Story by Joel Berly
June 30, 2025
If you’re injured at work or due to someone else’s negligence, understanding the difference between personal injury claims and workers’ compensation claims is crucial.
Sometimes, you might qualify for both – for example, if a third party caused your workplace injury. Knowing the distinctions can help you decide the best course of action.
| Criteria | Workers’ Compensation | Personal Injury |
|---|---|---|
| Fault Requirement | No-fault | Must prove negligence |
| Compensation Types | Medical bills, partial wages, disability | Medical bills, full wages, pain & suffering |
| Pain & Suffering | Not covered | Covered |
| Source of Payment | Employer’s insurance | At-fault party’s insurance |
| Time to File | 90 days to notify employer; 2 years to file | 3 years from injury date |
Each claim type has its own processes, eligibility rules, and benefits. If you’re unsure which applies, consulting an attorney can help you navigate the legal complexities.
Let’s break down how personal injury claims and workers’ compensation claims differ in their purpose and process.
A personal injury claim is a legal action aimed at recovering compensation for injuries caused by someone else’s negligence. To succeed, you need to prove that another party was at fault and that their actions – or lack of reasonable action – directly caused your injury.
These claims can arise from various non-work-related situations. Examples include car accidents caused by distracted drivers, slipping on a wet floor in a grocery store, or medical errors by healthcare professionals. In all these cases, the key is showing that another party’s negligence led to your injury.
To build a strong case, you’ll need evidence such as accident reports, witness statements, medical records, or even expert testimony. This evidence helps demonstrate how the other party’s negligence caused your damages.
A workers’ compensation claim is part of a no-fault insurance system designed to provide benefits to employees injured on the job. Unlike personal injury claims, workers’ compensation does not require proving fault. If the injury happened while you were performing your work duties, you’re generally eligible for benefits.
Workers’ compensation covers a variety of workplace injuries and illnesses, including falls, machinery-related accidents, repetitive motion injuries, occupational illnesses, and even work-induced mental health conditions.
Because proving negligence isn’t required, the process is typically quicker and less complex than pursuing a personal injury claim.
The most notable difference between these two types of claims lies in the fault requirement. Personal injury claims require proving that another party was negligent, while workers’ compensation operates on a no-fault basis.
As Brown & Crouppen explains, "The main difference between workers’ comp vs personal injury cases is that personal injury claims are based on ‘fault’ whereas workers’ compensation claims are not."
In a personal injury case, proving liability often involves gathering extensive evidence and, in some cases, presenting your case in court. This process can be lengthy, sometimes taking months or even years. Workers’ compensation, on the other hand, focuses solely on whether your injury occurred while performing job-related duties, making it a faster process.
The source of compensation also differs. Personal injury claims seek damages from the negligent party or their insurance provider, while workers’ compensation benefits come from your employer’s insurance.
Another key distinction lies in the types of compensation available. Personal injury claims can cover medical expenses, lost income, pain and suffering, and emotional distress. Workers’ compensation, however, typically covers medical bills and a portion of lost wages but does not include compensation for pain and suffering.
While workers’ compensation benefits are quicker to access, personal injury claims may result in higher payouts, albeit with a longer timeline.
Understanding these differences is essential when determining which type of claim applies to your situation and what you can expect from the process. Up next, we’ll explore the qualifications and legal requirements for each claim type.
The qualifications and legal requirements for personal injury and workers’ compensation claims in South Carolina differ significantly, reflecting the distinct nature of these cases.
To file a personal injury claim in South Carolina, you must have suffered physical, emotional, or financial harm due to someone else’s negligence or intentional actions. Four key elements must be proven: duty, breach, causation, and damages. For instance, if a driver fails in their duty to drive responsibly by texting and causes an accident, they could be held accountable for your injuries.
South Carolina applies a modified comparative negligence rule, which reduces your compensation by your percentage of fault. If you are more than 50% at fault, you cannot recover damages at all. Additionally, the statute of limitations gives you three years to file a claim, starting from the date of the injury or when it was discovered. Common scenarios that qualify include car accidents, slip and fall incidents, medical malpractice, defective products, and dog bites.
South Carolina’s workers’ compensation operates under a no-fault system. This means you don’t have to prove your employer was negligent – your injury simply needs to have occurred while performing work-related duties. Most businesses with at least four employees are required to carry workers’ compensation insurance, and this count includes part-time employees and family members. Non-profits are held to the same standard as for-profit companies.
However, certain employers are exempt from carrying workers’ compensation insurance, such as:
Similarly, not all employees are covered, even if their employer has insurance. Exemptions include:
If you’re injured, you must notify your employer within 90 days. It’s important to note that conditions like stress or depression are only covered if they are directly caused by a workplace injury.
Under South Carolina’s workers’ compensation laws, the exclusive remedy rule generally prevents employees from suing their employers for additional damages related to workplace injuries. Workers’ compensation benefits are typically the sole recourse. However, exceptions exist. If a third party caused your workplace injury, you may be able to file a personal injury claim against that party. Additionally, if your employer doesn’t carry the required workers’ compensation insurance, you could receive benefits through the Uninsured Employers Fund (UEF).
