If you were injured or got sick because of your job in South Carolina, you may be eligible to receive benefits through the state workers' compensation system. The compensation you actually receive will depend on the nature of your injuries, whether you're able to return to work, your pre-injury earnings, and other factors unique to your case. This article explains how the most important workers' comp benefits are calculated in South Carolina, including temporary disability and permanent disability benefits. (To get these benefits, you'll need to file a workers' comp claim within the state's time limits and show that your injury or illness is work related.)
Can You Get Workers' Comp in South Carolina If You Get COVID-19 on the Job?
Under South Carolina's workers' compensation laws, on-the-job injuries don't include any diseases unless they unavoidably result from an accident or they qualify as an occupational disease. In order to be considered an occupational disease, an illness must be directly caused by a hazard that's peculiar to the employee's occupation, and it must result from continuous exposure to normal working conditions in that job. The definition of an occupational disease specifically rules out contagious illnesses that result from exposure to coworkers or to hazards that employees would've been exposed to outside of work as much as on the job. (S.C. Code §§ 42-1-160, 42-11-10 (2020).)
In the context of a pandemic, those requirements present almost insurmountable hurdles for most South Carolina employees with workers' comp claims for COVID-19—except, perhaps, first responders and some healthcare providers whose jobs involve direct, repeated contact with infected patients. Some states have enacted measures making it easier for certain frontline employees to get workers' comp benefits for COVID-19 by presuming that the disease is work related unless the employer proves otherwise. South Carolina has not joined those states.
Temporary disability benefits cover a portion of your lost wages if you're unable to return to your regular job while you're recovering from your work-related injury or occupational disease. In South Carolina, you won't receive these benefits for the first seven calendar days of your disability, unless you're off work for more than 14 days. (S.C. Code § 42-9-200 (2020).)
If you're completely unable to work because of your injury, you're entitled to receive benefits equal to two-thirds of your average weekly wage before the injury, up to the legal maximum. For injuries that happen in 2020, the maximum is $866.67. (The South Carolina Workers' Compensation Commission website publishes a list of the maximum compensation rate for other years.) There's also a minimum of $75 per week, unless you earned less than that before your injury. (S.C. Code § 42-9-10 (2020).)
Temporary total disability benefits will continue until you're able to return to work or your doctor says that you've reached maximum medical improvement (MMI), which basically means that your condition has stabilized and isn't expected to improve any further.
You may receive temporary partial disability benefits if you're able to work but you aren't able to earn as much as you did before your injury while you're still recovering from your injury. This typically happens when your doctor has placed restrictions on your ability to work—such as limits on how long you can stand, how much you can lift, or how many hours you can handle in a day—and the light-duty job your employer has offered pays less than your normal wages.
Partial disability benefits are calculated as two-thirds of the difference between your pre-injury wages and what you're able to earn now (subject to the same maximum amount as for total disability benefits). For example, suppose you normally earn $900 a week but now can only earn $600 at a light-duty job. You would receive two-thirds of $300 ($900 - $600), or $200 per week.
South Carolina places a 340-week limit on receiving partial disability benefits based on reduced earning capacity. If you begin receiving these benefits after being temporarily totally disabled, the time period in which you received total disability benefits won't be deducted from the 340-week cap. (S.C. Code § 42-9-20 (2020).)
Once you've reached MMI, your doctor will evaluate you to determine if your injury has left you with any lasting disability—and if so, to what extent.
In South Carolina, there are generally two different ways of qualifying for permanent disability benefits:
You will automatically be considered permanently and totally disabled if, as a result of your injury, you lost both hands, arms, shoulders, feet, legs, or hips; the vision in both eyes; or a combination of two of those. In addition, if you've lost at least 50% of the use of your back, workers' comp will presume that you're permanently and totally disabled unless your employer or the insurance company proves otherwise.
Permanent total disability benefits are paid at the same rate as temporary total disability benefits, with the same maximum and minimum. South Carolina generally places a 500-week limit on total disability benefits. However, benefits will continue for life for those who are permanently, totally disabled and are paraplegic, quadriplegic, or have physical brain injuries.
The 500-week cap applies to both temporary and permanent total disability; that means that any time you received temporary disability could be deducted from the 500 weeks. (S.C. Code §§ 42-9-10, 42-9-30(21) (2020).)
If your injury has led to the permanent loss or lost use of part of your body, you may receive partial disability benefits according to a schedule in South Carolina law. These benefits are paid at the same weekly rate as temporary total disability (two-thirds of your pre-injury wages, with the same maximum and minimum). The payments will continue for a set period of time, depending on the affected body part and the extent of your lost use (expressed in a percentage).
For certain body parts—mostly the extremities, shoulders, hips, and eyes, as well as hearing—the schedule gives a corresponding number of weeks that benefits would continue for 100% lost use. For less than complete loss, benefits would continue for a period of time in proportion to the percentage of loss. For example, the schedule lists 140 weeks for loss of a foot. If you've lost 50% of the use of your foot, you would receive 70 weeks' worth of benefits. The schedule treats lost use of the back somewhat differently, with a maximum 300 weeks for lost use of 49% or less and 500 weeks for 50% or more lost use. (As discussed above, the state will presume that you're permanently and totally disabled if you have 50% or more lost use of your back.)
For lost use of other parts of your body not included in the list (such as a neck injury, damage to your kidneys, or neurological damage), you will be assigned what's known as a "whole person impairment rating," expressed in a percentage. That rating will then determine the duration of your benefits, as a proportion of 500 weeks. For example, for a 10% permanent disability to the body as a whole, you will receive payments for 50 weeks.
The South Carolina law on scheduled loss also allows workers' comp judges to award up to 50 weeks' worth of benefits for a serious disfigurement to any part of the body that's normally exposed at work. (S.C. Code § 42-9-30 (2020).)
South Carolina courts have consistently ruled that employees who have permanent disability to more than one body part may choose to collect benefits under either the "medical model" (that is, based on specific injuries or scheduled losses to the affected body parts) or under the "economic model" (that is, based on their loss of earning capacity, just as for temporary disability).
For instance, if you have permanent impairments to both your back and a leg, you could decide to seek benefits based on your reduced ability to earn as a result of those impairments, if that would result in higher compensation. Under this economic model, if you're completely unable to work, you would receive two-thirds of your pre-injury wages; otherwise, you would receive two-thirds of the difference between your pre-injury wages and what you can earn now. The same maximum and minimum weekly amounts for temporary disability will apply to permanent disability based on income loss, as will the same maximum number of weeks you can receive benefits (500 weeks for total disability or 340 weeks for partial disability).
The flip side of this rule is that even if experts have said that you're completely unable to work as a result of a permanent disability that affects only one scheduled body part, you may only receive partial disability benefits under the South Carolina schedule.
South Carolina workers' compensation also provides additional benefits, including:
If you're having trouble getting the workers' comp benefits you deserve in South Carolina, you would be wise to talk to a workers' compensation attorney. A lawyer who's experienced with South Carolina's workers' compensation system can evaluate your claim, advocate for your rights with the insurance company (and workers' comp judge, if need be), and ensure that any settlement agreement is fair. (Learn more about how a good workers' comp lawyer can help.)