Understand When an Injury at Work Qualifies for Workers’ Compensation

A work-related injury can create serious concerns about your future health and income. Thankfully, South Carolina has a workers’ compensation system that creates a legal process for you to receive necessary benefits while you recover. 

Important nuances in the law will determine the applicability of workers’ compensation benefits to your injury. Without the guidance of a lawyer, these nuances can make it difficult to know if workers’ compensation will cover your injury. Here, you’ll learn about the types of injuries that workers’ compensation often covers and excludes. This article also addresses some key tips for what to do after an injury at work.  

How to Know if Your Work Injury Might Be Covered?

The facts of your specific workplace injury will determine eligibility for workers’ compensation benefits. Generally, eligibility depends on a couple of items. First, the cause of the injury must be in the course of a qualifying employment relationship. Second, you must have a qualifying type of injury.

The Work Injury Must Arise Out Of and In the Course of Employment

In South Carolina, workers’ compensation injuries must arise out of and in the course of employment (i.e., the employment must cause the injury).  Most workplace injuries are easy to identify as employment-related, because a noticeable injury quickly follows some event while you are working. 

Other times, connecting an injury to your work will be more difficult. For example, you may experience a delay in time between your symptoms from the injury (e.g., pain, swelling, fatigue, etc.) and the work event that caused it. 

The issue of establishing a causal connection between your injury and employment can also occur when the injury happens on the fringe of your employment. This could be an injury while traveling to and from work, or an injury from a task that was not squarely within the scope of your work duties. 

Common Types of Work Injuries in South Carolina

A personal injury that qualifies for workers’ compensation benefits will often be physical in nature. This could be a physical injury from an unexpected trauma, overexertion, damage from repetitive tasks (e.g., arthritis), and other labor-intensive jobs. Common types of injuries might include:

  • Back and spine 
  • Broken bones
  • Nerve damage
  • Head trauma (e.g., concussions)
  • Muscle and ligament tears
  • Cuts and lacerations
  • Loss of use injuries (e.g., amputations of major limbs)
  • Burns and injuries from exposure to chemicals 

As explained in more detail below, mental and emotional injuries (with limited exceptions) don’t generally qualify for workers’ compensation. 

When Will Workers’ Compensation Not Cover a Work Injury?

Several issues and scenarios can prevent workers’ compensation benefits from applying to your injury at work.  

If the Injury Was Not the Result of a Qualifying Employment Relationship

South Carolina law exempts some employers and work relationships from coverage under its workers’ compensation laws. If your injury results from employment in one of the following scenarios, you might not qualify for workers’ compensation:

  • Casual employment (irregular or temporary work that is not in the trade of the employer). For example, a mechanic the employer hired to fix company vehicles.
  • Employers who have less than 4 employees or, in the previous calendar year, had an annual payroll of less than $3,000. 
  • Certain agricultural employees
  • Federal employees in South Carolina
  • A real estate salesperson

This list of employment excluded from workers’ compensation is not exhaustive. You should consult with a lawyer if you have specific questions about the eligibility of your employment for a workers’ compensation claim.

If the Cause of the Injury Was Not Accidental

The cause of most workers’ compensation claims must be accidental. A work injury that results from certain non-accidental behavior can also disqualify you from workers’ compensation. This includes:

  • A fight with a coworker, depending on the circumstances
  • Injuries that happen from or while under the influence of alcohol or drugs
  • Crime-related activity

South Carolina’s Workers’ Compensation Act Excludes Certain Injuries 

As mentioned above, a mental or emotional injury (e.g., stress, anxiety, depression, etc.) won’t generally qualify for workers’ compensation unless tied to a physical injury. However, you can sometimes show that the mental injury was from extraordinary or unusual events in comparison to normal employment and receive workers compensation benefits. 

Diseases also will not qualify unless you can show they arose naturally and unavoidably from a work accident. Conditions like cancer and other rare illnesses won’t generally apply to workers’ comp claims without strong evidence of a causal connection (e.g., exposure to chemicals or other toxins).

What to Do After You Have an Injury at Work

You should generally take a few important steps following an injury at work:

  • Notify your employer of the injury. In South Carolina, you normally have 90 days from the date of the event causing injury. 
  • Get medical and emergency attention. 
  • Consult with a lawyer to protect your interests. 
  • And of course, take  care to avoid further injury.

If You Have Additional Questions About Work Injuries

Workers’ comp claims can quickly become complex because of your injury or the nature of your employment. You can schedule a free consultation with one of our attorneys if you have further questions about a workers’ compensation claim and need representation.