Was Your Workers Compensation Claim Denied?
Our law firm helps injured South Carolina workers appeal
You might think you’ll be all set after being hurt on the job. After all, workers’ compensation in South Carolina exists to provide benefits to workers like you. All you need to do is report the injury to your employer and file a claim, and your lost wages and medical bills will be paid.
It sounds easy, but too often, it’s anything but simple. If your claim was denied, you may think you’re out of options. That’s why you need an experienced workers’ compensation appeal lawyer at Benjamin R. Matthews and Associates, LLC to get your claim moving forward again.
We know how to handle the insurance company on your behalf
Because workers’ compensation is a no-fault system, the workers’ compensation insurance company is likely to dispute whether your accident was job-related. They may argue that you weren’t on the job when your injury happened, or they may claim that a pre-existing condition – something that had nothing to do with work – led to your injuries. Or they may acknowledge that you were injured but deny that you need certain treatments, which means they’ll give you less compensation than you need. Even a seemingly clear-cut workplace injury, such as a slip-and-fall at the office, may lead to an unexpectedly denied claim.
The appeals process is complicated. Our legal team can help.
Once your initial claim is denied, your next step is to appeal to the South Carolina Workers’ Compensation Commission, a group of seven commissioners who oversee workers’ compensation claims. From there, the appeals process proceeds through several steps:
- Initial Hearing: Your appeal will first be heard before one Commissioner at a hearing scheduled by the Commission. Typically, hearings are held in the county where the injury took place. The Commission may require that you see a doctor of their choice prior to the hearing. Once the hearing is complete, the Commission will issue an “order” – a decision on your claim.
- Panel Hearing: If you disagree with the order after your original hearing, you can appeal again. This time, your appeal will be heard before a panel of three Commissioners. The Commission will then issue a decision called an “Award,” which will be accompanied by legal rulings and findings of fact regarding your claim. A second appeal at this level will be heard by the full Commission, consisting of six Commissioners – that is, all the Commissioners except for the one who heard your original appeal.
- Court Appeal: Either you or your employer can appeal the Commission’s decision to the South Carolina Court of Appeals. Your appeal can be based on the facts of your case or the Commission’s interpretation of the law. If you disagree with a decision made by the Court of Appeals, you have the option of appealing one more time, to the South Carolina Supreme Court. Any decision made by the Supreme Court is final – there is no further appeal beyond that stage.
You may also be able to pursue mediation instead of progressing through the lengthy appeals process. If you and your employer both agree to mediation, an impartial arbitrator will work with both parties to reach a settlement.
Going before the Workers’ Compensation Commission alone is a difficult process, to say the least – and your employer will likely have the upper hand. With an experienced workers’ compensation attorney on your side, you can level the playing field. Our attorneys have handled appeals at all levels of the workers’ compensation system. We know how to prepare you for a hearing and how to find critical evidence that will help you get the benefits you need.
If your claim has been denied, you have legal options – but you need to move quickly. There are strict deadlines to be met in the appeals process, and you need to start preparing right away. Contact us today for your free case consultation.