The Workers Compensation Process in South Dakota
1. Injured Worker Should Seek Medical Treatment
After an injury on the job, your first priority should be to seek medical care and treatment.
If the injury is relatively minor, you may seek medical care from your primary care physician or a clinic.
If the injury is serious, you should seek immediate care at the hospital.
2. Injured Worker Must File the First Report of Injury Form with Employer
In South Dakota, the law specifies that an injured worker must notify their employer within three (3) days. If the injured worker does not notify the employer within three days, the claim for worker’s compensation benefits may be denied.
3. Employer Must File the First Report of Injury with the Department of Labor
In South Dakota, the Employer is obligated to send the First Report of Injury to the South Dakota Department of Labor. The Department of Labor also will send the First Report of Injury to the Employer’s worker’s compensation insurance carrier.
4. Employer and Insurer Investigates the Claim Determining Compensability
The first thing the insurer must do is file a Calculation of Compensation (Form 110). This is the form that set the benefit rate of what the injured worker should receive if the claim is accepted. In South Dakota, the benefit rate is 2/3 of the injured worker’s average weekly wage. The injured worker’s average weekly wage is calculated by averaging the injured worker’s wages fifty-two (52) weeks prior to the injury. If the employee hasn’t been working for fifty-two (52) weeks, the average weekly wage is calculated using the number of weeks the employee work prior to the injury.
At the same time as filing the Calculation of Compensation Form, Employer and Insurer will be investigating the claim to determine whether they are liable to the injured worker to pay the injured worker benefits for their injury. This includes interviewing the injured worker and having the injured worker sign a Health Authorization so that the Employer and Insurer can obtain the injured worker’s entire medial history. The injured worker is obligated to sign the authorization. If the injured worker refuses to sign the health authorization and is barring the Employer and Insurer from being able to investigate the claim, the injured worker may be denied their claim without adequate evaluation.
After Employer and Insurer finish its investigation, the insurer must decide whether to accept the claim (pay benefits) or deny the claim. In South Dakota, the Insurer has thirty (30) days to do this. If the Insurer can’t make a decision in thirty (30) days, it can ask that Department of Labor for an additional twenty (20) days. If the Insurer is late in filing the acceptance or denial, they could face fines from the Department of Labor.
Disclaimer: This guide is not intended to, nor does it create an attorney-client relationship. This is a general overview for informational purposes only and is not intended to be fully inclusive, nor a comprehensive guide to the legal process. Each case has specific facts and circumstances that will dictate how it proceeds. Past results do not guarantee the same or similar results in the future. It is important that you speak to an attorney about your specific case.