Even though the South Carolina workers’ compensation scheme was designed as a no-fault system, there are still many disputes that arise between employers and workers when comp claims are denied.
Most of the conflicts stem from whether a legitimate reason for denying a claim was applicable in a particular case. To resolve these disputes and receive the workers’ comp benefits you deserve, you must show that the facts and the law are on your side, not the employer’s.
Contact our Workers’ Compensation Lawyers Today
Even if your claim has already been denied, the proven South Carolina workers’ comp attorneys at Joye Law Firm will fight to get you the benefits you deserve for a workplace injury or occupational disease. Respect, compassion and care are what you can expect from our lawyers and staff from the first time you contact us until your case is resolved. It is one of our firm’s client commitments that we return all our client’s phone calls within 24 hours or one business day.
Since 1968 we have helped injured people like you recover not just the money they are entitled to, but also their lives. Let us help you too. Just Call Joye. You can reach us at (877) 537-1920 or fill out an online form for a free case review.
Joye Law Firm has offices in Charleston and Myrtle Beach, but our highly qualified workers’ compensation attorneys are ready to take care of your case anywhere in South Carolina. We’ve successfully represented clients all over our state, including Florence, Richland County, Orangeburg, Columbia, Horry County (including Conway and North Myrtle Beach), North Charleston, Mount Pleasant and Summerville.
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The proven workers’ compensation attorneys at Joye Law Firm are committed to our clients. With more than 110 years of collective litigation experience, multiple South Carolina attorneys at Joye Law Firm have received an AV rating from the prestigious Martindale-Hubbell, and several have been recognized as Super Lawyers.
While every case is different, and past results are in no way intended to guarantee that a similar result can be obtained in another case, past results obtained by a law firm are an indication of the firm’s experience when it comes to serious injury and wrongful death cases. For more details about the results obtained for previous Joye Law Firm clients, please click on the Results tab on our home page.
Common Reasons Why SC Workers’ Comp Claims Are Denied
Although not every comp claim is legitimate, it is not uncommon for a workers’ compensation insurance company to deny a valid claim in an effort to keep payouts low. Many of these cases involve factual or legal disputes over whether a claimant is entitled to workers’ compensation benefits.
The attorneys at Joye Law Firm understand that there are two sides to these arguments, and we will strongly advocate for your rights.
Here are some common reasons why a South Carolina workers’ compensation claim could be denied:
- Deadlines not met. State workers’ compensation law sets strict deadlines for when you must give notice to your employer of your workplace accident, and how long you have to file a claim. Generally, notice must be given with 90 days and a claim must be filed in two years. If you fail to comply with these deadlines, the carrier could deny your workers’ comp claim.
- Not injured on the job. The SC Workers’ Compensation Act provides for benefits when you were injured “by accident arising out of and in the course of employment.” Your claim could be denied if your employer claims that you were not performing a work function at the time of your accident. For example, workers’ compensation typically doesn’t apply when you are commuting to or from work. Some diversions from your assigned duties — horseplay with other employees, for example — could also lead to a denial of benefits.
- Not an “employee.” Even though the statutes provide a broad definition of “employee,” and most workers fit that description, it is not uncommon for a workers’ comp insurance company to try to avoid liability by asserting that a claimant was an independent contractor not entitled to benefits. This issue comes up a lot with truck and taxi drivers, though it is also not rare in other contexts. In deciding your status, one of the main things the law looks to is the degree of control your employer had over your work life.
- Intoxication. If you were intoxicated at the time of your accident and your intoxication was the proximate cause of your accident, the statutes prevent you from recovering workers’ compensation benefits. The intoxication could be from alcohol or other drugs, potentially even ones prescribed for you. The law puts the burden to prove intoxication on the party alleging it — typically the employer/comp carrier.
- Intentional harm. Workers who intentionally hurt themselves are not entitled to workers’ compensation benefits for their injuries. This includes suicides, although there may be situations where it can be argued that the injured worker’s mental state was such before the suicide attempt that they could not act ‘intentionally. As with intoxication, the burden to prove the accident was intentional is on the party making the accusation.
- Pre-existing Condition. Although the SC Workers’ Compensation Act provides for benefits for workplace injuries that aggravate a pre-existing condition under certain circumstances, this is an issue that employers and insurance companies will vigorously dispute. In order to arrive at the truth about your injury, a great deal of expert medical testimony is often required.
- Fraud. Certain injuries are less obvious than others. A good example is back or shoulder pain. In many instances, the responsible insurance company will reject such a claim, arguing that the claimant has fabricated the accident and the resulting injuries.
- Medical opinion. South Carolina law requires you to be examined by a doctor of the employer’s choosing. Sometimes that physician will render an opinion that you don’t agree with, finding that your injuries are not as debilitating as you believe them to be. The employer might use that opinion to reject your claim outright or offer significantly fewer benefits than you believe you deserve. Our experienced workers’ comp attorneys can often help set up an independent medical examination by a doctor with no ties to the insurance company for you.
Contact Our Charleston Workers’ Comp Lawyers Today
If you’ve been injured in a South Carolina workplace accident, you can trust our dedicated attorneys to get you the money and benefits you are entitled to.
Just Call Joye at (877) 537-1920 or fill out our free online case evaluation form.
