Has your workers’ compensation claim been denied in Myrtle Beach, South Carolina? When you’re trying to recover from an injury you received at work, the news that the insurer is denying your claim can be distressing. You have the right to appeal the denial, but can you navigate the appeals process effectively on your own?
The good news is that you don’t have to. The experienced workers’ comp attorneys at Jebaily Law Firm are here to help you fight back and seek the benefits you deserve. Contact a denied workers’ compensation benefits lawyer at Jebaily Law Firm today for a free consultation.
Can My Claim for Worker’s Compensation Be Denied?
Yes, your workers’ compensation claim can be denied. However, many initially denied claims go on to be approved during the appeals process.
South Carolina’s Workers’ Compensation system is meant to provide a reliable, no-fault system to ensure injured workers get the medical care and financial help they need. Still, employers and insurers sometimes stand in the way of an injured worker’s claim.
Some reasons a workers’ comp claim could be denied include:
- Missed deadlines
- Ineligibility
- Employee intoxication or misconduct
- Employer disputes
- Misclassification of an employee as an independent contractor
However, the insurance company does not get the last word on your eligibility for workers’ compensation benefits. You can appeal if the insurer initially denies your workers’ compensation claim.
If your intoxication caused your injury or you were trying to harm yourself or others, you are not eligible for workers’ compensation under South Carolina law. However, failing a drug or alcohol test does not prove that intoxication caused your injury. If you failed a drug or alcohol test after being injured at work, a workers’ comp lawyer can help you prove that you were not intoxicated or that any chemical impairment did not cause the accident.
Employers sometimes dispute a workers’ comp claim if they do not believe the injury is as serious as the employee says it is or if they do not believe the injury happened at work. Our lawyers can help you build a solid claim to back up your eligibility for benefits.
If an employer has wrongly classified you as an independent contractor, our attorney can help you prove that you are an employee. South Carolina workers’ compensation law looks at the actual relationship between the employer and the worker – not the labels the employer applies to it.
What to Do If Your Workers’ Compensation Claim Is Denied in Myrtle Beach
“What happens if my workers’ comp claim is denied?” We hear this question all the time. In many cases, a denial is only the beginning of a process that could eventually lead to you receiving the benefits you deserve.
According to the South Carolina Workers’ Compensation Commission, these are the steps you should take when you are injured at work:
- Report the injury to a manager, supervisor, or nurse on-site within 90 days.
- File a Form 50 workplace injury claim with the Commission within two years.
- Schedule an appointment with the doctor chosen by your employer.
- Follow any instructions the doctor gives you.
Workers’ compensation should provide coverage for medical care, partial replacement of lost wages, and certain disability and vocational benefits. If the insurer denies your claim, you should immediately contact our denied workers’ comp benefits lawyers.
With our lawyer’s help, you can request a hearing with the Judicial Department of the South Carolina Workers’ Compensation Commission. A $50 fee is required when requesting a hearing. At the hearing, a South Carolina Workers’ Compensation Commissioner will review the evidence, listen to testimony, and decide your benefits. Further appeals can follow if the commissioner’s decision is not favorable.
Common Mistakes That Lead to Denied Workers’ Compensation Claims
Why would my workers’ comp claim be denied? In many cases, the employer and their insurance company are simply trying whatever they can to avoid a payout. In some situations, they will cite an alleged error on the part of the injured worker as the reason for a denial, such as:
- Failing to report the injury or reporting it to a co-worker rather than a supervisor
- Failing to seek medical care promptly
- Not following the doctor’s instructions
- Getting medical care from an unauthorized doctor
- Not documenting the injury or the circumstances of the accident
- Exaggerating the severity of your injuries
- Not meeting a deadline
Insurance companies also frequently dispute whether the workplace accident caused the injury, including disputes over pre-existing injuries. The insurer may also allege that the worker was an independent contractor who does not qualify for benefits or that the accident occurred outside the scope of the injured person’s work duties.
Don’t let your employer and their insurance carrier get away with denying your valid claim. The attorneys at Jebaily Law Firm stand ready to help you fight for what you deserve.
How Long Do I Have to Appeal a Denied Workers’ Comp Claim in Myrtle Beach?
If the South Carolina Workers’ Compensation Commissioner denies your claim, you have 14 days to file Form 30, a Request for Commission Review, along with a $150 filing fee. If the Commission Review panel denies your claim, you have 30 days to file an appeal with the South Carolina Court of Appeals.
The Workers’ Compensation Appeals Process for Denied Claims
The levels for appeals in the workers’ comp appeals process in South Carolina begin after your initial hearing with the Workers’ Compensation Commissioner. Next, you can appeal your case to:
- A hearing with the Commission Review Panel
- The South Carolina Court of Appeals
- The South Carolina Supreme Court, in rare situations when the court agrees to hear a case
The South Carolina Supreme Court chooses to hear only select cases, so in most situations, the South Carolina Court of Appeals is the last stage in the appeals process.
When you’re filing an appeal of a denied workers’ comp claim, you must provide a clear statement of the reasons for your appeal as well as any evidence or documentation that supports your appeal. Our workers’ comp lawyers can best put together a convincing appeal.
How Our Attorneys Help Injured Workers with Denied Claims
At Jebaily Law Firm, we have extensive experience with workers’ compensation cases, and we know how to fight effectively for the rights of injured workers. We can help you with many aspects of your workers’ comp appeal, including:
- Determining why your claim was denied
- Gathering witness statements, medical records, and other evidence to support your appeal
- Seeking the help of medical experts who can testify about your injuries
- Filling out all necessary forms correctly
- Meeting all deadlines
- Negotiating a settlement with the insurer if possible
- Representing you at your appeals hearings
Jebaily Law Firm operates according to a clear set of values: serving our clients with dignity and respect while fighting for their rights with passion and dedication. We have more than 100 years of combined legal experience. If your work-related injury claim has been denied in Myrtle Beach, South Carolina, contact Jebaily Law Firm immediately to set up a free consultation with an experienced workers’ compensation lawyer.
