Getting hurt on the job can be painful and stressful. After the injury, you have to navigate complex workers’ compensation rules, such as the 90-day rule. The workers’ compensation 90-day rule is key to accessing benefits like medical care, lost wages and disability payments. Missing deadlines or not following procedures could result in consequences for your claim for benefits.
Moreover, many workers fear being fired for a disability after a work accident, adding another layer of stress to an already difficult situation. That is why it is essential to handle your case with care and educate yourself about time-sensitive requirements and deadlines. Your financial security, health and recovery depend on it.
With this guide, you will gain a clear understanding of the workers’ compensation 90-day rule, and other important time requirements and deadlines. You will also learn the necessary measures to protect your rights and secure compensation for your recovery.
Remember, knowledge is power when it comes to workers’ comp claims. Do not let a lack of information jeopardize your benefits and financial well-being.
What is the workers’ compensation 90-day rule?
The workers’ compensation 90-day rule is an important concept when it comes to dealing with a work-related injury or illness. In many states, this rule requires that you report your injury to your employer within 90 days. This timeframe is crucial as it allows employees a reasonable period to recognize that their injury or illness is work-related and report it accordingly.
States like California and New York strictly adhere to this 90-day reporting deadline, but they implement it differently. In California, for instance, employers have 90 days to review and respond to a claim, during which they must provide up to $10,000 in medical care. If employers fail to respond within 90 days, the law considers the claim accepted. Other states, like New York, require reporting within 90 days of the injury.
However, there are other states that do not follow this time requirement or do not have a 90-day rule, such as South Dakota. In South Dakota, the rules are a bit different. Here is what you need to know about filing a workers’ comp claim in this state:
- Report your injury to your employer as soon as possible, ideally within three business days.
- You have one year from the date of your injury to file a workers’ compensation claim.
- Your employer or insurer can choose your doctor for the first 45 days of treatment.
While you have a year to file, it is best to act quickly. Reporting your injury right away helps protect your right to benefits and can prevent issues with your claim later on. If you are unsure about the process, many lawyers in Sioux Falls, South Dakota handle workers’ comp cases and can provide guidance on state law.
Workers’ comp: Timelines and payouts
After you have reported your injury, you probably have questions about when you will start receiving benefits and how much you can get. Here is a breakdown of the frequently asked questions specifically for South Dakota to help you understand the process better:
Q: When does workman’s comp start paying in South Dakota?
Usually, wage loss benefits start on the eighth calendar day after your injury. But if you are off work for more than seven days in a row, you will also get paid for those first seven days. This waiting period ensures that claims are for significant injuries that require time off work rather than minor incidents.
Q: How much does workers’ comp pay for lost wages?
In South Dakota, you can get up to 66 2/3% of your average weekly wage. There is a maximum amount set by the state, so if you are a high earner, you might not get the full 66 2/3%. As of July 1, 2024, the maximum weekly benefit will be $1,066, while the minimum will be $533. These rates are adjusted annually based on the state’s average weekly wage.
Q: How long does workers’ comp last?
The length of time you can receive benefits depends on how badly you are hurt. For temporary total disability, benefits can last up to 104 weeks. If you have a permanent disability, you might get benefits for a longer time.
Q: How long can you collect workman’s comp?
This varies based on your specific situation. Some people only need benefits for a few weeks, while others with more serious injuries might receive benefits for years or even for life.
Workers’ comp in South Dakota covers more than just lost wages. You can also get:
- Payment for all reasonable and necessary medical care related to your work injury
- Travel expenses for medical appointments
- Disability benefits if you cannot return to your regular job
- Vocational rehabilitation if you need help finding new work
The benefits outlined above cover most workers’ comp situations in South Dakota. However, each claim is unique, and the specific benefits you receive will depend on the nature and severity of your work-related injury or illness. In some cases, you may be offered a settlement, often after a dispute with the insurer or during legal proceedings. A settlement can provide a lump sum payment but may end your right to future benefits. Workplace injury lawyers can help you understand your situation before you accept any settlement offers.
Q: Why would you have to pay back workers’ comp?
There are instances where you might need to pay back workers’ comp benefits. This could happen if:
- You got an overpayment by mistake
- You are found to have committed fraud
- You received both workers’ comp and Social Security Disability benefits without the proper offset
To avoid these issues, always be honest about your injury and report any changes in your condition or work status to your employer and the insurance company.
Protect your rights and stay informed of workers’ comp requirements
No matter where you are, you should educate yourself about your state’s specific reporting rules for workers’ comp. Knowing your state’s specific reporting deadlines can make the difference between receiving benefits and losing out on vital compensation. For instance, in South Dakota, failing to report your injury within three business days could result in your claim being disputed, potentially leading to delays or even denial of benefits. While you have a year to file, reporting within three days strengthens your claim and helps avoid complications.
To understand your specific rights and benefits under workers’ comp, consider seeking legal guidance. A legal professional can help you understand the nuances of your case. They can explain the importance of prompt reporting despite South Dakota’s more lenient one-year filing requirement and how this compares to the stricter 90-day rule in other states’ workers’ comp systems. They can also advise you on the potential consequences of delaying the reporting of your injury.