South Dakota’s workers’ compensation system provides benefits to employees who are injured at work. Employees usually have to go through workers’ comp to get compensation, rather than suing their employers in court. (There are, however, a few exceptions. To learn more, see Workplace Injury: When You Can Sue Outside of Workers’ Compensation.) This article explains how to start a workers’ comp claim if you were injured at work.
Nearly all private employers in South Dakota must have workers’ compensation coverage for their employees. All employees are covered by workers’ comp, except for certain domestic employees, agricultural employees, and elected state officials.
Like in many other states, employers in South Dakota typically secure coverage through private insurance companies. The insurance companies review claims and decide whether to accept or deny them. The South Dakota Division of Labor & Management oversees the administration of workers’ comp and resolves disputes between employees and insurance companies.
Workers’ compensation covers injuries that happen in the course of employment. Most injuries that occur at work, or while the employee is performing job duties, are covered. For example, if you get hurt while walking through the company warehouse or while running a work errand off-site, your injury will likely be covered.
To start your workers’ comp claim, you need to report your injury to your employer in writing within three business days. If you miss this deadline, you may lose your right to collect benefits.
You should also get medical treatment right away. If you need emergency treatment, you can go to the nearest emergency room or urgent care. In South Dakota, employees have the right to choose their treating doctor for non-emergency treatment as well. However, if you want to switch doctors during your claim, you will need approval from the insurance company.
Once you give notice of your injury, your employer should notify its insurance company and file a First Report of Injury form with the South Dakota Division of Labor & Management. The insurance company has 20 days to investigate your claim and decide whether to accept it. If your claim is accepted, you will receive medical coverage and wage loss benefits almost immediately.
Workers’ compensation should pay for all necessary medical treatment related to your work injury. This includes the cost of doctors’ visits, hospital stays, prescriptions, and medical equipment. You can also receive disability benefits if you need time off work or if your injury causes permanent impairment.
If the insurance company denies your claim, you can challenge its decision with the Division of Labor & Management. (For common grounds for a denial, see Denied Workers’ Compensation Claims.) To do so, you must file a petition for hearing within two years of the denial. At your hearing, a workers’ comp judge will review evidence, listen to testimony, and make a decision in your case.
Most workers can handle the initial workers’ comp claim process on their own. If the insurance company readily accepts your claim and pays your benefits, you probably will not need to hire a lawyer. However, if the insurance company denies your claim or disputes the amount of benefits you are entitled to, you should consider hiring a lawyer. This is especially true if you need to attend a workers’ comp hearing, which follow complex procedural rules. For more information, see Should I Hire a Workers’ Comp Attorney or Can I Handle My Own Case?