box, or scaffolding collapsing at a great height, workplace accidents account for 4.07 million medically consulted injuries each year. In South Carolina, you have 90 days to report a work injury, with a two-year limitation to file a workers’ compensation claim. It is an employee’s responsibility to report your work injury to your supervisor or human resources manager.

The Insurance Company Will Assign a Nurse Case Manager

Once your claim is reported, the following will take place:

• Your employer will report your workplace injury to their workers’ compensation insurance carrier. Your supervisor must report your accident or injury within 10 days of being notified.
• The insurance company will hire a medical management vendor to assist workers in receiving the necessary care following a work injury.
• The medical management vendor will assign a nurse case manager (NCM) to oversee your case. The NCM serves as a liaison between the employer, employee, and your treating physicians. 
• Your case will be assigned to an insurance adjuster at the State Accident Fund. Upon receiving all relevant information, the adjuster will either accept or deny your claim.
• Under SC Code §42-9-360, a treating physician cannot attempt to collect payment on a medical claim until the claim has been approved or denied by the insurance company.
• If your claim is approved, the NCM will provide information to the insurance adjuster to obtain treatment authorizations to ensure that you receive the care you need. However, to ensure that your medical bills are covered, you must seek treatment through an employer-approved provider. The NCM has the right to discuss your diagnosis, course of treatment, and prognosis with any of your treating providers.

The Insurance Company Will Choose Your Treating Provider

If you file a workers’ comp claim, you must seek treatment through a provider approved by your employer or your employer’s insurance company. The exception lies with emergency care, in which the insurance company will most likely cover any provider in which you seek treatment, although the process can be complicated. Given the complexities of navigating the medical system on workers’ comp, it is important that you speak with a Greenville workers’ compensation attorney who can put you on the right track.

The Insurance Company Will Cover Lost Wages

While all reasonable and necessary medical expenses, disability benefits for a workers’ compensation claim in Greenville also include wage replacement. Wage benefits typically equal 2/3 of an employee’s average weekly wages, based on the four quarters prior to their accident or injury. However, wage benefits are subject to minimum and maximum limits, with a statutory cap adjusted yearly. A Greenville workers’ compensation lawyer can help you secure maximum compensation by completing the necessary forms and providing pertinent information relating to your injury.

Injured? Speak with Our Greenville Workers’ Compensation Lawyers Today

Each year, millions of people are injured at work, with disability benefits allowing them to support their loved ones. If you have recently been injured on the job, our Greenville workers’ compensation lawyers are here to advocate for the benefits you deserve. For over four decades, our team of professionals has been fighting for individuals’ rights, not for big businesses.

To learn how our legal team can help you navigate the complexities of a workers’ comp claim, contact Fulton & Barr Attorneys at Law online or give us a call at (864) 778-3092 today. We offer free, no-obligation initial consultations.