With these qualifications in mind, the next section will explore the financial recoveries available for each type of claim.
When it comes to financial recovery after an injury, personal injury claims and workers’ compensation offer distinct options. Knowing the differences can help you understand what types of compensation you might qualify for.
Personal injury claims provide the widest range of financial recovery under South Carolina law, covering both economic and non-economic losses.
Economic damages focus on tangible financial losses. These include all past and future medical expenses, ranging from emergency care to long-term rehabilitation. You can also recover your full lost wages, not just a portion, and any reduction in your future earning capacity if your injury impacts your ability to work. For example, if you previously earned $60,000 annually but can now only work part-time, you could seek compensation for the difference in income.
Non-economic damages set personal injury claims apart from workers’ compensation. These damages compensate for pain and suffering, emotional distress, and loss of enjoyment of life. For instance, if a car accident leaves you with chronic back pain that limits your ability to enjoy family activities or hobbies, personal injury law accounts for those losses.
In cases involving severe negligence or intentional harm, South Carolina courts may also award punitive damages. These are designed to penalize the wrongdoer and discourage similar behavior in the future.
Workers’ compensation provides guaranteed, but limited benefits regardless of who caused your workplace injury. The system is designed to ensure you get medical treatment and partial wage replacement quickly.
Medical coverage under workers’ compensation includes all reasonable and necessary treatments related to your injury. This might involve doctor visits, surgeries, medications, physical therapy, and even medical equipment. However, your employer or their insurance company typically controls which doctors you can see and what treatments are approved.
Wage replacement benefits pay about two-thirds of your average weekly wage, up to a state-mandated maximum. For example, if you earned $900 per week before your injury, workers’ compensation would provide roughly $600 per week during your recovery.
Permanent disability awards offer additional payments if your injury leads to lasting impairment. You might receive ongoing benefits for total disability or a lump-sum payment for partial disability affecting specific body parts, like an arm or leg.
Unlike personal injury claims, workers’ compensation does not cover pain and suffering, emotional distress, or loss of enjoyment of life. Additionally, it only replaces a portion of your lost wages – not the full amount.
| Type of Compensation | Workers’ Compensation | Personal Injury |
|---|---|---|
| Medical Expenses | All reasonable and necessary treatment | Past and future medical expenses |
| Lost Wages | Two-thirds of average weekly wage (capped) | Full wage loss and future earning capacity |
| Pain and Suffering | Not covered | Fully compensated |
| Emotional Distress | Not available | Compensated |
| Loss of Enjoyment | Not available | Compensated |
| Permanent Disability | Lump sum or ongoing benefits | Included in overall damages |
| Fault Requirement | No-fault system | Must prove negligence |
| Medical Provider Choice | Limited by insurer | Greater control over treatment |
In short, workers’ compensation offers quicker, guaranteed benefits but with limitations, while personal injury claims provide more comprehensive compensation if you can prove fault. In some cases, you may be able to pursue both types of claims, but navigating the legal complexities – such as subrogation rights – requires careful coordination.
Knowing who is responsible for covering your compensation is a critical part of shaping your legal approach. Payment responsibilities differ between personal injury and workers’ compensation claims, and understanding these differences can help you navigate your options effectively. Let’s break it down.
In personal injury cases, compensation typically comes from the at-fault party’s insurance. For instance, if you’re injured in a car accident, the at-fault driver’s auto insurance is responsible for covering costs like medical bills, lost wages, and even pain and suffering. Similarly, if you slip and fall at a business, their commercial liability insurance would handle the claim.
Because personal injury claims require proving negligence, they allow for full compensation, including non-economic damages like emotional distress or physical pain. However, if the at-fault party’s insurance coverage falls short or doesn’t exist, you may need to seek compensation directly from their personal assets.
Workers’ compensation follows a no-fault model. This means your employer’s workers’ compensation insurance carrier is responsible for paying your medical expenses and a portion of your lost wages, regardless of fault. However, workers’ compensation is usually your sole remedy, which means you generally cannot sue your employer for additional damages. That said, there are cases where other parties may share liability.
Sometimes, workplace injuries involve a third party, which might allow you to file both a workers’ compensation claim and a personal injury claim. Examples include injuries caused by defective equipment or unsafe conditions on a customer’s property. This dual approach can provide compensation from multiple sources.
It’s important to coordinate these claims carefully to avoid receiving duplicate payments. For example, your workers’ compensation insurer might place a lien on your personal injury settlement to recover benefits it has already paid.
If your claim is denied – whether it’s workers’ compensation or personal injury – you have the right to appeal. In fact, nearly half of workers’ compensation claim denials are overturned on appeal.
Navigating claims in South Carolina requires understanding deadlines, procedures, and legal requirements. Whether you’re dealing with a workplace injury or an accident caused by someone else’s negligence, taking the right steps can mean the difference between securing compensation and losing your benefits. Here’s a breakdown of when and how to file each type of claim in South Carolina.
