SC Workers Compensation Commission Carolinas AGC South Carolina - - PowerPoint PPT Presentation
SC Workers Compensation Commission Carolinas AGC South Carolina Update July 16, 2020 South Carolina Workers Compensation Commission Commissioners Susan S. Barden Melody L. James T. Scott Beck Term Expires Term Expires Chairman
South Carolina Update July 16, 2020
Chairman
Term Expires June 30, 2020
Susan S. Barden
Term Expires June 30, 2022
Melody L. James
Term Expires June 30, 2022
Avery B. Wilkerson, Jr.
Term Expires June 30, 2020
Aisha Taylor
Term Expires June 30, 2020
Gene McCaskill
Term Expires June 30, 2024
Michael R. Campbell II
Term Expires: June 30, 2024
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Apply facts of case to law Apply rules equitably to all All stakeholders on level playing field Promote efficiency and effectiveness Provide timely responses to all stakeholders Remember … a case involves a person
Hearings Approve Settlements Motions Attorneys’ Fees Appellate Hearings
Administrative Policies and Procedures Regulations Medical Fee Schedules Applications to self insure South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
July 1,2019 – June 30, 2020 Medical $ 451 (18%) Compensation $ 587 (-4%)
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Maximum Week ekly Compen ensation 66 2/3% of individual average weekly wage Not to exceed AWW $866.67 Sched eduled ed Body Part Value e of I Injury ry = = Number er of W Week eks ( (sched eduled ed body part) ) x AWW x % D Disability ty Medical cal Rati ting of I Impai airm rmen ent t Disability ty
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Venues/Hearing Sites
100 throughout state
Vocational Rehabilitation
47 referrals YTD 19 counties Case manager on site in near future
Probation, Pardon and Parole Partnership
Incarcerated individuals Hearings held via video conference
DEW
Employer wage and personnel data for compliance
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
62,000 employer records 351 employers not in compliance 469 employers came into compliance 3,800 workers were covered $1,027,000 fines collected coverage and compliance
Subcontractors are statutory employees of an upstream general contractor Business owners, contractors, and subcontractors required to carry insurance.
South Carolina Workers’ Compensation Commission
Any contractor or employer can register a policy with the Commission’s Coverage Verification System to be notified of a midterm cancellation. Go to the Commission’s website: http://www.wcc.sc.gov and select the verify coverage tab at the top of the page. Then follow the and then follow the prompts. Once you have located your policy through the search portal, you can register that policy using your email address and you will be notified if that policy is cancelled prior to its expiration date.
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission http://www.wcc.sc.gov
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Feb 1 – June 30
can M Medica cal A Associ ciation design gnated
edural al Terminolog
T) i is a a med edic ical al code de set et th that i at is used ed to to rep eport t medi dical, s surgi gical, a and diagn gnostic proced edures es and nd s servi vices
Codes C Created f for corona navirus us
y Code ( (DN0037) 0037) as s 83 – “Pand ndemic”; ”;
njury Code ( (DN0035) as s 83 – “COVID-19” 19”; o
” or “Coronavirus us” i ” in t the Accid ident/I /Injury D Descriptio ion Narrat ative ve ( (DN0038) 0038)
Top 10 Occupations - COVID 19 Claims
Claims REGISTERED NURSE 46 CNA 14 POLICEOFFICER & DRIVERS 13 LPN 12 SERVICE REP 12 FIRE FIGHTERS AND DRIVERS - VO 11 GENERAL OFFICE STAFF 7 Not provided 7 Rehab Nursing Tech 7 X-RAY/DIAGNOSTIC TECHNICIAN 7 NURSING STAFF (NOC)(I.E. PCT/I 6 REP PA II 6 RN 6 TIDLEANDS HEALTH EMPLO 6 OCCUPATIONAL THERAPIST 5 BD MEMBERS, CLERICAL OFFICE EM 4 OTA 4 PACKAGE DRIVER 4 SOCIAL WORKER 4
upational d disease se d define ned
a disease ar arising o
and i in the c e cou
e of em employment
e to
zards i in ex exces ess of
those o
inaril ily i y inci cident t to empl ployment a and d is pe peculiar t to the oc e occupation of
e em employee ee
. Code A Ann. . §42 42-11 11-10(A (A). ).
