Detailed Answer
If you suffer an injury at work in South Carolina and pursue a personal injury lawsuit against a third party, you must coordinate your workers’ compensation benefits with any settlement you obtain. Workers’ compensation benefits cover medical expenses and partial wage loss regardless of fault. Under South Carolina law, specifically SC Code Ann. ”>§ 42-15-20, your employer’s workers’ compensation insurer has a right of subrogation or lien against your third-party recovery.
Here’s how coordination typically works:
- Notify the Insurer Early: Inform your workers’ compensation carrier once you decide to pursue a third-party claim. Early notice helps protect your insurer’s subrogation rights.
- Calculate the Liens: The insurer can recover up to the amount of benefits it paid. However, South Carolina law requires the insurer’s reimbursement to be reduced proportionally by your attorneys’ fees and litigation costs based on the formula in § 42-15-20.
- Allocate the Settlement: When negotiating a global settlement, draft an allocation that separates compensation for medical expenses, lost wages, and pain and suffering. This allocation directly affects how much the insurer can claim.
- Obtain a Release: Provide the insurer with a copy of the proposed settlement agreement for review. A formal release from the insurer prevents later disputes over subrogation.
- File Required Papers: If you also wish to settle your workers’ compensation claim, you must obtain approval from the South Carolina Workers’ Compensation Commission under SC Code Ann. § 42-9-10. This ensures the carrier releases any future comp claims.
- Respect the Statute of Limitations: Ensure your personal injury lawsuit is filed within three years of the accident (SC Code Ann. § 15-3-530) to avoid losing your right to sue.
By following these steps, you can minimize disputes and ensure that your workers’ compensation benefits and your personal injury recovery are coordinated effectively under South Carolina law.
Helpful Hints
- Review all correspondence from your workers’ compensation insurer carefully to track benefit payments and lien amounts.
- Work with counsel experienced in both workers’ compensation and personal injury to negotiate lien waivers or reductions.
- Request a lien statement from the insurer early in your case to budget for the subrogation amount.
- Clarify fee-splitting rules: calculate how attorney’s fees apply to both comp and third-party claims.
- Keep detailed medical records and wage documentation to support benefit calculations.
- Consider alternative dispute resolution to streamline settlement discussions.