Reasons for Denial of Workers’ Compensation Benefits
Many injured workers in South Carolina are initially denied benefits for a valid work-related injury or illness. An employer may claim you didn’t properly notify the company of an injury. An employer may contend you deviated from your work duties before an accident occurred. An employer may claim you failed a drug test, so your workers’ compensation benefits are denied for injuries related to an on-the-job traffic accident.
Whatever the reason for denial, the good news is many injured workers whose claims are initially rejected do obtain benefits with the help of a knowledgeable workers’ compensation attorney.
The experienced attorneys at the Joye Law Firm will work to secure the workers’ compensation benefits you deserve for a workplace injury or occupational disease. Talk to us if an employer has denied your claim for the workers’ compensation benefits you need and deserve or if you are unsure whether you have a claim. We will review your case free of charge.
Joye Law Firm, based in Charleston, has successfully represented injured workers across South Carolina, including North Charleston, Mount Pleasant, Goose Creek, Summerville, and Moncks Corner.
To discuss your workers’ compensation claim denial, call Joye at (888) 324-3100 or fill out our free online case evaluation form.
Common Reasons Employers Deny Workers’ Compensation Claims
South Carolina has many good employers who stand behind injured workers after they are involved in a serious accident on the job. But, regrettably, there also are many employers and workers’ compensation insurance companies that try to shirk their responsibility to pay injured workers’ medical bills and the other workers’ compensation benefits to which they are entitled. These employers are more focused on pinching pennies than on doing what is right by an injured worker. Among the common reasons for rejecting workers’ compensation claims are:
- Lack of Notice—Employers frequently try to get out of paying workers’ compensation benefits by claiming the injured worker failed to provide proper notice of an injury. It’s one of the most common excuses we see in workers’ compensation claims disputes. An employer will assert that company policy requires an injured worker to notify a supervisor or human resources officer of an injury within 24 hours of being injured on the job. Many workers assume a pain or injury is relatively minor and try to work through the pain rather than reporting it. You should be aware that South Carolina law allows workers 90 days to report an on-the-job injury—regardless of what your company policy says. Many denials of workers’ compensation claims for lack of notice won’t stand up when challenged by an effective workers’ compensation attorney.
- Course and Scope—An employer may contend a worker was acting outside the course and scope of their job when an accident occurred and that, therefore, the worker is not eligible for workers’ compensation benefits. Driving to and from work is usually not covered by workers’ compensation in South Carolina, unless your employer provided your transportation or you were carrying out some task for the employer between home and work. If you are driving to a business meeting outside the office during the workday and crash on the way, you were furthering the employer’s business interests by going to the meeting. The travel is considered to be in the course and scope of employment, and your injuries may be covered. In some instances, a worker may be eligible for workers’ compensation benefits for an injury incurred even while on a lunch break, if unique circumstances bring it within the course of employment. Showing an injury is work-related is much more clear cut when a worker is injured during the normal course of performing their assigned duties at the workplace. Disputes about denial of benefits for deviation from the course and scope of employment are very fact specific. Therefore, it’s best to discuss the specifics of your case with a qualified SC workers’ compensation lawyer.
- Intoxication Defense—Many larger companies have policies requiring mandatory drug/alcohol testing if a worker is injured on the job. It’s not uncommon for an employer to tell an injured worker that they tested positive on a drug test, so their workers’ compensation benefits are being denied. In fact, a drug test showing a residual amount of drugs in a worker’s body is not sufficient to deny a workers’ compensation claim. An employer has to meet a high legal standard in South Carolina, proving that the worker was intoxicated at the time of the accident and the impairment was the proximate cause of the accident. An effective workers’ compensation lawyer can often successfully overcome a claim denial for a positive drug or alcohol test and secure the benefits you deserve.
- Employee Questions Injury—It’s the nature of workplace injuries that many injuries occur from the daily routine of a worker doing their job rather than from a sudden accident. You may lift heavy loads repeatedly, stand in an awkward posture or put other strains on your body that eventually cause a ruptured disk or other repetitive trauma injury. We often represent injured workers whose employers have denied a benefits claim because the injury occurred gradually rather than in a traumatic accident. Whether an injury occurs as a result of a one-time traumatic accident, such as a fall, or gradually over time, the injury may still be covered by workers’ compensation insurance in South Carolina.
Disputes Involving Claim Denials Demand Experienced SC Workers’ Comp Lawyer
If an employer or workers’ compensation insurance carrier has denied your workers’ compensation claim, then talk to a highly qualified Charleston workers’ compensation attorney. You are legally entitled to certain workers’ compensation medical benefits under South Carolina law. But some employers deny workers’ compensation claims because they know many workers won’t pursue them aggressively.
You need an experienced workers’ compensation attorney working to protect your rights.
If you’ve been injured in a South Carolina workplace accident, you can trust the dedicated attorneys at the Joye Law Firm to get you the money and medical benefits you are entitled to receive. Since 1968, we have helped injured workers like you obtain the money and medical coverage that you are entitled to so you can regain control of your life.
To discuss your claim, Just Call Joye at (888) 324-3100 or fill out our free online case evaluation form.