This Article Was Updated on 3/23/2022
Reasons Workers’ Comp Claims are Denied
What happens if your workers’ claim is denied? Unfortunately, a significant share of South Carolina workers’ compensation claims are denied. Sometimes, these denials are warranted — but often, companies go out of their way to turn claims down. Still, with a proactive approach, it’s possible to limit the potential for denial. Common reasons workers’ comp claims denied include the following:
- Missed deadlines. One of the most frequent — and most avoidable — issues underscoring denied workers’ comp claims, missed deadlines often occur when employees attempt to submit claims on their own. Often, it’s simply not clear when, exactly, the injury developed. This makes it difficult to discern when the deadline might arrive.
- Injuries occur off the job. Workers’ comp is reserved, as its name indicates, for injuries that occur at work. Employees injured elsewhere will typically not qualify. As with missed deadlines, however, this workers’ comp obstacle is not as straightforward as it seems. Workplace obligations can sometimes exacerbate existing injuries, after all.
- Misclassified employees. Unfortunately, workers’ compensation benefits are not available to independent contractors. If employees are misclassified, they may be deemed ineligible for benefits when injuries occur while completing contract work.
- Insufficient proof. Extensive documentation must accompany workers’ compensation claims. If this is not provided, employers or insurance providers may argue that these injuries are nowhere near as severe as the employee insists.
Is it Too Late to Hire a Lawyer After a Claim is Denied?
A denied claim is one in which the insurance company or the employer does not want to accept the claim. Often, the insurance company will deny the claim because the employer did not give it the correct information, or they think the injured worker will just give up if the claim is denied.
That is why you need to hire an experienced workers’ compensation attorney in the Greenville area to help you with your case. The attorneys at Smith Jordan work everyday to help injured workers with their workers’ compensation claims.
Under South Carolina Law, any employer with four or more employees is subject to the South Carolina Workers’ Compensation Act. Often called the “Act,” the Workers’ Compensation Statute provides certain benefits for injured workers, including medical care, weekly payments during periods out of work, and money for any permanent impairment or disability. Getting these benefits without an attorney can be a difficult task.
Making a claim for workers’ compensation benefits can be complex and securing the benefits that a person needs often requires an experienced workers’ compensation attorney who knows the law and the system. An injured worker needs an attorney that can guide them through the process of a claim.
Do I Have to Pay an Attorney By the Hour?
No, you do not. The workers’ compensation attorneys at Smith Jordan are paid a percentage of the benefits received by the injured worker for contested back wages and for any permanent disability at the end of the case. The injured worker does not have to pay the attorney to get the case started or to fight for the benefits that he or she deserves. The attorney is paid when the injured worker is paid.
If you’re worried that you can’t afford a South Carolina workers’ compensation lawyer, consider the big-picture. While your lawyer will earn a contingency fee, this key representative will also dramatically increase your chances of getting your claim accepted in the first place. By helping you gather and present key evidence, your lawyer can also help you achieve the maximum compensation to which you’re entitled.
How Can a Greenville Workers’ Compensation Lawyer Help?
With so many potential issues standing in the way of workers’ comp claim acceptance, the process can seem all but hopeless to injured employees. With strong guidance, however, it’s possible to secure much-needed benefits.
A Greenville workers’ compensation lawyer can assist with every step of this process, beginning with claim preparation and submission — and extending through the appeals process, if necessary. Your attorney knows exactly what to do if a workers comp claim is denied. Instead of stressing about your situation, you can feel confident that a solution is within reach.
Other oft-forgotten benefits? Your Greenville workers’ comp lawyer can help you gather a wealth of evidence to demonstrate that your injuries occurred when and where you’ve reported — and that they’re severe enough to warrant benefits.
Your lawyer can also keep you on track to ensure that your claim is submitted on time. Attention to detail is crucial, so your lawyer will review your claim thoroughly to limit the potential for a denial. No matter where you find yourself within the workers’ comp process, there’s no substitute for strong legal support.
Reach out to the experienced attorneys at Smith Jordan today.