Risk Management

Personnel Policies and Procedures Manual

SECTION: Office of Risk Management
SUBSECTION: Injury
SUBJECT: Workers’ Compensation Last Update: 4/29/03
Effective: 10/1/85
Revised: 02/16/09
Reviewed:

THE LANGUAGE USED IN THIS DOCUMENT DOES NOT CREATE AN EMPLOYMENT CONTRACT BETWEEN THE EMPLOYEE AND THE AGENCY. THE DOCUMENT DOES NOT CREATE ANY CONTRACTUAL RIGHTS OR ENTITLEMENTS. THE AGENCY RESERVES THE RIGHT TO REVISE THE CONTENT OF THIS DOCUMENT, IN WHOLE OR IN PART. NO PROMISES OR ASSURANCES, WHETHER WRITTEN OR ORAL, WHICH ARE CONTRARY TO OR INCONSISTENT WITH THE TERMS OF THIS PARAGRAPH CREATE ANY CONTRACT OF EMPLOYMENT.

Workers’ Compensation Procedure

Procedure in the Event of Employee Injury

Initial Notification:  In case of accidental injury, it is an employee's responsibility to notify his supervisor or department head immediately. Any injury, no matter how slight, must be reported.

Medical Attention for the Work Injured Employee:  If the injured employee or his supervisor judges that the medical attention is needed, the supervisor or other designated person may call Compendium Services at 1-877-709-2667 to report the injury and assist in completing the First Report of Injury. The employee will be referred to Redfern Health Center. In the event of life or limb-threatening emergencies, treatment should be sought at the nearest emergency facility.

Once an employee receives initial treatment, any subsequent treatment must be by the same physician or a physician within the same practice, or upon referral by that physician. An employee, who initiates a change in physicians without referral, or without notification and approval through Compendium Services, may not be covered further under workers' compensation.

The time away for the initial treatment and any subsequent treatments should be recorded as hours worked, not as sick or annual leave. If subsequent medical treatments are prescribed the employee may leave work to go directly to the treating physician and/or other approved treatment with the understanding that the employee will return to work immediately following completion of the treatment. For these subsequent treatments time will be listed as regular work time.

Workers' Compensation Coverage of Medical Treatment:  All parties treating a work injured employee should be informed to direct the charges to: State Accident Fund, PO Box 102100, Columbia, SC 29221-5000.

Notice: A work injured employee should not provide group medical insurance (Blue Cross-Blue Shield) information to any agent in the treatment of his injury. If there is any knowledge of a claim for work injury treatment being directed to Blue Cross-Blue Shield, notify Risk Management immediately.

Charges may include emergency transportation, physician fees, X-ray charges, medical facility services and medication prescribed by the physician. The employee is responsible for providing Risk Management with the name and complete mailing address of any party involved in his treatment. If the employee has paid personally for any medical service, he may request reimbursement by forwarding his payment receipt to Risk Management.

Risk Management shall ensure to the best of its knowledge at the time a claim initially is reported that the injury comes under the provisions of the South Carolina Workers' Compensation Law, and shall communicate as necessary with all parties concerned regarding medical charges. The official files on an employee's work injury claim shall be maintained within Risk Management.

Official Reporting of Work Injury - IMMEDIATELY after initial treatment, the injured employee and his supervisor are responsible for notifying ComPendium Services and for preparation of the EMPLOYER'S FIRST REPORT OF INJURY. Failure to give immediate notice may cause serious delays in the payment of compensation.

If the employee does not wish to be treated at the time of injury, the supervisor shall complete the First Report of Injury and forward to Risk Management.

Additional Procedure in Event of Lost Days from Work Injury

Notification of Absence: If upon treatment of a work injury, the physician declares the employee unable to resume his regular duties, the employee may remain absent unless alternate work is made available which the employee can perform without detriment. The employee must obtain a doctor's statement indicating first date of absence and estimated date f return.

When work absence is necessary, it is the responsibility of the employee and his supervisor to notify Risk Management immediately by telephone.

Temporary Light Duty Program: Each department should provide temporary light duty work for employees whose physician allows them to return to work after a work related injury. If the employees' department cannot provide a light duty job, the supervisor must contact Risk Management for an alternative work assignment in another department. If an employee refuses light duty assignment, workers' compensation benefits may be terminated. Funding of the employee's salary and leave accrual will remain in the home department. The employees' supervisor and Risk Management will review the light duty assignment for continuation at the end of thirty (30) calendar days.

Notification to Employee on Pay and Compensation Options: Upon notification of a work absence, Risk Management will issue a letter to the disabled employee informing him of the pay and compensation options provided by the South Carolina Worker's Compensation Law. Refer to the Lost Time form letter which explains these options in detail.

Notice of Election: The disabled employee must decide on an option which is available to him and which is advantageous to his personal circumstances. It is recommended that the employee consult by telephone with Risk Management before electing an option because the direction taken can affect fringe benefits, earnings, service credit, etc. An employee's choice of option shall be irrevocable for the duration of his disability period. Refer to the Notice of Election.

Note: An employee who chooses Option (1) or Option (3) will remain in the chosen option unless paid leave is exhausted. Upon exhaustion of available paid leave, the employee will revert automatically to Option (2).

Agreement as to Compensation: After the disabled employee's choice of option has been established, he will be required to sign a prepared Agreement as to Compensation to indicate paid leave and/or temporary total disability compensation payments. The Agreement termination date, if not otherwise specified, depends upon the treating physician's declaration that the employee may return to work.

When the treating physician releases the employee for return to work, Risk Management must be notified immediately by telephone regarding the specific date the employee will begin work.

Compensation shall cease:

  1. When the injured employee returns to work upon the direction of the treating physician, at a pay rate equal to or greater than his average pay rate before injury.
  2. If there is discovered any fraud or intent to deceive.
  3. If the injured employee refuses employment which is suitable to his capacity and approved by the S.C. Worker's Compensation Commission.

If an injured employee is unable to maintain his former responsibilities while recovering from his injury or because of disability from the injury, he may be able to accept other work. If he must accept less pay than his average pay rate before injury, he is entitled to compensation based on 66.67% of the difference in pay rate.

Permanent Impairment

In the event that maximum medical improvement is attained and the injured employee exhibits evidence of a permanent disability or disfigurement, his treating physician will specify the amount of impairment upon his final treatment statement.

The South Carolina Worker's Compensation Commission will schedule a conference and notify the employee of the time, date, and location. If the employee cannot attend, he should notify Risk Management to arrange an alternate date or location.

Please refer to Compensation Conference Policy for information regarding the conference.

For more detailed information, please contact Denise Godwin at 864-656-3365 or the department of Risk Management.