Although we typically use our blog to report news and developments in SC Workers’ Compensation Law, from time to time it helps to get back to basics. We hope our “Workers’ Comp Fundamentals” series will be useful as a learning tool for those who are relatively new to the world of workers’ compensation, while providing a good refresher for the more “seasoned” practitioners among us.
Today’s entry is a reminder of when and how to properly suspend or terminate payment of TTD benefits in SC claims. The Claimant’s entitlement to temporary disability benefits typically ends once he reaches MMI and/or returns to work. Other instances where temporary disability benefits may be stopped include a claimant’s unjustified refusal of authorized medical treatment, or the employer/carrier’s discovery of grounds to deny compensability of the alleged injury. During the first 150 days following an injury, the employer/carrier must file a Form 15 immediately if TTD benefits are suspended or terminated for any reason. Failure to timely and properly file the Form 15 will likely result in a fine from the Commission. The carrier must complete section II of the Form 15, indicating the reason for stopping payment. The Claimant’s signature is not required on the Form 15, but a copy of the form must be provided to the claimant or the claimant’s attorney at the time of filing, along with supporting medical records or other relevant documentation. If the claimant believes TTD benefits should be continued, he or she may request a hearing before the Commission.
After the initial 150-day period, terminating TTD payments requires either a Form 17 signed by the Claimant or an order from the Commission. If a Claimant returns to work after the 150-day period, the employer/carrier may suspend TTD payments while the Claimant is working. The employer/carrier may also suspend TTD benefits if the claimant refuses medical treatment. However, benefits are not terminated after the 150-day period until the Claimant signs a Form 17, or the Commission issues an order. If the Claimant refuses to sign a Form 17 within 30 days of returning to work, the employer/carrier must refer the claim to defense counsel for a hearing request. Likewise, the employer/carrier must request a hearing if TTD is suspended due to the claimant’s refusal of medical treatment outside the 150-day period. Failure to timely file a Form 17 or request a hearing will subject the employer/carrier to Commission fines.
In addition to fines related to the timeliness of filing these forms, the Commission can order a penalty where it determines the employer/carrier suspended or terminated benefits without proper cause. The Act provides for a 25% penalty on the amount of any benefits that the Commission deems to have been withheld in violation of the Act’s requirements. As a result, the employer/carrier should be very careful when making decisions as to when and whether to stop payment of temporary benefits.
Please do not hesitate to contact us if you have any questions about payment of TTD benefits in South Carolina.