Does Workers' Comp Cover Illnesses in South Carolina?

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Scenes from Joye Law Firm's Columbia office in May of 2024.

Willie Robertson dedicated nearly 40 years to his job at a North Charleston factory. When he realized that his long-term noise exposure had led to hearing loss, he assumed his company would cover the cost of hearing aids.

Unfortunately, he was mistaken. Not only did the company refuse to pay for the hearing aids, but they also denied any connection between his hearing loss and his work. Frustrated, Willie reached out to Joye Law Firm. Our workers’ compensation attorneys not only secured his hearing aids but also obtained additional benefits for him.

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South Carolina’s workers’ compensation laws cover employees who develop a work-related illness, but it isn’t always clear who is eligible. Many workers, like Willie, face an uphill battle in proving their job caused their illness. Read on to learn when an illness is covered under workers’ compensation in South Carolina and how Joye Law Firm can help ensure you receive the benefits you deserve.

Does Workers’ Compensation Cover Illnesses?

While most people associate workers’ compensation with physical on-the-job injuries, South Carolina law also offers workers’ comp to employees who become sick due to their jobs.

However, catching a cold or flu at work does not make you eligible for workers’ compensation. To receive workers’ comp, the illness, referred to as an “occupational disease” in workers’ compensation claims, must be:

Caused directly by your work duties
A condition not considered an “ordinary disease of life,” like a cold or flu
Unrelated to the outside climate
Transmitted by someone other than a colleague
Unrelated to your joints

Some illnesses also have specific requirements to be eligible for workers’ comp. For example, if your occupational disease affects your heart or lungs, the sickness must result from exposure to a harmful substance at work.

Occupational Diseases Covered under Workers’ Comp

chemical plant employee working Occupational diseases can affect various parts of the body and range from mild conditions that improve with rest to severe, progressive diseases that may lead to death. Here are some common examples of illnesses that are covered under workers’ comp:

Respiratory Diseases

Respiratory diseases related to work involve conditions that impact the lungs and respiratory system, often due to exposure to harmful substances such as dust, fumes, and chemicals. Common work-related respiratory diseases include:

Asthma: Triggered or worsened by workplace irritants like fumes, chemicals, or dust, affecting workers in industries such as healthcare, manufacturing, and cleaning services.
Silicosis: Found in miners and stonecutters, this disease results from inhaling silica dust over long periods, leading to symptoms such as a persistent cough, shortness of breath, and chest pain.
Chronic Obstructive Pulmonary Disease (COPD): This progressive condition is aggravated by exposure to fumes, chemicals, and dust, particularly in industries like mining and manufacturing.

Cancer

Occupational cancers result from long-term exposure to hazardous substances or conditions, including:

Chemicals: Such as benzene, formaldehyde, and arsenic
Radiation
Heavy Metals: Like cadmium, chromium, and nickel
Silica Dust
Wood Dust
Textile Fibers
Pesticides
Asbestos

Exposure to certain irritants has been scientifically linked to specific types of cancer. Mesothelioma, a type of cancer linked to asbestos, is particularly notable. Workers in construction, shipbuilding, and automotive repair face a higher risk of exposure to asbestos and, consequently, mesothelioma. This cancer often takes decades to develop, making early detection challenging and prognosis generally poor.

Skin Conditions

Occupational skin conditions can significantly affect a worker’s quality of life. The most common condition is contact dermatitis, characterized by red, itchy, and inflamed skin, often due to exposure to irritants or allergens such as:

Solvents
Detergents
Oils
Rubber
Latex
Certain Plants

Hearing Loss

Occupational hearing loss results from prolonged exposure to high noise levels or ototoxic chemicals (like lead, pesticides, and mercury). Common in industries with heavy machinery, construction, mining, and manufacturing, this type of hearing loss is usually irreversible. Preventive measures, including hearing protection and regular hearing tests, are essential for early detection and mitigation.

