Appealing the Denial of a Workers’ Compensation Claim
If you have been hurt on the job, you are likely entitled to workers’ compensation benefits. This statutory-based system was enacted to ensure that South Carolina employees receive the care and support that they need after becoming injured or ill at work. In exchange for the benefit payments system, workers are prohibited from bringing a civil claim against their employer, except in some limited situations. Applying for benefits can be complicated, particularly when preexisting injuries are involved or when the employer’s insurer is being uncooperative. However, the initial denial of a claim does not mean that it lacks merit. Many deserving claims are initially denied but then succeed on appeal. Greenville and Spartanburg workers’ compensation lawyer Patrick E. Knie has guided many injured South Carolina workers through this process.Appealing the Denial of a Workers’ Compensation Claim
You can appeal the denial of your claim for workers’ compensation benefits if the claim was denied outright or if it was partially granted, but you believe that it should have been granted in its entirety. The South Carolina Workers’ Compensation Commission, which consists of seven commissioners, is responsible for hearings and the initial steps of the appeals process. If you receive a denial of your claim from your employer’s workers’ compensation insurance company, you may submit a request for a hearing. One of the seven commissioners will preside over this hearing. You may be required to attend a medical examination conducted by a commission-appointed doctor. The physician may then testify at the hearing about his or her findings in the examination. Following the hearing, the commissioner will issue an order that contains his or her findings about whether the denial should stand.
If you disagree with the commissioner’s findings in the order, you may pursue an appeal by submitting a Request for Commission Review within 14 days after you receive the order via mail. The form will require you to provide information about your employment situation and your spouse’s employment situation, if you are married. At this review, the full commission will determine whether your benefits should be granted. If the appeal is denied, you can seek redress with the South Carolina Court of Appeals by filing a lawsuit within 30 days from the date that you returned your receipt of notice to the commission, alerting them that you received their decision. In your lawsuit, you must explain the grounds for your appeal, including the reason that you believe the commission was incorrect in concluding that you are not entitled to benefits. During the time that the appeal is pending, your employer is required to pay benefits and compensate you for any medical care.Enlist a Workers’ Compensation Lawyer in Greenville or Spartanburg
If your workers’ compensation claim has been denied, you may wish to consider bringing an appeal to pursue the benefits that you need. Spartanburg and Greenville workers’ compensation attorney Patrick E. Knie can advise injured employees throughout Union, Cherokee, Spartanburg, Greenville, and Laurens Counties, among other areas of South Carolina. Call our office at (864) 582-5118 or contact us online to set up a free consultation with a dedicated workplace accident attorney.