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Workers' Compensation 'Opt-Out' Plan Proposed in South Carolina

The Anastopoulo Law Firm

Workers who are hurt or injured on the job have always counted on the security of knowing that workers’ compensation is available to help with their recovery. State-controlled workers’ compensation plans are a form of insurance that employers provide, which assures injured workers get medical care, transportation to and from doctor’s appointments, reimbursement for lost wages, and financial compensation when they suffer a disability. While workers’ compensation plans have been providing benefits for those who suffer on the job accidents and injuries since 1920, a new ‘opt-out’ plan could allow employers to opt out of the state workers’ compensation program and provide their own form of benefits. For injured workers, this could end up resulting in a significant reduction in the quality, variety, and amount of benefits these employees and their families receive.

South Carolina’s Proposed ‘Opt Out’ Bill

S.C. Republican Representative David Hiott introduced the South Carolina Employee Injury Benefit Plan, otherwise known as House Bill 4197, in May of 2015. The bill would allow employers to be exempt from the state workers’ compensation program, instead of allowing them to develop their own injured employee benefit programs. According to an article in June 2015 from the Insurance Journal, an employer’s plan would have to be certified by S.C. Department of Insurance and would still need to provide benefits that comply with the South Carolina workers’ compensation laws. The benefits that would be required under workers’ compensation opt-out plans in order to conform to the law include:

  • Doctors’ visits
  • Surgical and hospital expenses
  • Nursing services
  • Rehabilitative benefits
  • Medications and prosthetic devices
  • Benefits for disability
  • Death benefits

While advocates of the plan point out the potential savings to employers as a result of making the workers’ compensation program more competitive, there are concerns that it is injured workers who would end up suffering if the opt-out program is passed.

Workers’ Compensation ‘Opt Out Plans’ In Other States

According to an investigation conducted by National Public Radio and ProPublica, opt-out plans generally cover fewer types of injuries, cut off employee disability benefits sooner, pay less for needed medical care and treatments, and yield tight control over the types of doctors an injured worker can access. The investigation also discovered that, as opposed to state workers’ compensation plans, there are widespread differences among employer opt-out programs, and numerous restrictions that could hinder employees from getting the care they need and even result in them being denied coverage. Examples of restrictions in workers’ compensation opt-out plans include the following:

  • Not covering illnesses and infections due to environmental or chemical exposure, such as those causing cancer or diseases related to asbestos
  • Not allowing enough funds to adequately cover medical aids and devices
  • Requiring injured workers be accompanied to doctors’ appointments by managers or supervisors
  • Limiting the time medical care would be provided
  • Refusing payment for services required by injured workers, such as wheelchair vans and chiropractic visits

Employer’s control literally every aspect of these opt-out plans, including any types of appeals regarding their claim that are filed by an employee.

Reach Out to an Attorney for Help

If you or a loved one has been injured on the job, contact the Anastopoulo Law Firm today. These experienced workers’ compensation attorneys provide the aggressive legal representation injured workers need to get the treatment and benefits they deserve. Call Akim Anastopoulo today for a free review of your case in South Carolina.


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