What Should I Do If My South Carolina Workers’ Comp Claim Was Denied?

The workers’ compensation system in South Carolina is supposed to provide broad protection to workers injured on the job. Workers’ compensation laws specify that any work-related injury should be covered if it arises in the course and scope of employment. Even so, many injured workers in South Carolina who have valid claims are denied workers’ comp. Was your workers’ comp claim denied? If so, you need to understand your legal options and how to fight a workers’ comp claim denial.

 

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To find out how we can help you, call us at 877-936-9707 or fill out our online contact form for a free and confidential claim evaluation.

Our attorneys at Joye Law Firm can guide you through the workers’ comp appeals process in SC and pursue the full benefits for your work-related injury or condition. A no-obligation consultation with an experienced workers’ comp lawyer can help you understand the options available to you. Call to find out how we can help you. It is one of our law firm’s commitments that we try to return all phone calls within one business day.

Joye Law Firm handles workers’ comp denied cases throughout South Carolina and has law offices in North Charleston, Columbia, Clinton and Myrtle Beach. The first thing that many clients notice is our legal team’s compassion and care for those who have received workers’ comp denied notices. We help injured workers and their families throughout South Carolina recover not only workers’ compensation, but their lives. Our lawyers at Joye Law are ready to assist you.

You can reach us at 877-936-9707 or fill out an online form for a free case review.

Reasons for Rejected Claims

There are many reasons that employers and workers’ comp insurance administrators use to deny claims of injured SC workers. An experienced SC workers’ compensation lawyer at Joye Law can review the reasons for your workers’ comp claim denial and evaluate whether you have grounds to appeal the decision.

Some of the reasons for workers’ comp 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 developed. This is especially true with repetitive stress injuries (carpal tunnel syndrome, for example) or diseases (asbestos-related diseases, for example) that develop over time from a workplace exposure. Many employers misread 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 that is less than 90 days. If your employer claims you missed the deadline, but you believe that you did let your employer know on time or there are special circumstances, then you should contact a workers’ compensation attorney to discuss your claim.
  • Off-the-Job Injuries— An employer may 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 work-related tasks of any type, or if your injury arose out of doing your job, it may qualify as a work-related injury. If your job duties involve driving, then your injuries in a car accident that occurred while you were working may be covered by workers’ comp.
  • Misclassification— Workers’ compensation provides coverage only to employees. Some employers incorrectly classify workers as independent contractors to avoid paying workers’ compensation benefits. If this has happened to you, and we can show that your work met the legal definition of an employee rather than an independent contractor, then you may qualify for workers’ compensation benefits.
  • 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 cause of your workplace 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 qualify for workers’ comp 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 our South Carolina workers’ comp lawyers at Joye Law Firm for help.
  • Inadequate Proof of Injury— Your employer or the insurance administrator might believe you are exaggerating your injury and contend that your injury is not as severe as you claim. When an employer or insurer tries to use the opinion of a doctor of its choosing to show that you shouldn’t receive workers’ comp benefits, you have the right to ask for an independent medical examination. Our attorneys at Joye Law Firm can help you locate a doctor and obtain a second medical opinion about your condition.

Can an Employer Deny Your Workers’ Compensation Claim?

If you suffered an injury that was not related to performing your job duties, your employer may deny your workers’ comp claim.

Workers’ compensation covers full- and part-time employees. If you are an independent contractor, the employer may deny your workers’ comp claim. However, employers sometimes try to misclassify workers intentionally to avoid paying claims. A knowledgeable workers’ comp attorney can evaluate the terms of your employment and determine whether you qualify for workers’ compensation benefits.

If you suffered an injury in a car accident while commuting to work, that typically is not covered by workers’ compensation. However, if your job duties include driving and you are injured in a car accident while in the course of your job, then that may be covered by workers’ compensation benefits.

SC Workers’ Comp Appeals Process

The workers’ comp appeals process in SC allows for claims disputes to be heard by an independent workers’ compensation commissioner.

Our attorneys can represent you at an informal conference with a representative of your employer and the S.C. Workers’ Compensation Commission. The S.C. Workers’ Compensation Commission administers the workers’ comp system and hears appeals of workers’ comp denials. The goal of the initial meeting is to try to resolve the dispute about your claim without going through a hearing, which is a judicial process.

If an agreement cannot be reached at the informal conference, a hearing can be scheduled before a workers’ compensation commissioner. Our attorneys can present evidence to support your claim at a formal hearing before a South Carolina Workers’ Compensation Commissioner. The appeal is heard initially by one commissioner. If the commissioner rules against you, you can request that a three-member panel of commissioners review the decision. If you are dissatisfied with the ruling of the three-member panel, you can appeal to the S.C. Court of Appeals.

Why You Should Hire a Workers Comp Lawyer

The workers’ compensation appeals process is complicated. You will have strict deadlines to meet and you will have to present persuasive evidence in the manner required by the workers’ compensation commissioner or panel. The rules of legal procedure at each step in the appeals process will vary.

While having legal representation is not mandatory, you will be at a big disadvantage if you do not have an experienced workers’ compensation attorney representing you at a hearing. The employer or insurance company will have legal counsel, and you should as well.

Having a SC workers’ comp claim denied lawyer guiding you through the hearing process gives you the best possible chance of prevailing on your claim.

Contact Our SC Workers’ Compensation Claim Denied Lawyers Today

If your workers’ comp claim has been denied, don’t accept “No” as the final word. Let our South Carolina workers’ compensation attorneys at Joye Law review your injury claim and discuss your rights to pursue workers’ compensation benefits. We offer a no-charge consultation and only get paid if you receive benefits.

If you have been injured in a South Carolina workplace accident or job site accident, you can trust our attorneys at Joye Law Firm to make every effort to get you all the workplace injury benefits provided by law.

While each workers’ compensation case has a unique set of facts and the results of previous cases are in no way predictive of a similar result in another case, the results obtained by Joye Law are reflective of the firm’s experience when it comes to workers’ compensation and personal injury cases. Click on the results tab to see more details about some of the case results obtained by previous Joye Law Firm clients.

Joye Law Firm has law offices in Charleston, Columbia, Clinton and Myrtle Beach. Our workers’ compensation lawyers offer a free case evaluation and are ready to handle your workers’ compensation case anywhere in South Carolina. We represent injured workers throughout the state including Florence, Richland County, Orangeburg, Conway, North Myrtle Beach, North Charleston, Mount Pleasant and Summerville.

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