We typically use our blog to provide timely updates on workers’ compensation issues in South Carolina, but from time to time it is helpful to get back to the basics. Today’s post is a refresher on the SC Workers’ Compensation Act’s rules for stopping temporary total disability (TTD) payments.
A claimant’s entitlement to TTD benefits typically ends once he or she 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. If these circumstances arise during the first 150 days after an injury, the employer/carrier may stop payment of TTD without the claimant’s consent and without the need of an order from the Commission. The employer/carrier must file a Form 15 with the Commission 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 to explain 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, either a Form 17 signed by the Claimant or an order from the Commission is required to terminate TTD payments. If a Claimant returns to work after the 150-day period, the employer/carrier may immediately suspend TTD payments while the Claimant is working. The employer/carrier may also suspend TTD payments 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.