What happens if you get notice of a denied workers' comp claim?

When a South Carolina employee suffers an injury in the workplace, it can leave him or her with much more than just a painful physical reminder of the accident. Workplace accidents often lead to issues such as expensive medical treatment and financial struggles related to missing time from work. In order to alleviate the stress of a workplace accident, an injured employee may seek benefits through a workers' compensation claim.

If you were hurt at work, you understand how important it is to seek benefits through an insurance claim after a work accident. It is vital for your family to get financial support during this difficult time, and it can be devastating to learn that your claim came back denied. While frustrating, this is not the end of the road for you.

Why did the insurance company say "no?"

When a workers' comp claim comes back denied, an applicant has the right to try again. The first step in this process is for you to understand why you were not successful and how you can fix the problem. The insurance company probably listed the reason for the denial in the letter sent to you. Some of the most common reasons include:

  • You did not act quickly enough to report the accident and your injuries to your employer. It is best to do this immediately after or as soon as possible after an accident.
  • There is not enough evidence to prove your injury is eligible for compensation, required medical treatment or related to your employment.
  • The deadline passed before you filed your workers' compensation claim. Typically, this deadline is 30 to 90 days after the injury.
  • Your claim was not successful because your employer is disputing it, alleging your injuries are not work related or eligible for workers' compensation benefits.

If you plan to appeal, you can then gather the documentation and evidence needed to fix the mistake and address the specific issue mentioned by the insurance company.

Fighting to get better

You have the right to fight for the financial and practical support you need to get better and move forward after a work-related accident. You do not have to fight for your rightful benefits alone, but you can seek the guidance of an experienced attorney who can explain what is available to you through workers' compensation laws and how you can maximize your benefits.