When you get injured on the job, successfully filing for workers’ compensation benefits can be critical for maintaining your financial stability. If you don’t receive the benefits you deserve, not only will you have to cover your medical bills yourself, but you will have to try to find a way to make ends meet while you aren’t working.

Unfortunately, workers’ compensation denials are common. While some of these denials are justified, many injured workers struggle to collect the benefits to which they are legally entitled. If you are struggling to collect the benefits to which you are legally entitled, here is an overview of what you need to know:

Common Reasons for Workers’ Compensation Denials

If you are struggling to collect workers’ compensation benefits, one of the first things you need to know is why. Employers and their insurance companies dispute workers’ compensation claims for numerous reasons, and understanding the specific issue (or issues) standing in the way of your claim will be critical for determining your next steps.

With this in mind, some of the most common reasons for workers’ compensation denials in South Carolina include:

  • You Aren’t Eligible for Workers’ Compensation Benefits – As a general rule, employees are eligible for workers’ compensation, while independent contractors are not. If your employer is claiming that you are an independent contractor, you will want to discuss this with a workers’ comp attorney promptly.
  • You Weren’t Injured on the Job – Since workers’ comp only covers job-related injuries, employers and their insurance companies will also frequently dispute employees’ claims that they were injured on the job.
  • Your Injury Isn’t Covered – While workers’ comp covers most job-related injuries, there are exceptions. If your employer (or its insurance company) is claiming that your injury falls outside of workers’ comp, you should discuss this with an attorney promptly as well.
  • You Waited Too Long to File for Workers’ Comp – In South Carolina, workers’ comp claims are subject to strict deadlines. If you waited too long to file, you may have lost your eligibility to seek benefits for your injury.
  • You Didn’t File Your Workers’ Comp Claim Correctly – From omitting dates and signatures to failing to include necessary details about your on-the-job accident, any deficiencies in your workers’ comp claim could lead to a denial as well.
  • You Were Intoxicated – If you were intoxicated when you got injured, you may not be entitled to workers’ comp benefits. However, it is up to your employer (or its insurance company) to prove you were impaired.
  • There Wasn’t Enough Evidence to Verify Your Eligibility for Benefits – If your employer (or its insurance company) couldn’t determine whether you are eligible for benefits, it may have simply erred on the side of denying your claim.

Again, these are just examples. When you speak with a workers’ compensation attorney, your attorney will be able to review your claim and determine if you are entitled to benefits. If you are entitled to benefits, your attorney can then assist you with taking the necessary steps to fight for the benefits you deserve.

How to Appeal a Workers’ Compensation Denial in South Carolina

If your employer (or its insurance company) has formally denied your workers’ compensation claim, fighting for the benefits you deserve will most likely involve filing an appeal. To start the appeals process, you will need to:

1. Gather Your Claim Documentation

You should gather all documentation you have related to your workers’ compensation claim. This includes your claim (if you have a copy) and any responses you received from your employer or its insurance company.

2. Talk to a South Carolina Workers’ Compensation Attorney

While you aren’t required to hire an attorney for your workers’ compensation appeal, you don’t want to take any unnecessary chances at this stage. With this in mind, you should schedule a free consultation as soon as possible.

3. File an Application for a Hearing with the South Carolina Workers’ Compensation Commission (SCWCC)

Formally appealing a workers’ compensation denial starts with applying for a hearing with the South Carolina Workers’ Compensation Commission (SCWCC). If you hire a workers’ comp attorney, your attorney will be able to prepare your application for you and represent you at your hearing.

FAQs: Dealing with a Workers’ Compensation Denial in South Carolina

Why do workers’ compensation claims get denied?

Workers’ compensation claims get denied for lots of reasons. Some common reasons include claims that employees’ injuries aren’t job-related and claims that employees waited too long to file. While some reasons for workers’ comp denials are legitimate, others are not. If your claim was denied, an experienced workers’ compensation attorney can determine if you have grounds to file an appeal.

Can a workers’ comp claim be denied even if the injury happened at work?

Yes. Being injured at work does not necessarily mean that you are entitled to workers’ compensation benefits. With that said, if you were injured at work and are struggling to obtain workers’ compensation coverage, you should consult with an attorney about your legal rights.

What should I do if my workers’ compensation claim is denied?

If your workers’ compensation claim was denied, you should collect any documentation you have in your possession, and you should schedule a free consultation with a South Carolina workers’ comp attorney promptly. You only have a limited amount of time to file, and there are other important reasons to act promptly as well.

Can I appeal a workers’ compensation denial on my own?

While you can appeal a workers’ compensation denial on your own, it is best to hire an experienced attorney to represent you during the appeals process. Hiring an attorney should not cost you anything out-of-pocket in this scenario.

Schedule a Free Consultation with South Carolina Workers’ Comp Attorney Rad S. Deaton

Are you struggling to obtain workers’ compensation benefits for an on-the-job injury? If so, contact us today. Call 843-557-6852 or contact us online to schedule a free consultation with South Carolina workers’ comp attorney Rad S. Deaton.