South Dakota Workers Comp Claims: Eligibility, Filing and Appeals

Under the South Dakota Department of Labor is the South Dakota Workers' Compensation program. This program pays for the medical and disability benefits for work related injuries, illnesses and disease. The program is funded through premium payments made by employers to the program, and through other means. Covered individuals include all workers except domestic servants, farm workers, independent contractors, some elected officials and workfare participants.

Common Covered Work Related Injuries

Employees have coverage for work related injuries, illnesses and deaths. The injury must occur during the scope of employment on or off premises, while on the clock. Common injuries include muscle strains, falls, injuries sustained while using equipment and many others. If you have received an injury at work, and the injury is not a pre-existing condition, nor a self-inflicted condition, file a workers' compensation claim.

How to File a South Dakota Workers Compensation Claim

To file a claim, specific steps must take place. Immediately at the time of injury, the injured employee must give written notice to the employer of the injury. Providing the notice must occur no later than three business days after the incident. The employee is not entitled to physician fees or other compensation that may have happened prior to giving notice unless the employer had knowledge of the injury or death or the employer was giving written notice after this time with good cause. When obtaining medical care, the employee must inform the physician of the managed care plan the employer is using. The insurer establishes an investigation into the claim and the Department of Labor must receive notification within 20 days of the acceptance of the claim.

Workers Compensation Claim Denials

If the claim receives denial, the Bureau of Personnel will send written notice to the employee, with reasons on why it received denial. This may occur due to missing, late or incomplete information, fraudulent claims, self-inflicting injuries or other injuries not covered under workers' compensation laws.

Appealing a South Dakota Workers Compensation Denial

The injured employee has the right to hearing. A letter of appeal is to occur in writing to the Bureau of Personnel, asking for reconsideration. An internal appeal process happens, and if not amended, the South Dakota Department of Labor will request to mediate the case.

Collecting South Dakota Workers Compensation Benefits

Medical care has coverage for the employee, including all warranted diagnostic procedures, travel expenses to and from the medical appointments and prescription medication. Disability benefits are available for those who have lost work time of more than seven consecutive days and have a statement confirming work status from the medical provider and from the Bureau of Personnel. The bureau itself determines lost work time.

An attorney is not necessary through most of the compensation claims, but it may be necessary to obtain one for denial of your claim, or the benefits amount not meet with your needs. If an employer does not report your claim, this should be cause for using a lawyer to aid in pursuing the case for you.

South Dakota Workers Compensation Office Locations

Pierre Location
500 East Capitol
Pierre, South Dakota, 57501-5070

Sioux Falls Location
PO Box 7406
Sioux Falls, SD 57117-7406