If your workers’ compensation claim in South Carolina was denied, don’t give up; here’s what to do next. One important step is to understand why it was denied so you and your workers’ compensation lawyer can address that reason. Here are some reasons your claim may have been denied in the first place.
Common Reasons The Commission Denies Workers’ Comp Claims
The South Carolina Workers’ Compensation Commission denies claims for procedural and legal reasons. An experienced workers’ compensation attorney who knows the system well can help you file correctly in order to reduce the chances of having your claim denied by the Commission. Here are common reasons the they deny claims:
There was a mistake in filing. Like all government agencies, the SCWCC has strict deadlines, forms, and procedures. Your claim may be denied if you make a procedural mistake, such as missing a deadline or failing to furnish required information.
Your injury or illness may not have been adequately proven. Certain illnesses must be documented according to the law. For example, asbestos or other occupational disease cases have certain proof requirements, as do stress and mental injuries. Your claim may have been denied for failure to prove the claim according the the law’s specific requirements.
Common Reasons Employers Deny Workers’ Comp Claims
Employers have an interest in denying claims when they reasonably can, as claims increase their workers’ compensation insurance premiums or may mean paying for the deductible out of pocket. Also keep in mind that you may not even be covered for workers’ comp by your employer in the first place if, for example, it has fewer than four employees, or if you are classified as an independent contractor.
The accident was your fault. Workers’ compensation is a no-fault system, but there are a few situations in which your employer can rightfully deny an employee’s claim on this basis. If you were intoxicated, were trying to commit suicide, or purposefully injured someone else, the claim may be denied.
The injury didn’t occur at work. You should be covered as long as you were injured in the course of performing your work duties, whether that was on company grounds or not. However, the location where an accident occurred is important and could be the basis for a denial.
You missed the deadline to report the injury. Your employer may claim you didn’t notify them in time after your accident, but that may be incorrect. In South Carolina, you have 90 days to notify your employer after your accident. It doesn’t matter if company policy is 24 hours; the law gives you 90 days.
Talk to the Workers’ Compensation Attorneys of The Carolina Law Group Today
Understanding why your claim was denied is an important step in figuring out how to move forward with your claim. If your claim has been denied, speak with the South Carolina workers’ compensation lawyers at The Carolina Law Group. The first consultation is always free, so you have nothing to lose by calling to schedule your appointment today. Call one of the numbers below or fill out this contact form.
The Carolina Law Group has four offices in upstate South Carolina for your convenience: Greenville (principal office; call 864.312.4444), West Greenville (864.312.4444), Greer (principal office; call 864.757.5555), and Spartanburg (principal office; call 864.757.5555). Call today.