In South Carolina, personal injury claims revolve around proving negligence. Your first step is gathering evidence to show the other party’s fault. You have three years from the date of the injury to file your claim. Under the state’s comparative negligence rule, you can recover damages only if you’re less than 50% at fault. Missing this deadline could eliminate your right to take legal action.
It’s crucial to consult an experienced injury attorney as soon as possible after your accident. Acting quickly ensures that evidence is preserved and witnesses’ memories remain fresh. Your attorney will focus on proving two key points: that the other party was negligent and that their negligence directly caused your injuries.
The legal process typically involves several stages, including a pre-suit investigation, filing a summons and complaint, discovery, mediation, and potentially a trial. Initially, your claim will be filed with the at-fault party’s insurance company. If no settlement is reached, your attorney will proceed by filing a summons and complaint in the appropriate court.
If you’re injured at work, report the incident to your employer immediately. If you fail to notify your employer within 90 days, you may lose your eligibility for benefits.
After reporting the injury to a supervisor, manager, or on-site nurse, you’ll need to be evaluated by the employer-designated medical provider. For emergencies, seek immediate treatment and inform your employer as soon as possible.
In addition to notifying your employer, you must file a formal claim with the South Carolina Workers’ Compensation Commission. You have two years to submit the appropriate claim form – Form 50 for workplace injuries or Form 52 for workplace-related deaths. Filing is free, and the forms are available on the Commission’s website. While your employer is generally responsible for submitting the claim to their workers’ compensation insurer, you should file the claim yourself if your employer fails to report the injury or if you don’t receive the benefits you’re entitled to.
In some cases, you might be eligible to file both a workers’ compensation claim and a personal injury lawsuit for the same incident. This often happens in third-party cases, where someone other than your employer or a co-worker is responsible for your injuries. For example, if you’re injured by a defective machine, you could pursue a claim against the manufacturer.
However, South Carolina law prohibits double recovery, meaning you can’t receive compensation twice for the same damages. If you win a personal injury lawsuit, your employer’s workers’ compensation insurer may have the right to subrogation, allowing them to recover benefits they already paid. Additionally, settling a third-party claim without the workers’ compensation insurer’s consent could void your benefits.
Coordinating both claims can be complex, so working with an attorney is essential. A skilled lawyer can help manage the process, ensuring you maximize your recovery while staying within South Carolina’s legal framework on double recovery.
Understanding the distinctions between personal injury claims and workers’ compensation claims is essential for securing the compensation you deserve. Here’s a quick breakdown of the key differences:
Another important difference lies in who pays. Workers’ compensation benefits come from your employer or their insurance, while personal injury settlements are covered by the at-fault party or their insurer.
Timing is also critical. In South Carolina, you have three years to file a personal injury lawsuit but must report workplace injuries within 90 days to preserve your claim.
If a third party is involved, you might be eligible to file both a workers’ compensation claim and a personal injury lawsuit. However, South Carolina law prevents you from receiving compensation twice for the same damages.
Given these complexities, working with an experienced attorney can help you navigate deadlines, choose the right type of claim, and maximize your compensation while steering clear of legal pitfalls.
Yes, in certain situations, you can pursue both a workers’ compensation claim and a personal injury claim stemming from the same workplace accident. This usually applies when a third party – someone who isn’t your employer or a coworker – played a role in causing your injury. For instance, if a negligent driver caused your accident while you were on the job, or if faulty equipment led to your injury, you could potentially file a workers’ compensation claim through your employer’s insurance and a personal injury lawsuit against the third party.
Keep in mind, these claims are handled separately, each with its own legal procedures and criteria. Seeking guidance from an experienced attorney can help you manage both processes and work toward securing the compensation you’re entitled to.
To establish negligence in a personal injury case, you need to provide evidence that clearly supports four main elements: duty of care, breach of duty, causation, and damages. This evidence is crucial in showing that the other party’s actions – or lack of action – directly led to your injury and subsequent losses.
Here are some common types of evidence that can help build your case:
Presenting this evidence in an organized and persuasive manner can strengthen your claim and increase your chances of achieving fair compensation.
In South Carolina, the modified comparative negligence rule determines how damages are awarded in personal injury cases. Under this rule, you can recover compensation as long as you are less than 51% at fault for the accident. However, if you’re found to be 51% or more at fault, you won’t be eligible to receive any compensation.
If you share some fault (but less than 51%), your compensation will be adjusted according to your level of responsibility. For instance, let’s say your total damages amount to $10,000, but you’re deemed 20% at fault. In this case, your compensation would be reduced by 20%, leaving you with $8,000. This approach ensures that damages are distributed in proportion to each party’s share of responsibility.
If you need experienced legal representation in Charleston, South Carolina, contact Berly Rouse. Our team is ready to help you achieve the best possible outcome. Visit our offices or call today to schedule a consultation to discuss your case.
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