When a Workplace Accident Falls Outside of Workers’ Compensation
When you suffer an injury or illness at work, the first recourse is usually to file a workers’ compensation claim to pay for your medical expenses, time missed from work, disability benefits, and related expenses. In South Carolina, almost all companies that have four or more employees are required to carry workers’ comp insurance.
If you work for a company that is covered by workers’ comp and you suffer a work-related injury, you are eligible for benefits regardless of who was at fault for the incident. There are a few exceptions to this, such as injuries caused by:
- The use of alcohol or illegal drugs;
- The commission of a serious crime;
- Intentionally violating a workplace policy;
- Intentionally trying to do yourself or someone else harm.
In exchange for “no-fault” coverage, South Carolina employees are generally barred from bringing a personal injury lawsuit against their employer.
When Would a Workplace Accident Fall Outside of the Workers’ Compensation System?
Workers’ comp is a complex and confusing system. Sometimes, workers are denied benefits even if their injury or illness was not the result of one of the aforementioned exceptions. In some cases, employers deny benefits because, for whatever reason, they mistakenly believe the employee is ineligible. This can be very frustrating for employees who have a right to compensation but have a hard time navigating the complexities involved with pursuing a workers’ comp claim.
There are other cases in which a workplace incident may not fall under the purview of a workers’ compensation claim. Here are some examples:
Your Employer Does Not Carry Workers’ Comp Insurance: As mentioned earlier, employers in South Carolina who have less than four employees are not required by law to carry workers’ compensation insurance. There are a few other types of employees whose employer may not have workers’ comp benefits available. These include:
- Agricultural workers;
- Railroad or railway express workers;
- Realtors paid on commission;
- Textile Hall Corporation workers; and
- Employers whose payroll is under $3,000.
The Injury Occurred Outside of Work: Some injuries happen while you are commuting to and from work, on your lunch break, or traveling during the work day or work week. This is a gray area in which some incidents may be covered while others may not. For example, if you have an automobile accident while you are driving straight home from work, that is probably not covered. On the other hand, if you were injured while running an errand for your boss, that might be covered.
The Injury Was Caused by a Third Party: There are some instances in which the party responsible for the injury or illness is someone other than the employer or employee. Examples may include:
- Accidents caused by a subcontractor who is working nearby the employee (this scenario is common in the construction industry);
- Automobile accidents in a company vehicle when the individual who caused the accident is a liable third party;
- Accidents caused by defective machinery, equipment, and other faulty products;
- Workplace illnesses caused by a toxic substance made by a third party; and
- Injuries caused by a co-worker through willful or wanton acts or gross negligence (ex: co-worker assault).
Bringing a Lawsuit Against your Employer or a Third Party
If you experienced a work-related illness or injury and your employer does not carry workers’ compensation coverage or the injury was caused by a third party, you might be able to bring a personal injury lawsuit against the party that was responsible. If you are successful with your personal injury action, you may be able to secure damages above and beyond what might be available through workers’ comp.
In South Carolina, you are generally allowed to pursue a personal injury lawsuit against a third party while simultaneously pursuing a workers’ comp claim through your employer. This would come into play if you suffered a work-related injury that qualifies you for workers’ comp benefits, but the injury was the fault of a third party. This could get complicated, however, and it is best to work with an experienced attorney to ensure that everything is done properly, and you don’t do anything to jeopardize your benefits.
At Peake & Fowler, we have been standing up for the rights of South Carolina workers since 2000. Our attorneys have in-depth knowledge of the complexities of both workers’ compensation and personal injury law, and how the two areas often converge during workplace injury cases. We work closely with our clients and explore every potential legal avenue to ensure they are fully compensated for their injuries. Call our office today at 803-998-2412 to schedule a free consultation. You may also send us a secure and confidential message through our web contact form.
