Workers’ Compensation: Denied Claims

After being injured at work, it is important to have the financial resources to aid in your recovery. Most employers in South Carolina are required to carry workers’ compensation insurance so that their employees are covered in case of a workplace injury. Unfortunately, a valid workers’ comp claim can sometimes be denied by an insurer. Charleston workers’ compensation attorney E. Lindsay Blanks assists employees who have been denied claims pursue the proper action to appeal. When you suffer a job-related injury, you are left with medical expenses as well as time away from work, all which can be costly. Mr. Blanks works tirelessly to make sure you receive the benefits you are entitled to from a workers’ comp policy. At E. Lindsay Blanks PA law firm, we have dedicated three decades of our practice to helping clients with their workers’ compensation claims throughout South Carolina. If you’ve need help after being denied benefits you due, call our office today at 843-863-1800 or contact us online to find out more about your legal options.

Reasons for Denied Workers’ Compensation Claims

When an insurance company denies an injured employee’s workers’ compensation claim, it must provide a letter detailing its findings and the reason for the denial. Some common reasons these claims are initially denied include:

  • Deadline issues
  • Preexisting conditions
  • Inadequate documentation of injury
  • Injury not related to work
  • Misclassification of employee status

Failing to notify your employer within the 90 day period of an accident at work could lead to a denial of your claim. However, some injuries, such as repetitive stress injuries or job-related diseases, do not have a specific timeline of first occurrence and therefore a denial based on a missed deadline may be invalid. An employer may have also misclassified a worker as an ‘independent contractor’ when they are employees to avoid having benefits paid.

Companies may also a deny benefits by asserting that your injury was not work-related. However, a job-related injury can be defined broadly, and if you were engaged in any work-related task at the time of your injury, you may appeal a decision. South Carolina is a ‘no-fault’ state, meaning your claim cannot be denied even if you were responsible for causing your injury. Exceptions apply where an employee was either intoxicated at work or if they caused their injury intentionally. It is important to consult a knowledgeable workers’ comp lawyer in Charleston if you believe your claim has been improperly denied for any reason.

Appealing a Workers’ Compensation Claim Denial

If you were denied your benefits under your employer’s workers’ compensation policy, the first step in this process is to try to work with your employer or insurance company to settle the dispute. If that fails, you may file an appeal to be heard by a South Carolina Workers’ Compensation Commission (WCC). An informal conference between you and your employer’s representative would take place before a formal hearing is initiated. The first formal hearing is heard by a single commissioner who decides whether benefits are due. If your claim is denied at this hearing, you have the right to request a three-member panel for further review. The assistance of a seasoned Charleston workers’ comp attorney is vital during this process, as they can advocate on your behalf and make sure your rights are protected every step of the way.

Experienced Charleston Workers’ Compensation Lawyer

Charleston workers’ compensation lawyer Lindsay Blanks of E. Lindsay Blanks PA Law Firm offers comprehensive legal services for injured employees at every stage of their case. Mr. Blanks and his team are committed to making sure South Carolina workers have the benefits they are entitled to in order to recover from their injuries suffered on the job. We assist clients throughout South Carolina, including Charleston, North Charleston, Summerville, Goose Creek, Ladson, Hanahan, Moncks Corner, Mt. Pleasant, and Kingstree. If your workers’ compensation claim has been denied and you need help determining your next step, contact our office today at 843-863-1800 or online to speak with an attorney.