Musculoskeletal Disorders (MSDs)

MSDs affect the muscles, joints, tendons, ligaments, and nerves. They often result from repetitive actions, heavy lifting, or awkward body positions during work. Examples include:

Carpal Tunnel Syndrome: A nerve disorder affecting the hands and wrists, often seen in repetitive tasks like typing or assembly line work.
Tendonitis: Involves inflammation or irritation of a tendon due to repetitive motion or forceful exertion.
Arthritis: May develop or worsen from repetitive tasks, heavy lifting, or prolonged sitting or standing.
Tennis Elbow: Pain in the outer elbow from repetitive wrist and arm motions.
Trigger Finger: A condition where a finger or thumb gets stuck in a bent position, often due to frequent grasping or repetitive hand use.

Chronic Pain Syndrome

Chronic pain syndrome involves persistent pain lasting more than three months, often exacerbated by repetitive motion, heavy lifting, or prolonged sitting or standing. Unlike acute pain, which resolves with treatment, chronic pain can interfere with job performance and quality of life.

Understanding these occupational diseases is crucial for recognizing symptoms and seeking appropriate medical care and compensation.

The Challenge in Obtaining Workers’ Comp for an Illness

Getting workers’ comp for an illness is much more complicated than a physical injury. While workplace injuries only require proof that your injury occurred at work, workplace illnesses require proof that your condition resulted directly from your job duties or conditions on your work site. You must have direct medical evidence that your employment caused or is highly likely to have caused your illness.

South Carolina requires that you follow specific procedures to be eligible for workers’ compensation for an illness. These procedures include notifying your employer of your illness within 90 days, treating with a doctor of their choice, and filing your compensation claim within a set time. For occupational diseases, you must file within two years of being diagnosed with the condition. Failure to follow these procedures can result in a denial of your claim and loss of benefits.

What Benefits Are Available for Victims of Occupational Diseases?

Understanding the different types of benefits available under workers’ comp and how they apply to various situations is essential for ensuring you receive the compensation you are entitled to. From temporary and permanent disability benefits to coverage for death and specific impairments, navigating the workers’ compensation system can be complex.

Temporary Total Disability Benefits:

If you suffer a work-related illness that leaves you completely unable to work for a period, you may be eligible for compensation. This benefit provides 2/3 of your average weekly wage based on the four quarters preceding your injury. For those with multiple jobs, all wage sources are considered. As of 2024, the maximum weekly benefit is $1,093.67. Note that insurance carriers sometimes underestimate wages by not accounting for overtime or bonuses. Benefits continue until you reach maximum medical improvement (MMI), but after 150 days, insurers can request a hearing to potentially terminate benefits.

Temporary Partial Disability Benefits:

If an illness limits your ability to perform some job duties, you may qualify for temporary partial disability benefits. These benefits compensate for lost income due to reduced hours or lower-paying assignments. The benefit amount is 2/3 of the difference between your pre-injury average wage and your current restricted wage. For example, if you earned $900 weekly before the illness and $500 afterward, you would receive benefits for 2/3 of the $400 difference.

Permanent Partial Disability Benefits:

When an injury leads to permanent partial disability, affecting your ability to perform certain job functions and reducing your earning potential, you may be eligible for permanent partial disability benefits. Compensation is based on medical evaluations and the impact of the injury on your work life. A vocational consultant can be helpful in assessing the extent of the disability.

Scheduled Member Disability Benefits:

For illnesses that lead to permanent injuries like the loss of a limb, benefits are calculated based on an impairment rating given by a physician. If you believe the initial rating is too low, your attorney can arrange for an independent medical examination to potentially improve your compensation amount.

Total and Permanent Disability Benefits:

If your illness is so severe that no stable job market exists for you, you may qualify for total and permanent disability benefits. The assessment considers factors like the nature of your injury, physical restrictions, age, education, work history, and local economic conditions. Generally, benefits are capped at 500 weeks, except for severe cases like paralysis or brain injuries, which may qualify for lifetime benefits.

Death Benefits:

When a worker dies from a job-related illness, their dependents may be entitled to death benefits, including 2/3 of the deceased worker’s average weekly wage for up to 500 weeks and up to $12,000 for funeral expenses. Eligible dependents also include full-time students and those incapable of self-support.

A workers’ compensation attorney from Joye Law Firm can help you navigate the complexities of the workers’ comp system and understand which benefits you are eligible for based on the outcome of your illness.