work comp questions

What is the Time Limit for Compensation, TTD and Medical Bills to Be Paid?

Work Comp Payment Time Limits and Possible Penalties

Compensation

  • Under Agreement: The first installment of compensation, payable under the terms of an agreement, is due on the fourteenth day after the employer has knowledge of the injury or death. Thereafter, it must be weekly (or monthly if ordered by the Commission) on the same day of week. S.C. Code Ann. §42-9-230.

  • Under Award: The first installment of compensation payable under the terms of an award by the Commission or under the terms of a judgment of a court upon an appeal from such an award shall become due seven days from the date of such an award or from the date of such a judgment of the court, including interest from the original date of the award. Thereafter, it must be paid weekly. S.C. Code Ann. §42-9-240.

TTD - Temporary Total Disability

Temporary Benefits are due eight (8) days after incapacity. If benefits are improperly withheld, an employer may be subjected to a 25% penalty based on the amount withheld. S.C. Code Ann. §42-9-260.

For General disability, the period coved by compensation may not exceed five hundred weeks. However, if the claimant is totally and permanently disabled and is either a paraplegic, a quadriplegic, or has suffered physical brain damage, the claimant is entitled to lifetime benefits. S.C. Code Ann. §42-9-10. The limit for TTD in partial disability claims is outlined in the schedules and charts referenced above and attached. If an employer's representative suspends, terminates or reduces temporary benefits without first complying with all necessary procedures, the claimant may be entitled to additional compensation and penalty. R.67-510.

Medical Bills

Payment to an authorized health care provider for services shall be made in a timely manner, but no later than thirty (30) days from the date the authorized health care provider tenders request for payment to the employer's representative, unless the Commission has received a request to review the medical bills. S.C. Code Ann. §42-9-360(D). Medical treatment, as may be reasonably required, shall be provided by the employer for a period not exceeding ten weeks from the date of injury to effect a cure or give relief and for additional time with judgment by the Commission if it will tend to lesson the period of disability. S.C. Code Ann. §42-15-60. There is no liability on the part of an employer to furnish medical treatment to an injured employee beyond ten weeks from the date of injury unless in the judgment of the Commission it "will tend to lessen the period of disability." Dykes v. Daniel Const. Co. 262 S.C. 98, 202 S.E.2d 646 (S.C. 1974). Medical benefits provision of Workers' Compensation Act allows the Workers' Compensation Commission to award medical benefits beyond 10 weeks from the date of injury only where the Commission determines such medical treatment would tend to lessen the period of disability. Dodge v. Brucoli, Clark, Layman, Inc., 334 S.C. 574, 514 S.E.2d 593 (S.C. App. 1999).

Does the employer have to begin paying total temporary disability benefits from the date the disability begins?

NO. If the case is denied, no benefits are due until ordered by the Commission.

Could there be any penalties for not beginning benefits promptly?

YES. If the case is admitted, benefits must be paid promptly according to the regulations. A penalty and/or interest may be assessed for late payments. R. 67-1602 (D). The interest is ten (10) percent of the unpaid installment. S.C. Code § 42-9-90. See also S.C. Code Ann. § 42-9- 230. Temporary benefits may be terminated up to 150 days after the injury is reported. Ground for termination of temporary benefits is discussed more thoroughly below.