It’s upsetting when you get hurt at work while trying to do your job, but even more so when your employer or their insurance company denies your workers’ comp claim. Unfortunately, in South Carolina, many injured workers with valid claims are denied benefits at first. If your workers’ comp claim was denied, don’t lose hope. We can help you appeal this denial and fight to get you what you deserve under South Carolina law.

Why Workers’ Comp Claims Get Denied?

The South Carolina workers’ compensation system exists to help protect injured workers. Yet, there are many reasons why employers/insurance adjusters may try to deny your claim, including: 

Missed Deadlines

In SC, you must notify your employer of the injury within 90 days of the accident. Failure to do so can lead to a denied claim. In some cases though, it’s not clear exactly when an injury occurred because symptoms developed over months or years. For example, with repetitive stress injuries such as carpal tunnel or diseases from toxic exposure. If your employer is arguing that you didn’t give proper notice, hiring a workers’ compensation attorney can help you fight the denial.

Improper Behavior/Failure To Follow Rules

Unique to workers’ comp injury claims, workers’ comp covers injuries regardless of who was at fault. The only ways your employer can deny your benefits due to your own behavior are if they can prove you A) intentionally hurt yourself or B) were intoxicated and that intoxication caused the injury. Otherwise, your employer should not be able to deny your claim based on the argument that you did something wrong.

“Off-the-job” Injuries

The definition of “work-related” under SC workers’ comp laws is very broad. An employer may try to say that your injury was not work-related, but if it was caused by a work-related task, then you should be eligible for benefits. An experienced workers’ comp attorney can help you prove your injury is work related and build a strong case on your behalf.

Misclassification of Employment Status

Another reason your claim may be denied is misclassification of work status. For example, if your employer classifies you as an independent contractor rather than an employee. Why would they do this? Simply put, independent contractors do not qualify for workers’ comp benefits in our state. We can fight this together by using our experience and resources to prove that your work met the legal definition of an employee and fight for the compensation you deserve.

Pre-Existing Conditions

Should you have had a pre-existing condition prior to your work injury, your employer may use that to deny your claim. If you had a pre-existing condition that was made worse or aggravated due to the workplace accident, you can still qualify for workers’ comp benefits. Proving this on your own can be difficult; however, our workers’ comp attorneys have done this for many injured employees throughout the state. Let us help you.

Inadequate Proof Of Injury

Sometimes the employer or insurance administrator will argue that you are exaggerating your injury. To do this, they may use their own doctor to explain why you should not receive workers’ comp benefits for your specific situation. If this happens, you have the right to ask for an independent medical examination, and we can help you set that up to get an honest second opinion from an expert.

Other

While the workers’ compensation system was created to protect workers hurt on the job, we have seen first-hand that some employers and insurance administrators deny the claim for no good reason at all. This makes workers’ feel bad for trying to get what they’re legally entitled to, which is unfair and wrong. 

If your workers’ compensation claim was denied for one of these reasons or a reason not listed above, speak to an experienced workers’ compensation attorney today. At Cavanaugh & Thickens, we offer free consultations so you can understand your rights as an injured employee and what your options are under SC law. To speak to an award-winning workers’ comp lawyer today, call (803) 888-2200 or fill out our online form. 

How Do I Appeal a Denied Work Injury Claim?

The first step to appealing a denied workers’ compensation claim is filing a hearing request. A hearing is a formal process of resolving any disputes directly with your employer and a representative. To file this hearing, you can contact the commissioner’s judicial department and request a form, or obtain the form on the WCC website.

During this hearing, a single workers’ comp commissioner will hear your case and make a decision on whether or not you should be approved for benefits based on the evidence presented. If you are still denied, then you will need to appeal this decision to the full commission.

In order to appeal a commissioner’s decision to the full commission, you must file a request for a commission review within 14 days of the decision. There may or may not be a fee for this request.

When you handle the workers’ compensation/denied appeals process on your own, you run the risk of getting your entire claim thrown out if you do not follow the timeline perfectly, properly complete the paperwork, and/or submit the appropriate hearing requests.

An attorney will handle the entire appeals process for you, including obtaining all documentation needed, ensuring you don’t miss any deadlines, and using all resources available to present the best case possible to get you the best outcome possible for your injuries.

Contact Our South Carolina Workers’ Compensation Lawyer Today

No matter where you are in the workers’ compensation claims process, our award-winning workers’ comp lawyer is here to answer any questions you may have and help you navigate the process. For a free consultation, simply call our office at (803) 888-2200. Accidents are unpredictable – that’s why we are available for you 24/7.