4 Reasons Your Workers’ Compensation Claim May Be Denied

Under South Carolina law, you have a right to receive any medical care that is “reasonable and necessary” for a work-related injury. But unfortunately, many injured workers find it difficult to obtain the benefits they are entitled to—leading to lost wages, pain and suffering, and other damages. After filing a workers’ compensation claim, some employees are surprised to learn that their claim has been denied. Insurance companies and employers deny workers’ compensation claims for any number of reasons, including:

  • Injury Was Not Reported in Timely Manner – Every state has certain deadlines for reporting a work-related injury. In South Carolina, an employee must give notice to their employer immediately or within 90 days of the accident to be qualified for benefits.

  • Failure to Seek Medical Treatment The S.C. Workers’ Compensation Act states that “your employer has the right to select the doctor who will treat you. If you see your doctor without the employer’s permission, the employer may not be held liable for the medical expense unless it constitutes an emergency condition. However, you have the right to choose a physician to evaluate you for the specific disability, but it will not be covered by the employer.”

    Failing to seek medical treatment might lead the insurance company to believe that you are faking the injury or it’s not as severe as you stated. If an injury is serious enough to request workers’ compensation, it’s serious enough for a trip to the doctor.

  • Preexisting Medical Conditions – A preexisting condition is not necessarily an automatic disqualifier, but if you have a preexisting condition or a previous injury and your claim is for a similar injury, the insurance company might raise suspicion and deny the claim.

  • No Witnesses During the Time of the Accident – Accidents happen every day, and there’s a chance you may get hurt working alone. Without a witness present, there’s a greater possibility for an insurance company to try and deny what actually occurred. This should not prevent your fair recovery.

The workers’ compensation claim process is unique for every employer and injured worker and can be an overwhelming task. Working with a workers’ compensation law firm like Smith Injury Law can strengthen your case and assist you with the appeals process. We have built our careers on helping the wrongfully injured in Greenville, SC receive the medical care and compensation they rightfully deserve.

Please fill out our online form or call 864-300-4878 today to schedule a free consultation to discuss the details of your case.

Disclaimer: Principle office is located at 1210 Laurens Rd, Greenville, SC 29607. No fee unless the case is settled or won; costs may be excluded

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