South Carolina law may enable you to receive benefits if you are an eligible employee and get hurt at work. If you filed a work injury claim and it was denied by your employer or its workers’ compensation insurance company, you may be able to appeal this decision.
Depending on your situation, you may submit this request to the Workers’ Compensation Commission, the Court of Appeals, or another court.
The law gives you a specific amount of time to take this step. The deadline to initiate the appeal depends on (among other things) whether a single or full panel of judges issued the final decision in your case.
Williams & Roche, LLC, can help you with the legal process of handling a denied workers’ compensation claim. We can assist you by reviewing the basis for the denial, filing an appeal, and presenting legal arguments on your behalf. Founded by two former Commissioners on the Workers’ Compensation Commission, we have a host of skills and knowledge at our disposal to give you an advantage over handling this by yourself.
Common Reasons for Denied Workers’ Compensation Claims
A workers’ compensation claim might be denied for several reasons. The paperwork — like the initial claims form — might have an error or be missing supporting documentation. Your employer and their insurer may not think the policy covers you. Or, the insurer may think your injury did not occur in the scope of your employment. Filing the claim outside the deadline is another reason for a denial.
Steps When Claim Is Denied
If your workers’ compensation claim is rejected, you can take a couple of steps to help protect your rights and challenge this decision. The first step is to identify the effective date of the denial — for example, the date the notice was sent or received.
Then, you should file an appeal within the appropriate time limit. The next step is to prepare and file paperwork and legal arguments to support your position that you deserve workers’ compensation benefits.
Figure out the date you received the denial
The first step in the appeals process is to identify the effective date of the denial. This helps you determine when the window of time to file the appeal begins. In most cases, this is the date you received the order — e.g. when you got it in the mail or electronically.
File an appeal within the correct time frame
The next step is to file the appeal in the correct amount of time. Depending on your situation, you may have to take this action no later than 14 or 30 days after receiving the order.
Under South Carolina regulations, you have 14 days to submit a reconsideration request after a single commissioner issues a decision. You may have up to 30 days to take this step for a denial from a full panel of commissioners.
The clock may begin on the day you receive the denial unless an exception applies. A reputable workers’ compensation lawyer can assist you by determining what your deadline is and what documents you need to take this step.
Prepare and submit paperwork for filing the appeal
The final step in the process of bringing an appeal is to prepare and file the appropriate documents. What forms you need to submit depends on your specific situation.
For example, challenging a single commissioner’s decision involves filing Form 30. In contrast, challenging a full panel’s order requires you to initiate a formal appeal with the Court of Appeals.
A workers’ compensation attorney can identify what documents you need to file, when, and with what agency.
Common Mistakes To Avoid When Filing an Appeal
You can increase your chances of winning your workers’ comp appeal by avoiding some common mistakes. The first is to file the appeal within the correct window of time. If you do not submit the reconsideration request before the deadline expires, the court may dismiss your claim.
If you do not know when the last date to file is or think it already passed, consider reaching out to an attorney. They may help you by calculating your filing deadline, researching exceptions, and submitting paperwork to preserve your rights.
Another mistake people make is filing the incorrect form or submitting the documents to the wrong agency. If you want to appeal the decision of a single commissioner who rejected your case, you may need to file Form 30. However, to challenge a full panel’s order, you bring a case to the Court of Appeals.
Why You Should Work With a Workers’ Compensation Lawyer
Moving through the workers’ compensation system can feel overwhelming, especially when you are hurt and do not have a legal team to support you. Handing over the claim to a capable attorney can feel empowering and give you a sense of relief.
Knowledgeable workers’ comp lawyers have the skills to research your case and find creative arguments to use in your favor. They could also help explain any legal jargon in the claims documents or orders you received from the Workers’ Compensation Commission or the court.
A respected lawyer also understands how to initiate an appeal and help move it in a productive direction. If you need to attend hearings or prepare legal documents, the attorney can take over these tasks and guide you along the way.
Contact Williams & Roche, LLC, for Help Handling Your Workers’ Compensation Appeal
When you are harmed while doing your job, receiving benefits may be something you depend on to support yourself and your family while you recover from your injuries. If you receive a claim denial notice, you may still have options in terms of filing an appeal and fighting for compensation.
An attorney at Williams & Roche, LLC, welcomes the opportunity to help you challenge the denial of your valid claim in South Carolina. We have decades of hands-on experience handling workers’ comp claims from multiple sides. We call on our diverse backgrounds to help us craft responsive and well-rounded legal strategies on behalf of our clients. Connect with our team today by calling 803.784.0503 to schedule a consultation to discuss your denied workers’ compensation claim and what you can do next.
