Seeking Workers’ Compensation for a Sprained Ankle at Work

Q: When does a sprained ankle count as a work injury?

When it is an injury by accident arising out of and in the course of your employment (O.C.G.A. § 34-9-1(4); S.C. Code § 42-1-160(A)): the work has to be what caused it and it has to happen while you are doing your job. Twisting your ankle on a walk at home is not covered; spraining it on an uneven factory floor at work generally is.

Q: What is the threshold requirement for a workers' compensation claim?

Work-relatedness, which both Georgia and South Carolina define as an injury by accident 'arising out of and in the course of' employment (O.C.G.A. § 34-9-1(4); S.C. Code § 42-1-160(A)). Both parts have to be true, and it is the question that has to be answered before the rest of the claim matters.

Q: Why should I get medical treatment for a minor work injury?

Because medical records are vital evidence, and because the bill is only covered if the right doctor treats you. In Georgia you choose from the employer's posted panel of at least six physicians and may switch once within it without Board approval (O.C.G.A. § 34-9-201); in South Carolina the employer chooses the treating doctor and treatment you arrange on your own may not be paid (S.C. Code § 42-15-60(A)). Emergencies are the exception in both states. Treatment protects your recovery and documents when, where and how the injury happened.

Q: Should I report a minor injury to my employer?

Yes, and there is a deadline: in Georgia no compensation is payable unless the employer gets notice within 30 days of the accident (O.C.G.A. § 34-9-80); in South Carolina the limit is 90 days (S.C. Code § 42-15-20). Both statutes excuse a late report only in limited situations, such as the employer already knowing about the accident or not being prejudiced by the delay. Tell a supervisor or manager, not just a co-worker. Minor injuries sometimes turn out to be more serious, and a late report gives the insurer room to dispute the connection to work.

Q: Does workers' compensation cover occupational illnesses too?

Yes, but under a separate, stricter test. Both states exclude disease from the definition of 'injury' except where it results naturally and unavoidably from the accident, and compensate occupational disease under their own rules. Georgia requires proof of all five elements in O.C.G.A. § 34-9-280(2), including a direct causal connection between the work conditions and the disease and that it is not an ordinary disease of life to which the general public is exposed. South Carolina requires a disease 'due to hazards in excess of those ordinarily incident to employment' and peculiar to the occupation, and excludes ordinary diseases of life and chronic skeletal joint diseases (S.C. Code § 42-11-10). Those claims turn on connecting the condition to the hazards of the particular job rather than to one event.

Key Takeaways

Report a work injury to a supervisor or manager right away: in Georgia no compensation is payable unless your employer gets notice within 30 days (O.C.G.A. § 34-9-80), and in South Carolina the limit is 90 days (S.C. Code § 42-15-20). File your claim within one year of the injury in Georgia (O.C.G.A. § 34-9-82) and within two years of the accident in South Carolina (S.C. Code § 42-15-40). In both states a sprained ankle is covered only if it is an injury by accident arising out of and in the course of your employment. In Georgia you choose a doctor from your employer's posted panel of physicians; in South Carolina your employer chooses the treating doctor, and care you arrange on your own may not be paid. Medical records documenting when, where and how the injury happened are vital evidence in your claim.

When is a sprained ankle simply a sprained ankle – and when is it something more? That’s a question that you may be asking yourself, particularly if you believe your injury may be work-related and might qualify for filing a workers’ compensation claim. It’s an important question to ask. After all, if your injury is work-related, you may be able to seek compensation to cover necessary medical treatment and lost wages among other benefits, so understanding the distinction between when an injury is just an “injury” and when it is a “work injury” is essential.

In both Georgia and South Carolina, workers’ compensation covers an “injury by accident arising out of and in the course of” your employment (O.C.G.A. § 34-9-1(4); S.C. Code § 42-1-160(A)) – the work has to cause the injury, and it has to happen while you are doing your job. In a nutshell, if you are out for a walk at home and you step on an uneven piece of pavement and twist your ankle, you likely won’t be able to claim a workers’ compensation injury – but if you are walking across the factory floor at work and you step on an uneven area of the floor and sprain your ankle, you may be able to, as it would be a work-related event. Certainly, there are far more complex examples than this one, and each unique set of circumstances will require consultation with a knowledgeable and experienced attorney – but work-relatedness is generally a threshold requirement for filing a claim.

If you feel that your injury – whether it’s an injured ankle, or something else – may qualify as a work injury, here are a few helpful things to keep in mind:

Seek medical treatment as soon as possible:

Seeking medical treatment is essential, not only for your own well-being and ensuring that your injury does not get worse, but also for purposes of documenting your injury and the important details surrounding it, like when it happened, where it happened, and how it happened, among other matters. Medical records can be vital evidence in a workers’ compensation claim, and the bill is only covered if the right doctor treats you. In Georgia, you choose from your employer’s posted panel of at least six physicians (O.C.G.A. § 34-9-201). In South Carolina, your employer chooses the treating doctor (S.C. Code § 42-15-60), and according to the South Carolina Workers’ Compensation Commission, care you arrange on your own may not be paid. Emergencies are the exception in both states.

Report your injury to your employer:

If you believe that your sprained ankle (or another injury) may be work-related, report your injury to a supervisor or manager, not just a co-worker, as soon as possible after it occurs. No compensation is payable unless your employer gets notice within 30 days in Georgia (O.C.G.A. § 34-9-80) or 90 days in South Carolina (S.C. Code § 42-15-20), with only limited exceptions. Even inside that window, a delay in reporting an injury can lead an insurer to attempt to deny the claim or argue that the claim isn’t legitimate. Reporting early helps to reduce the likelihood that this might happen.

Don’t delay in filing your claim:

After you’ve reported your injury to your employer, you’ll want to be sure to move on with the process of filing a claim and finding an attorney if you believe you may have a valid work-related injury to make a claim for. In Georgia, a claim generally must be filed with the State Board of Workers’ Compensation within one year of the injury (O.C.G.A. § 34-9-82). In South Carolina, it must be filed with the Workers’ Compensation Commission within two years of the accident (S.C. Code § 42-15-40). You don’t want to miss the chance to assert any rights you may have.

Consult with a workers’ compensation attorney:

The value of having an attorney on your side who knows and understands workers’ compensation law, and who can help you pursue the best strategies in your case can’t be overstated. It can make all the difference between a confusing and stressful experience and a successful one. An attorney who is familiar with workers’ compensation law will be able to tell you whether or not your injury may qualify for benefits, and if so, what types of benefits may be available.

These are only a few helpful tips of many. Navigating a workers’ compensation claim can be complex, your claim may even get denied – and it’s not a process you want to go through alone. That’s why, at Roden Law, we’re here to help.

RODEN LAW – YOUR WORKERS’ COMPENSATION ATTORNEYS

If you have been injured, and you believe your injury may be work-related, don’t delay in taking the steps you need to take to find out. If your injury does qualify for a workers’ compensation claim, you’ll want to begin taking the necessary steps to seek the maximum amount of compensation you deserve. At Roden Law, that’s where we come in. Our talented and experienced legal team understands workers’ compensation law, and we know the best legal strategies to pursue on your behalf. You deserve to focus on your recovery – while we focus on your claim. If you’re ready to get started, we’re here to help. Call us today. We look forward to speaking with you soon.

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Frequently Asked Questions

When does a sprained ankle count as a work injury?

What is the threshold requirement for a workers' compensation claim?

Why should I get medical treatment for a minor work injury?

Should I report a minor injury to my employer?

Does workers' compensation cover occupational illnesses too?

About the Author

Graeham C. Gillin

Partner, COO