Why Your South Carolina Workers’ Compensation Claim Failed
Accidents that happen on the job can leave you suffering serious personal injuries that impact your ability to work and provide for yourself and your family. Workers’ compensation benefits in South Carolina can help in this situation, protecting you from lost wages and out-of-pocket costs.
Unfortunately, it is not uncommon for an injured worker to file a claim only to have it either delayed or outright denied. The following details ten common causes why your workers’ compensation claim may have failed and how our Aiken workers’ compensation attorney can help you get the benefits you deserve.
Find out more about personal injuries and workers' comp, and what you can do about fighting for your case, by contacting the Surasky Law Firm today. Request Consultation
Ten Reasons For Denied Workers’ Compensation Claims In South Carolina
While some jobs are inherently more dangerous than others, work-related accidents can happen in any occupation. According to the Bureau of Labor Statistics (BLS), close to three million people are injured on the job each year.
In addition to requiring you to take time off for your recovery, often without pay, these types of injuries can leave you facing ongoing medical expenses while suffering potentially permanent disabilities. Workers’ compensation benefits help to cover your losses, providing a steady income while ensuring you get the medical attention you need.
If you are counting on these benefits to provide for yourself and your loved ones, it can come as a shock if your benefit claim fails. There are some common reasons why this can happen:
1. You did not report your injury immediately to your employer.
Any time an on the job accident happens or if you are diagnosed with an occupational illness, it is important to report it immediately to your boss or supervisor so that an incident report can be filed. Failure to do so could result in a denial of your claim.
2. You failed to properly document your injury.
Once you report your accident, seek medical care as soon as possible and follow all of your doctor’s instructions regarding follow up care and activity restrictions. Not getting treatment or not having medical records to support your claim could result in a workers’ compensation denial.
3. Your injury was not work-related.
Administered through the South Carolina Workers’ Compensation Commission (WCC), benefits are available to workers who are injured on the job or in the course of performing work-related duties. If your injuries happened at home or on your way to work, you will not be covered.
4. Your injury stems from a pre-existing condition.
Workers’ compensation benefits in South Carolina can be denied if your injury is due to a pre-existing condition. There are some limited circumstances where you may be eligible, so it is important to still report the incident, seek medical care, and consult with our experienced Aiken workers’ compensation attorney before taking further action.
5. You engaged in certain types of behavior that increased the risk of injuries.
Generally, even if you are partially at-fault for an on the job accident, injuries you suffer are still covered. However, this is not the case if you blatantly ignored your employers instructions or refused to take safety precautions. You will also be ineligible for workers’ comp benefits if you were engaged in fighting with another employee at the time or if you were under the influence of alcohol or drugs.
6. There is evidence that casts doubt on your injuries.
As stated above, it is important to follow all of your doctor’s instructions regarding activity restrictions. You should also avoid posting about your activities on social media accounts while filing a workers’ compensation claim or collecting benefits. Evidence obtained through these or other sources could be used to cast doubt on your injuries.
7. Your employer failed to report the incident.
Always confirm with your employer that a claim was filed on your behalf if you do not hear from the WCC within a week of your accident. It is not uncommon for employers to fail to notify insurers or file the appropriate paperwork.
8. You did not fill out the appropriate forms.
Not filling out the required forms is a common reason for denied workers’ compensation claims. Consulting with our experienced Aiken workers’ comp attorney when filing a claim can help avoid this mistake.
9. You did not respond to communications promptly.
Keep a record of all correspondence you receive from the WCC and respond promptly to any requests for additional information or other communications.
10. Administrative errors were made in your case.
According to the South Carolina Department of Insurance, close to 65,000 workers’ compensation claims are filed each year in the state. This averages to more than 5,400 each month. With this large a volume, administrative errors and mistakes can easily be made.
Dealing With A Denied South Carolina Workers’ Compensation Claim
Finding out your South Carolina workers’ compensation benefits have been denied can be a devastating blow. However, it is important to be aware that you have options available. Under the South Carolina Statutes, you have the right to appeal your denied benefit claim. At The Surasky Law Firm, we can guide you through the process, acting as a strong legal advocate on your behalf. Steps we can take in dealing with the situation include:
Thoroughly reviewing all the circumstances of your claim;
Reviewing all of the forms and other documents you have thus far submitted;
Reviewing medical records and gathering additional statements from your doctor as needed;
Informing the WCC and the insurance company involved of your intent to appeal;
Representing you at administrative hearings and making strong legal arguments on your behalf;
Filing a lawsuit against the insurer, your employer, or others involved in the event your claim continues to be wrongfully denied.
Let Us Help You Today
When dealing with a denied or delayed South Carolina workers’ compensation claim, get the Surasky Law Firm on your side. We take the swift legal actions needed to help you get you the benefits you deserve. To request a consultation, give us a call or contact our Aiken workers’ compensation attorney online today.