With other states that have recently decided to change their workers’ comp system—such as Arizona, which we just talked about, and New York, which we talked about a month ago—add South Carolina to that list, almost. The House in South Carolina just passed a bill that would make important changes to the way that workers’ on the job injuries and disability are done in the state.
Some of the changes would include: an end almost to the Second Injury Fund, which has been a money loser for the state as of late. The Second Injury Fund was meant to help workers who had been previously hurt on a work site to get back to work, either at their original employer or at other locations of employment.
Another change: the law would make it so that employees have to prove that their injuries or illnesses had actually happened at work. The law would also make it more difficult for workers to make claims of workplace stress or mental illness and get benefits for it. Claims like these would still be possible but, again, there is more burden of proof on the workers to prove that the stress or mental illness related problems were directly because of work.
Last but not least of these important changes is one that has do to with repetitive stress injuries. The law makes it so that there are new limits on these types of injuries in terms of what workers can collect from the workers’ comp system in benefits for them. This is especially true for repetitive stress injuries that are often related to getting older, and not necessarily related to work.
All these changes are not settled of course. The House approved its bill, but the Senate version of the workers’ comp reform bill is different. So a compromise legislative session between the two houses will be necessary, according to my sources.
The South Carolina Workers’ Compensation Commission is not stopping with just a new mediator for appealed workers’ comp claims. It has also set up a new hospital payment system that went into effect last year and is now in full effect. The new system could come as a shock to employers who self insure for their workers’ comp coverage, or even their insurance companies if an employer goes through an insurance company for the coverage.
Anticipating that trouble, the South Carolina Workers’ Comp Commission has offered to help out any self insured employers, insurers, or any one else handling workers’ comp bill payments to make the transition to the new hospital billing and payment system. As such, I’ve got wind that the Commission is offering to price, for free, any hospital outpatient, inpatient, or ambulatory surgery bill. To get this service, send these bills to the South Carolina Workers’ Comp Commission’s Medical Services Division, which will then reprice the bills according to the new system. The new rate is Medicare’s current pricing rate, plus an additional 40 percent.
If you or the medical provider sending these bills to you have any sort of problem with the new rate or a particular workers’ comp medical bill, the Medical Services Division also offers to mediate any sort of dispute. You can request the Medical Services Division to do an administrative review of the bill.
This whole system change has come about in South Carolina because the commission is getting a bit fearful of the enormous raise in the costs of medical care when it comes to workers’ comp. The system overall is meant to save employers as much as $60 million a year on workers’ comp medical bills. That alone should make you and other South Carolina employers very enthusiastic about the new hospital bill system and pricing.
South Carolina employers now have a trusted mediator to count on when workers’ comp claims go sour—and it is all for free. The South Carolina Workers’ Comp Commission has been faced with a huge deluge of workers’ comp claim rejection appeals brought before their Full Commission, and to so to try to cut through the pile a bit, the Commission has decided to hire a professional workers’ comp claim mediator. Her name is Ginger Crocker.
Crocker’s job will be to help deliberate when an employer and a worker disagree over a workers’ comp claim. So, say, for instance that one of your workers claims carpal tunnel syndrome was caused because they were typing day in and day out at your office. If you didn’t agree, and refused to pay the claim, the issue would normally have gone from one commissioner to the South Carolina Workers’ Comp Commission to the Full Commission. It’s on the way to the Full Commission that this backlog has built up.
Crocker will now be there for you and your employees before the case reaches the Full Commission. Her job in that spot will be to hopefully convince the employer and the employee to negotiate and settle, saving everyone involved the save and money that would be spent if the case had to go all the way to the Full Commission. Her job—mind you—is not to make a decision on the case, but rather to try to help the conflicting parties come together in some sort of agreement and end their feud.
This position is going to at least last for six months, with all expenses associated with Crocker’s work to be picked up by the Workers’ Comp Commission in South Carolina. Without Crocker, the whole process could have taken you at least four months to get an appeal to the Full Commission, despite the fact that the commission are literally working overtime to deal with the flood of cases they face.
We don’t have much time or space here at this blog to share every last detail about a human resource product, human resources news, or workers’ comp. Instead, we have had to pick and choose what we feel is the most important stuff for you to know. You might not agree with us all of the time, but the fact of the matter is, loyal readers, you trust us enough to keep coming back for more of this important info.
Today is no different. Today, we are looking at the workers’ comp injury reporting system for the state of South Carolina, and if you are an employer in the state of South Carolina, there may be no more important topic when it comes to helping you contain the costs of workers’ comp. And for most employers in the state of South Carolina—in fact probably in most states across the Union—the costs of workers’ comp can be a big headache, so any way to contain them could come in mighty handy.
Of course, injury reporting is a two way street. Not only are there things that employers can do better to make the process go more smoothly and less expensive, but your employees can do some things to help out their own situation if they get hurt. For instance, employees should know to report their injuries as soon as possible to you or their direct supervisor.
A injury report from the employee then allows you to grant them the right to go to a medical care provider. It also allows you to file a Workers’ Comp claim form. In either case, a slow reporting by the employee or by the employer can lead to the workers’ comp claim being denied by the state or by your insurance carrier.
The workers’ comp picture in South Carolina is relatively clear compared to some of the other states we’ve looked at. Where we’ve seen states with set number of employees that companies must have before they must have workers’ comp, or different employee levels depending on what industry the company is in, South Carolinas basically says that all employers must have workers’ comp if they have four or more workers employers at a full time or part time level, on a regular basis.
But the South Carolina workers’ comp picture gets a little bit more complicated, admittedly, when we look at some of the exceptions to the workers’ comp system that the state has. For instance, farm workers, railway workers, railway express workers are all exempt from workers’ comp. Plus, any company that made less than $3,000 in the previous year is also exempt from workers’ comp in the state of South Carolina.
Then again, even if these employers and their certain types of workers are exempt from the workers’ comp coverage laws in the state, South Carolina opens the door for them to choose to have workers’ comp for these employees anyway. It is the employers choice in these situations. The process doesn’t go the other way, though. There is no choice for all the other employers. If you are mandated by law to have the workers’ comp coverage, you can’t choose not to have it.
The way the compensation part of workers’ comp works in the state of South Carolina is that the workers’ comp coverage pays for a portion of the medical care that the employee needs after their injury, and a portion of the lost wages the worker gets after they have to miss work because of the said injury. This compensation extends to people who get a permanent disability from the injury or worse, a disfigurement because of what happened on their job.