When you are injured at work, you have specific rights to treatment and compensation under the workers compensation laws of the state. However, there are instances when a worker may not be covered. Understanding what these exceptions are, and what other options you may have, will help you seek the treatment necessary to help your injuries.
Exceptions To Workers Compensation Laws
1. Businesses With Under 5 Employees. If a business does not have more than five employees, they are not required to carry workers compensation insurance. However, this does not exempt them from covering the expenses associated with the injuries. For additional compensation, the injured employee will have to sue the employer or business directly.
2. Intentional Injuries. Regardless of the size of the business, workers compensation will not cover injuries that it views as intentional. While it is hard to believe that this type of event occurs, it has happened. Employees that willingly place themselves in harm’s way so that they can collect a settlement do exist. According to Howell and Christmas, LLC , a law firm in South Carolina, “law in South Carolina is designed to provide those injured on the job”, not those that intentionally injure themselves. Medical coverage and compensation is denied for this type of event. If falsely accused of this, the employee has the right to seek legal representation to appeal the decision.
3. Under The Influence. Any injury that occurs when an employee is under the influence of drugs or alcohol is not covered by workers compensation. It is very difficult to fight this type of decision, but a lawyer may be able to have this decision overturned.
4. Farm Workers. In some cases, farmers are not required to have workers compensation insurance on their employees. Much like the small employer, any event that takes place may require the injured party to sue the farm directly for compensation.
Other Reasons That A Claim Can Be Denied
1. Pre-Existing Condition. In some cases, the insurance company will claim that you had a pre-existing condition that led to the accident or injury. While this is rare, it does occur. It should be noted, South Carolina is a no-fault workers compensation state. This means that when an injury occurs, the insurer cannot claim a pre-existing caused the problem and deny the claim.
2. Inadequate Documentation. It is very important that when you are injured on the job that you complete all the necessary information with your employer to document the event. If there is not enough information on the accident report, or if treatment was verbally authorized but not documented, the insurer can deny the claim. You will need legal representation to correct this problem.
In most cases, workers compensation will work like it should for the injured employee. It is always recommended, however, that the employee seek legal assistance to ensure that they are receiving all the benefits they are entitled to under the law. Sadly, the insurance provider often forgets certain benefits that the employee should receive when they are injured. When you know your rights it will be less likely that your case will be mismanaged by the insurance company.
While working for a large company, writer Melanie Fleury suffered from an eye condition due to faulty ventilation in the office. She knows the pain and financial burden that can come from being injured at work. The lawyers at Howell and Christmas, LLC know the laws, and how to help people who are unable to work due to an injury at the job.