4th Annual Workers' Comp Academy

Preliminary Program

Monday, October 21, 2013

10:30 am – 12:45 am

Overview of the SC Workers’ Compensation System and Forms Used

• Statutes, regulations, and case law that make up the SC Workers’ Compensation system
• Commissioner appointments/terms/who they are
• Forms

Compensable Injuries

• What qualifies as a compensable injury by accident
• Repetitive trauma claims
• Mental/Mental claims
• Occupational disease claims

Defenses to Claims

• Statute of limitations
• No notice to employer
• Intoxication/willfulness
• Fraud in the application for employment
• Going and coming rule
• Not a compensable injury (denied case)

12:45 pm - 2:00 pm

LUNCH

2:00 pm – 3:00 pm

Benefits Provided by the Workers’ Comp System

• Medical benefits
  • What treatment must be provided/choice of  physician
  • Medical Care after MMI/Lifetime Care
  • Obtaining medical records and communication with healthcare provider (§ 42-15-95)

• Temporary benefis
  • Determining AWW/CR
  • TTD
  • TPD

• Permanent Disability benefits
  • PPD
  • Wage Loss
  • Permanent & Total disability
  • Lifetime benefits

Starting and stopping temporary total/partial benefits

• Starting TTD (Form 15)

• Stopping TTD within 150 days from date of notice of injury

• Stopping TTD after 150 days

Closing Claims

• Informal conference process
  • Form 16A and its effects
  • Process if no agreement reached

• Hearing process
  • Award
  • Appeal process
  • Change of condition rights

• Agreement & Final Release/Clincher Agreements
  • Represented claimants
  • Unrepresented claimants

• Medical Only Claims

3:00 pm - 3:30 pm

Break

3:30 pm - 5:30 pm

Fines & Penalties

• Failure to file forms

• Improperly stopping temporary total disability

• Failure to timely pay award/interest

• How & when fines are assessed