Workers’ compensation tends to get a bad reputation from both employers and employees alike. Neither side tends to be satisfied with the benefits paid to an injured worker; however, it can be a lifesaver to the employee when they are injured in unforeseeable ways. Stephen Whigham, an employee of Jackson Dawson Communications, can testify to that. He was injured in a company kickball game, breaking two bones in his leg as he was trying to avoid being tagged out. The South Carolina Supreme Court held on Friday that Whigham was entitled to workers’ compensation, as he was required to attend the game as part of his ‘professional duties.’
Workers’ Compensation General Facts
Workers’ compensation is a system sponsored by state governments that will cover both medical expenses and lost wages for an employee who is injured on the job. In exchange for guaranteed compensation upon injury, the worker gives up the right to bring suit against their employer. The amount and type of benefits given will vary by state, but in South Carolina, a weekly check will be provided, at an approximate rate of 66 ⅔% of wages (taking an average from the previous four quarters before the injury). The Workers’ Compensation Act also provides that you can receive any ‘reasonable medical treatment intended to lessen your disability.’ This is not always the case; in other states there are many restrictions on what treatment will be covered by workers’ compensation.
The important thing to keep in mind is that workers’ compensation is designed to take care of employees who have been injured – without any fault being laid at the door of the employer. Negligence or other tort law does not come into the picture in a workers’ compensation case – there is simply a statutory authority that states that employers must cover on-the-job injuries.
Defining the Standard – Combating Fraud
Two justices on the Supreme Court did dissent on the Whigham ruling, stating that playing in the game was not part of his ‘professional duties,’ even if attending was. This attempt to strictly define the standard is likely trying to cut down on fraud. There is actually no agreed-upon method to identify the number of workers’ compensation fraud cases, as the parties differ on what constitutes fraud. However, the rate of fraud has been rising. South Carolina’s premiums for workers’ compensation insurance were among the lowest in the nation during the 1990s; by 2007 they had risen to approximately 25th. While the amount of claims being filed actually went down during that period, the rate of appeals rose – and it is on appeal that final decisions are made.
As of the most recent data, the amount spent on workers’ compensation by the nation’s employers was only around 1.6%, though some industries had higher claim rates than others – construction, for example, had 4.4% of its spending listed as workers’ compensation awards and insurance premiums, while the manufacturing industry only spent 1.8%. This is important to note, because even if massive fraud on a nationwide scale is alleged, the total amount spent on workers’ compensation claims (legitimate and illegitimate) is still a small fraction of employer spending as a whole.
Contact A Workers’ Compensation Attorney
Mr. Whigham will be able to support his family even while injured, thanks to a keen eye and talented representation. If you have been injured in an accident, and need help obtaining your rightful workers’ compensation, we may be able to assist. Contact Callihan & Syracuse today.