pational al d diseas ase
if cau aused by by a a haz azard r recognized as as pe peculiar to a a par particular t trade ade, pr process,
ccupation o
r employment
rect ct re result o
continuous e exposure t to the normal w work rking co conditions Grady L
Beard, S Shannon T nnon Till Poteat, M Marcy J Johns hnson
Vernon non R. . Sumwalt lt, M Margaret Blue luestein & & Alli llison P.
ullivan, The Law o w of f Workers’ Compens nsation I
nce i in South h Caroli
na Ch.7 7 §I (6 (6th e ed. . 2012) 12).
upat ationa nal disease ses
ay rese semble inj njur uries b by ac y accident
the hey have have sub substantive ve and and p procedural p peculiarities
Which ch do
tain in to
jury-by by-accid ident cl t claims ims.
ady L. Bear ard, Shanno hannon n Till Poteat, Mar arcy Johns hnson n Lam amar ar, Verno non R. Sum umwal alt, , Margaret Blu luestein & & Alli llison P P. . Sulli llivan, The he Law aw of Workers’ s’ Compens nsation n Insu nsuran ance in n Sout uth h Car arolina Ch. h.7 7 §1 1 (6t 6th e h ed. 2012) 2012).
sults f from a a haz hazar ard that hat i is s ac ackno nowledged as as different f from haz hazar ards f found und in n the he g gene neral r run o un of
ations ns.
, Dixi xiana na Mill D Div.
sing, 289 289 S.C. 130, 130, 139, 139, 345 S 345 S.E.2d 2d 249, 249, 254 254 (Ct. A
1986).
Peculi uliar t to
loyment means ns t tha hat e employment i inc ncreased t the he risk k
ay be be an an o
diseas ase i if pr produced o
aggravated by by di distinctive condi ditions o
employ loyment nt
ady L. B Beard, d, S Shan annon T Till Poteat, M Marcy J y Johnson Lamar ar, Ve Vernon R.
walt, M Margaret B Blue luestein & & Alli llison P.
ullivan, The La Law of Work rkers’ C Compensation I Insurance i in South Caroli
na Ch.7 7 §II A 4 4 (6t 6th e ed.
2012).
e em employee s e shall es establish t the e dis isea ease e arose f e from ex exposure t e to the e hazards pec eculiar t to the e em employment b by a a prep eponder erance o e of the e ev evid iden ence e
Code A e Ann. §42 42-11 11-10(A (A). ).
t must sh st show connecti tion b betw tween o
tional d dise sease se a and th the conditi tions s
the e employ loyment nt
Corp rp., Dix ixia iana Mil ill D Div
isin ing, 289 S. 289 S.C. 130 130, 138 138, 345 345 S. S.E. E.2d 249 249, 254 254 ( (Ct. A App.
1986).
contrast, i injuries b by acci ccident occu ccur suddenly
dis isea eases es f freq equen ently have e in indef efinite o e onset et
e onset et d date is e is not d det eter erminative, e, howev ever er t the e date o e of dis isability is is
ee Glen enn v
Columbia S Sil ilic ica S Sand Co Co., 236 236 S. S.C. 13, 13, 112 112 S. S.E. E.2d 711 ( 1 (1960) 960).
isea ease s shall b be e deem eemed ed a an o
ional d dis isea ease e
cau aused by a h by a haz azard recognized as as pe peculiar to a par a particular trade ade, pr process,
ccupation o
r employment
rect ct re result o
continuous e exposure to the normal w work rking co conditions of that part rticular t tra rade, p pro rocess, o
ccupation, o
r employment
ady L. B Beard, d, S Shan annon T Till Poteat, M Marcy J y Johnson Lamar ar, Ve Vernon R.
walt, M Margaret B Blue luestein & & Alli llison P. P. Sulli livan, n, The e Law of Workers’ Co Compen ensation I Insurance in e in South C h Carol
na Ch.7 7 §I (6t 6th e ed.
