Under South Carolina law, the workers’ compensation system is supposed to provide broad protection for injured workers. Not only do workers’ compensation laws specify that any work-related injury should be covered if it arises from the course and scope of employment, but the laws also make clear that workers’ compensation is a no-fault system. This means that even if your employer wasn’t negligent or careless and didn’t contribute to your accident, workers’ compensation insurance is still supposed to cover your injury. Further, in most cases, even if the injured worker did something negligent to cause his or her injury, this would not bar the employee from receiving benefits.
Despite the legal protections guaranteed to workers in South Carolina, employers and insurers routinely deny legitimate claims or otherwise make attempts to give workers less than they deserve. If your South Carolina workers’ compensation claim has been denied, you need to take action to preserve your right to recover for your medical bills and lost wages. Our South Carolina workers’ compensation lawyers at Joye Law Firm are ready to assist you.
Contact Our Workers’ Compensation Lawyers Today
Even if your claim has already been denied, our South Carolina workers’ comp attorneys at Joye Law Firm will review your claim to see if they can 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 888-324-3100 or fill out an online form for a free case review.
Reasons for Rejected Workers’ Compensation Claims
There are many reasons for workers’ compensation claims to be denied. Although a few of these reasons are legitimate, many others could be trumped-up and frivolous defenses. Some of the reasons for workers’ compensation denials that may be improper include:
- Missed deadlines — If you fail to notify your employer within 90 days of a workplace accident, your claim could be denied. However, in some cases, it may not be clear exactly when an injury develops. This is especially true with repetitive stress injuries (carpal tunnel syndrome, for example) or chronic illnesses (asbestos-related diseases, for example) that develop from a work condition. Also, many employers misconstrue the law and advise injured workers that they are barred from benefits if they don’t report a work injury “within 24 hours” or some other period of time which is far less than 90 days. If your employer claims you missed the deadline but you believe that there were special circumstances or that you actually did let your employer know on time, you should contact a workers’ compensation attorney for help in proving your claim.
- “Off-the-job” injuries – In some cases, your employer might claim that your injury was not work-related and that you should not receive benefits as a result. Remember, there is a very broad definition of “work-related” under South Carolina workers’ comp laws. If you were doing required work tasks of any type, or if your injury arose out of doing your job, it could be a work-related injury. This is often true even if it happened outside of normal working hours or away from your normal job site.
- Incorrect classification — Workers’ compensation provides coverage only to employees. Some employers incorrectly classify workers as independent contractors instead of employees in order to avoid paying workers’ compensation benefits. If this happens to you, and you can show that you were really an employee and not an independent contractor, you could receive workers’ compensation benefits for your workplace injury.
- Improper behavior — Your employer may try to claim that you did something wrong and that you should not receive workers’ comp benefits as a result. It is a rare situation, however, where an employee is disqualified from receiving workers’ compensation benefits as a result of his or her own actions. Unless you intentionally hurt yourself or were intoxicated at work and the employer can prove that your intoxication was the proximate cause of your work injury, you should not be disqualified based on your own actions, even if you were careless.
- Pre-existing conditions — Employers sometimes deny claims based on the fact that you had a pre-existing condition when your work injury occurred. However, you can still receive benefits if your workplace accident aggravated or worsened your condition. Proving the extent of your work injuries and your right to benefits is complicated in these situations, so you should consult with a lawyer for help.
- Inadequate proof of injury — Your employer might believe you are exaggerating your injury and argue that your injury is not as severe as you claim. When an employer tries to use the opinion of a doctor of its choosing to show that you shouldn’t receive the benefits you are asking for, you have the right to ask for an independent medical examination.
What to Do if Your Workers’ Compensation Claim Is Denied
If your worker’s compensation claim has been denied, it is very important that you speak with a South Carolina workers’ compensation attorney right away. There is a hearing process for workers’ compensation denials that allows your claim to be considered by an independent commissioner. In fact, there are multiple stages of appeals in South Carolina.
In some cases, a hearing is held before the South Carolina Workers’ Compensation Commission. This is an administrative body that reviews workers’ compensation denials and other violations of South Carolina workers’ comp laws. When you file a hearing request with the SC Workers’ Compensation Commission, your claim will first be heard by a single commissioner. If the hearing commissioner rules against you and you are not satisfied with the decision, you can request review by a three-member panel of commissioners. Finally, if you are still dissatisfied and you believe that you have been unfairly denied benefits, you can appeal to the Court of Appeals and possibly to the South Carolina Supreme Court.
The workers’ compensation hearing and appeals process is complicated, as you will have strict deadlines to follow and you will have to provide persuasive evidence in the manner required by the single commissioner, the commission panel or the state courts. The rules of procedure at each of these stages of appeal will vary, as will as the arguments that must be made and the types of evidence that must be presented. Having a South Carolina workers’ compensation lawyer on your side is essential to make sure you comply with all the requirements and to give you the best possible chance of successfully prevailing on your claim or appealing a denied claim.
Contact Our Charleston Workers’ Compensation Lawyers Today
If you’ve been injured in a South Carolina workplace accident, you can trust our attorneys to work to get you the money and benefits you are entitled to.
Just Call Joye at 888-324-3100 or fill out our free online case evaluation form.
Joye Law Firm has offices in Clinton, Charleston and Myrtle Beach, but our workers’ compensation attorneys are ready to take care of your case anywhere in South Carolina. We represent 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.