Text Us!

Has Your Workers’ Compensation Claim Been Improperly Denied? A Legal Professional Can Help You Through the Appeal Process

Posted on

If your worker’s compensation claim was denied, you still have the option of appealing this denial. What this means is that you can essentially move up the chain of authority in the worker’s compensation claim arena and present your case to higher authorities in hopes that you are able to convince them to reverse the denial of your claim.

The well-known saying “It ain’t over till it’s over” certainly rings true in the worker’s compensation claim, not to mention civil litigation in general. However, appealing your workers’ compensation claim isn’t a task that you should endeavor to accomplish all by yourself. The rules and procedures which are outlined in South Carolina Worker’s Compensation law as it relates to the appeals process are complex and full of numerous technicalities and procedural requirements. If you are contemplating appealing a workers’ compensation claim in the Rock Hill area, your first step should be to contact Workers Compensation attorneys at Elrod Pope Law Firm to help you navigate your Workers’ Compensation appeal.  

Under What Types of Circumstances Might My Workers’ Compensation Claim Be Denied in the First Place?

There are various reasons that you may find yourself facing a Workers’ Compensation denial. Some of these reasons are substantive in nature while others simply come down to missing a deadline. A few examples of reasons for a Workers’ Compensation denial are as follows:


You were not considered to be an “employee.”


If you think that proving that you are actually an “employee” is a simple task, think again. Defining what it really means to be an employee is a frustratingly gray area of the law in general.

Section 42-1-130 provides a very long and complex definition of what constitutes an “employee” for Workers Compensation purposes. Some of the vague elements of this description include such ambiguities as being under an “appointment,” “contract for hire,” or “apprenticeship.” To make this statue even more convoluted, whether you happen to be an apprentice, under appointment, or hired on a contractual basis, you can still be considered an “employee” if you are a child or even if you happen to be “unlawfully employed.”

For whatever it’s worth, you are “not” an employee under South Carolina law if the nature of your employment is “casual” or if it is of a different type than the type of work that your employer typically engages in as a general part of doing business.

The main takeaway from this very detailed definition of an “employee” from a practical standpoint can be explained in just one short sentence:

If you are an independent contractor, you are not entitled to Workers’ Compensation benefits.

Clearly, understanding the difference between what constitutes as an “employee” versus an “independent contractor” is an entirely separate legal issue that is far from being delineated under South Carolina law. Ascertaining whether or not an employment relationship exists is a very fact heavy analysis that largely hinges upon the circumstances of each and every individual case.  Namely, there are various factors apply. Predicting exactly how the assigned judge will ultimately weigh these factors is yet another contingency that comes to play in many workers’ compensation cases.  

As such, it is often the case in the wonderful world of law, reasonable minds may differ. Indeed, even the minds of experienced legal professionals may differ. This is a fact-intensive analysis that absolutely requires that you have an experienced workers’ compensation lawyer in your corner. A workers’ compensation attorney can help you determine which classification best applies to your employment relationship.


Your injury was not considered “work-related.”


Thankfully, South Carolina’s definition of a “work related” injury is very broad. It essentially encompasses any type of injury sustained either while at the job site or while in the course of performing work related duties. Nevertheless, while far less common than many of the other grounds for denial, this still remains yet another possible ground for the denial of your workers’ compensation benefits.

The applicable South Carolina Code Section provides an explanation that is far from clear in this respect. Specifically, the subject accident and corresponding injury must arise “out of ” and “in” the course of one’s employment.


You “were asking for it,” figuratively speaking.


This one is fairly straight forward and hopefully not something that which you will find yourself having to worry about. If you brought the injury upon yourself by engaging in reckless behavior or otherwise unreasonably placing yourself at risk, this very well might lead to the denial of your claim. For clarity here, the idea is that if you engage in behavior such as showing up to work drunk or intentionally hurting yourself to acquire worker’s compensation benefits, you may find that your claim is ultimately denied.


You failed to adequately document your injury and treatment


Document everything. Visit a medical professional to have your injury evaluated promptly after the accident and ensured that you waste no time seeking the requisite medical care and treatment. A legitimate injury is of little consequence if you can’t prove it.

What Will the Appeals Process Be Like?

As a general overview, appealing your worker’s compensation claim may involve some or all of the following:

  • Filling out a specified form and sending it to the South Carolina Workers’ Compensation Commission whereby you request a hearing with one of the Commissioners. 
  • Following a hearing with one of the Commissioners, a decision will be made as to the merits of your claim.
  • If the decision is not in your favor, you are entitled to a Panel hearing with multiple Commissioners. However, you only have 14 days from the original order to appeal the decision from the original hearing by filing a Form 30 (Request for Commission Review).
  • If the panel decision is still not in your favor, and your injuries occurred prior to July 1, 2007, you may file an appeal with the Circuit Court within 30 days.
  • If the panel decision is still not in your favor, and your injuries occurred after July 1, 2007, you may file an appeal with the Court of Appeals.
  • Eventually, once you have exhausted these options, you may be able to file an appeal with Supreme Court of South Carolina.

Consult with a South Carolina Workers’ Compensation Attorney

Seek the workers’ compensation benefits you deserve when you reach out to Elrod Pope Law Firm to discuss the details of your case during a consultation.

Get in touch with us today to get started with your FREE case review. We’re only a call, click, or short drive away.

*Disclaimer* The information contained in this Website is provided for informational purposes only, and should not be construed as legal advice on any subject matter. No recipients of content from this site, clients or otherwise, should act or refrain from acting on the basis of any content included in the site without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from an attorney licensed in the recipient’s state. The content of this Website contains general information and may not reflect current legal developments, verdicts or settlements. The Firm expressly disclaims all liability in respect to actions taken or not taken based on any or all the contents of this Website.

Any information sent to The Firm by Internet e-mail or through the Website is not secure and is done so on a non-confidential basis. Transmission of information from this Website does not create an attorney-client relationship between you and The Firm, nor is it intended to do so. The transmission of the Website, in part or in whole, and/or any communication with us via Internet e-mail through this site does not constitute or create an attorney-client relationship between us and any recipients.

Some links within the Website may lead to other web-sites, including those operated and maintained by third parties. The Firm includes these links solely as a convenience to you, and the presence of such a link does not imply a responsibility for the linked site or an endorsement of the linked site, its operator, or its contents.

This Website and its contents are provided “AS IS” without warranty of any kind, either expressed or implied, including, but not limited to, the implied warranties of merchantability, fitness for a particular purpose, or non-infringement.

Furthermore, The Firm does not wish to represent anyone desiring representation based upon viewing this Website in a state where this Website fails to comply with all laws and ethical rules of that state.

E-production, distribution, republication, and/or retransmission of material contained within The Firm Website is prohibited unless the prior written permission of The Firm has been obtained.

Any results achieved on behalf of one client do not necessarily indicate similar results can be obtained for other clients.

Fee Disclosure: If your case is taken on by the firm, the fee arrangement will be a percentage of the final value of the case as follows: up to 40% for litigation, 35% for pre-litigation, and 33% for workers comp. This calculation will be done before the deduction of expenses. Additionally, the client will be responsible for the expenses resulting from the case.