Under the South Carolina Workers’ Compensation Act, injured employees are entitled to the reasonable cost of medical treatment. This means that if you suffer a workplace injury, your employer’s insurance must reimburse all medical care that helps you heal. Although you are obligated to seek treatment from a preapproved medical provider, the insurer does not have a right to determine which tests or procedures you need for treatment; that is up to your doctor.
There are often disputes about what type of medical coverage a worker is entitled to and when they can return to work. An experienced workers’ compensation attorney could advocate for you during this process. Our skilled lawyers are prepared to negotiate on your behalf to ensure you receive the benefits you need. If you have questions regarding your right to medical treatment after a workplace injury in Greenville, contact our office.
South Carolina’s workers’ compensation laws provide that injured employees are entitled to any “medical, surgical, hospital, and other treatment, including medical and surgical supplies as may reasonably be required.” South Carolina Code § 42-15-60. The treating physician or provider will determine what is reasonably necessary to treat the worker’s ailment. When there is a dispute regarding treatment, the employee can request a hearing before the commissioner.
After reporting their injury to an employer, workers will have an initial appointment with a preapproved doctor. It is crucial to inform the doctor of any injury or symptom related to the condition. This information can be critical if there is a dispute about treatment. During the appointment, the doctor may ask questions about prior injuries and pre-existing health conditions. Be prepared to answer those questions as clearly and completely as possible. If you disagree with the doctor’s assessment, you may request a second opinion and if this request is denied, a hearing before the commissioner.
If the insurance company determines the injury is work-related, the company will cover surgery, hospitalization, medical supplies, prosthetic devices, and prescriptions. In addition, Greenville workers are entitled to reimbursement for travel expenses to and from the doctor and the pharmacy. In addition to a treating doctor, an employer’s representative may provide a nurse case manager to help manage the injured worker’s care.
The doctor will determine if the injury is severe enough to prevent the employer from carrying out their job duties. If it is, the doctor will provide a note with a recommendation on how long the employee should stay home and assign an impairment rating. When the treating physician determines that additional medical treatment will not improve the condition, they will declare the worker has reached “maximum medical improvement” or MMI.
While all employees in Greenville are entitled to the reasonable cost of their medical care related to their on-the-job injury or illness, their benefits will not extend for an indefinite period. However, some injuries may require long-term care, or the worker could develop related conditions in the future. The insurance company will determine the best course of action. Typically, the medical claim will be left open and treatment will be paid for as it is needed, or the claim will be clinched meaning that the company will pay for future medical care upfront.
If you have concerns about your right to coverage for future medical care, contact a workers’ compensation lawyer at our firm.
When you suffer an on-the-job injury, understanding what your options are for medical treatment and future care can be complicated. A qualified attorney could advise you of the applicable laws under South Carolina’s Workers’ Compensation Act and help you determine the best course of action. There are often disputes with insurers about what treatment an injured worker is entitled to receive, but our lawyers are prepared to advocate for you.
If you have questions about your right to medical treatment after a workplace injury in Greenville, contact our office to schedule a free and confidential consultation.
864-740-8540 