Temporary Disability Income

Q. How do I become eligible for temporary disability benefits?

A. Generally, these benefits begin when your authorized treating physician determines that you are unable to work as a direct result of your job-related injury.

Q. How are benefits paid?

A. Generally, if you are out-of-work for a fixed period of time, you will receive one check for the total amount of benefits you are eligible to receive. If your injury requires you to be out-of-work for an extended period of time, SAF will send you checks on a weekly basis equal to the amount of your "compensation rate."

Q. How is the weekly "compensation rate" calculated?

A. SC law establishes the compensation rate for all job-related injuries to be 2/3 of your "average weekly wage," subject to a minimum and maximum rate. This rate is the amount of benefits that you are eligible to receive each week.

Q. What is meant by the term "average weekly wage?"

A. This term is used to reflect your average salary at the time of your accident. SC law requires that your salary (including bonuses and overtime) be verified and averaged for one (1) year prior to your accident or illness. Your employer is required to submit this payroll information to SAF. It is important to note that this amount is based on "earned" income. Interest, rental, mortgage, and/or dividend income is not included.

Q. I have a second job. Will that income be considered in the calculation of my "average weekly wage?"

A. In most cases, yes. You must submit the income information to SAF. For more information, call your claims adjuster.

Q. I was injured while working for the National Guard or as a Volunteer with a Fire Department or Rescue Squad. Do special provisions apply to me?

A. Yes. The amount of benefits you are eligible to collect is set by SC law. Call your claims adjuster for more information.

Q. Are these benefits subject to normal payroll taxes.

A. No. Workers' compensation benefits are not subject to any FICA, federal, or state payroll taxes.

Q. What will happen to my normal payroll deductions (retirement contributions, regular health insurance, etc.) and other benefits while I'm not receiving a regular paycheck?

A. Your workers' compensation benefits do not cover any kind of payroll deductions or other normal benefits that are associated with your regular employment. Check with your employer's human resources department for further information.

Q. Will I be compensated for every day I am out of work?

A. SC law sets a seven (7) calendar day waiting period to receive temporary disability benefits. You will be eligible for compensation on and after the 8th day. If your injury is such that your authorized treating physician requires you to be out of work for fifteen (15) or more calendar days, you will be paid for every day you are out-of-work, retroactive to the first day.

Q. Does the term "calendar days" include weekends and holidays?

A. Yes.

Q. Can I use my sick/annual leave instead of electing to receive temporary disability benefits?

A. The option to use sick/annual leave varies with each employer. Contact your employer's human resources office to get specific information regarding the options available to you. State government employees must sign a statement (Notice of Election Form) indicating their intention to use sick/annual leave or receive temporary disability benefits.

Q. What is meant by "temporary total" (TT) disability?

A. This concept means that you are temporarily unable to work and earn wages. For example, if you are out-of-work because of a knee injury for a six week period, you would be considered "temporarily totally disabled" for that six week period.

Q. What is meant by "temporary partial" benefits?

A. Temporary partial (TP) benefits are paid to help "make up the difference" in your salary if you return-to-work in a part-time or light-duty capacity. The amount of these benefits will vary. Check with your claims adjuster for more details.

Q. How soon should I expect to receive my first compensation check for the time I am out of work?

A. Ordinarily, you should expect to receive your first check within fourteen (14) days after your claim has been approved by SAF. A copy of the WCC Form 15 (Agreement for Compensation) will be included for your records. Your signature is not required.

Q. For claims with a date of accident prior to 06/18/96:

A. Upon receipt of your first check, you will be required to sign and return a WCC Form 15 (Agreement for Compensation.)

Q. How and when can my benefits be terminated?

A. In most cases, your benefits will be suspended when your authorized treating physician releases you to return-to-work. If you are released to return-to-work within 150 days of the date you reported your job-related injury to your employer, SAF will notify you in writing that your benefit checks will be suspended. If you are released to return-to-work after the 150 day period, you will be asked to sign a WCC Form 17 (Receipt for Compensation) indicating that you have returned to your regular job, or are able to return-to-work.

Q. For claims with a date of accident prior to 06/18/96:

A. Regardless of the length of time you have been out-of-work, you will be asked to sign a WCC Form 17 (Receipt of Compensation.)

Q. What happens when I sign the WCC Form 17 (Receipt for Compensation?) Will all my benefits stop?

A. No. The signing of a WCC Form 17 allows SAF to suspend the payment of TT or TP benefits because you have been released to return-to-work. It does not affect your legal right to receive further benefits (including more TT or TP) under SC law.

Q. What happens if I return-to-work after being injured, but later have to miss more work due to the same injury?

A. If your authorized treating physician requires you to go back out-of-work, you must notify SAF immediately. Additional forms may have to be completed.

Q. For claims with a date of accident prior to 06/18/96:

A. SAF will send you a WCC Form 16 (Supplemental Agreement For Compensation) which must be signed by you and returned to SAF. Compensation benefits will then be restarted.

Q. I have been released to return-to-work, but I'm still receiving TT checks. What should I do?

A. Contact SAF immediately. It is against the law to receive TT benefits and your regular salary.

Q. What happens to my medical benefits when I return-to-work full-time?

A. You will continue to receive medical benefits until you are released by your authorized treating physician as having reached "maximum medical improvement."

Q. What does "maximum medical improvement" mean?

A. The concept of "maximum medical improvement" (MMI) is a technical term that indicates, in the physician's opinion, that your medical condition has reached the maximum level of healing possible for your injury, based on guidelines set by the American Medical Association.

Q. What if I am able to go back to work either part-time or full-time but earn less than I was earning before I was injured? How does that affect my compensation for lost wages?

A.If you return to work either part-time or full-time but earn less than your previous wages, you may be entitled to receive two thirds (2/3) of the difference in compensation up to the maximum amount for a period not to exceed 340 weeks.

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