2012).
when
t is s a conta tagious d dise sease resulti ting f from e exposure to to fello llow e emplo loye yees
rom a a hazard rd t to which t the work rkman would h have been een eq equally ex exposed o
his em employment.
.C. C . Code A Ann. . §42 42-11- 10(B)( )(3). ).
when
disease o
the cardiac, pulmonary, o
circu culat latory y system m
lting direct ctly ly from m
ernal g gaseo eous p pressure e exer erted ed up upon t n the he body
the natu tural entr trance i into to th the body th through th the sk skin o
natu tural o
gn o
ganic o
inorga rganic m matter r under r circumstances peculiar to the emp mployme ment and the proces esses es utilized zed therei ein.
.C. C . Code A Ann. . §42 42-11- 10(B)( )(5). ).
shall b be c consi nsidered an an occup upationa nal d disease w whe hen i n it d does no not r resu sult directly and and nat natur urally y from exp xposur ure in n thi his Stat ate to the he haz hazar ards peculiar to the he par articul ular employm
nn. §42 42-11 11-10(B)(1).
shall b be c consi nsidered an an occup upationa nal d disease w whe hen i n it r resul sults f from exp xposure to out utside cl clima matic tic con conditio
42-11 11-10(B)(2).
shall b be c consi nsidered an an occup upationa nal d disease w whe hen i n it i is s a a cont ntagious us dise seas ase r resu sulting from e exp xposur ure to fellow e employees or from a a haz hazar ard t to w whi hich t the he w workman n woul uld have have b been e n equal ually y exp xposed o
utside o
his e s employm
42-11 11-10(B)(3).
shall b be c consi nsidered an an occup upationa nal d disease w whe hen i n it is s any any disease of the he car ardiac, pulmonary, or
circulato tory syste tem m not
resultin ing d directl tly fr from a
external g gaseous pressure exe xerted up upon t the he b body o
the he nat natur ural e ent ntranc nce i int nto t the he b body t thr hrough t the he sk skin n or nat natural al orifices thereof
foreig ign or
ic ma matter under ci circumstances pecu culia iar to
mploy
ment t and the he p processes ut utilized t the herein.
S.C. C Code A Ann.
42-11 11-10(B)(5).
pational al disease
hen it is one ne o
f the he o
diseases of l f life t to w whi hich t the he g general p pub ublic i is equa uall lly exposed
less t the d disease f foll llows as a complication n and a a natura ural i l incident nt o
an
upationa nal d l disease
less there re is continuo nuous us exposure ure pecul uliar r to the occup upation itself f which h makes such disease a a hazard rd i inhe here rent i in such o h occup upation. n.
. Code A
42-11 11-10(B)(4 (4). ).
joint nt r resolut ution f from the S Sena nate R Re-Open n Sout uth C h Caroli lina na S Sele lect C Committee
nators rs Alexand nder, r, Mallo lloy, Sheheen, Davis, Johns nson, Shealy ly & Turne ner
workers rs to b bene nefi fits u under T r Title le 42 for c r contra racting ng C Covid-19 wi with thin th the scope of their r emplo loyment nt.
rs, healt lth h care providers rs, and corre rectiona nal emplo loyees are afford rded a a conclus lusive p presum umption that at they c y contrac acted C Covi vid-19 wi with thin th the scope o
their e r emplo loyment nt.
ntial l workers are afford rded a rebuttable p presumption that t at they c contr tracte ted Covi vid-19 w withi hin t n the scope o
their e r emplo loyment nt
must show beyond the p preponderance ce o
the e evidence ce t that they y contrac acted Covi vid-19 duri ring ng the scope of their r emplo loyment.
Earliest reported Date of Injury for a COVID related claim February 26th, 2020
Number of COVID related claims being Denied Number of COVID related claims being reported as Fatal 2 Number of COVID related claims with Attorney Representation 11 Number of COVID related claims with Judicial Activity 1 Youngest Employee reporting COVID 18 Oldest Employee reporting COVID 74 Total Amount Paid on closed COVID cases $115,894
Questions?