Why Was Your Workers’ Compensation Claim Denied?

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It is not uncommon for workers’ compensation claims to be denied in North and South Carolina. The best thing that you can do if this happens to you when you’ve been injured on the job is to contact the attorneys at Elrod Pope Law Firm for a free consultation. We can answer all of your questions and get you started on the right track to receiving the compensation that you are entitled to. Beyond this, you can educate yourself by learning as much as you can about why your claim may have been denied. Following are some of the most common justifications from employers and insurance companies who have denied workers’ compensation claims.

You Missed a Deadline

If you don’t act quickly after a workplace injury, it is easy to miss an important deadline and disqualify yourself from receiving workers’ compensation benefits. In most cases, you are required to notify your employer that an accident and/or injury has occurred within 90 days of the incident. In some cases, employers will require you to notify them within 24 hours of the incident. Then, there is a limited amount of time to file your workers’ compensation claim.

Having said that, it is not uncommon for workers to dispute their employer’s claim of a missed deadline. There are also situations where the deadline can be less concrete, such as with repetitive motion injuries and occupational illnesses, which are more difficult to pinpoint as having occurred on a specific day. If you think that you have been falsely accused of missing a deadline, contact the attorneys at Elrod Pope Law Firm to learn more about your options.

You Were Negligent

Although South Carolina has a no fault workers’ compensation system, meaning that you can file a claim even if you are the one who caused your injuries at work, there are some situations where you can be disqualified from workers’ compensation approval because of your own negligent actions. For example, if you were intoxicated on the job or if the injury was intentional, then you can legally be denied for workers’ comp. However, if your injury was caused by a simple mistake or carelessness, you should still be eligible for benefits.

Your Injury is Not Work Related

Another reason that your workers’ compensation claim can be denied is if your employer claims that your injuries did not occur at work or in the course of work related activities. For example, if you injured yourself by helping your friend move, but then claim that the injury occurred at work, and your employer can prove otherwise. If you are sure that your injury occurred at work or in the course of work related activities, then your claim may have been unfairly denied and you will need legal representation to fight for your deserved compensation.

You Are Not An Employee

Some employers will intentionally avoid workers’ compensation requirements by classifying their workers as independent contractors. However, you cannot legally be classified as not being an employee just because your employer decided to call you something else. Rather, your status as an employee or otherwise will be determined by how you are paid, your rights of control, your employer’s right to fire you, and who provides your tools and equipment. You may still be eligible for workers’ compensation benefits if you can prove your status as an employee.

You Have a Pre-Existing Condition

A common excuse for employers and insurance companies to deny workers’ compensation claims is that you had a pre-existing condition. Yet, in many cases, this is not a good cause for workers’ compensation denial. Even if you do have a pre-existing condition, you have a right to receive benefits if a work-related injury worsened that condition. It can be difficult to prove the difference between your former condition and your condition after the work-related injury, so it helps to work with an experienced workers’ compensation attorney.

You Incorrectly Reported Your Injury

If it is suspected that you have exaggerated your work-related injury or lied about how it occurred, then you can be denied for workers’ compensation for incorrectly reporting your injury. If your employer is basing this accusation on the report of a doctor whom you were referred to by the employer or the employer’s workers’ compensation insurance company, then it may be possible to seek an independent medical assessment to disprove this allegation.

You Did Not Fill Out Your Employment Application Correctly

This is a less common justification for denying workers’ compensation benefits, but some employers will claim that you are not eligible because you did not disclose certain information on your initial application for employment. For example, they may say that you did not accurately disclose your work history or medical restrictions.

Denial Without Cause

It is surprisingly common for employers to deny workers’ compensation claims without any good justification for doing so. This is typically an employer tactic to prevent you from continuing to pursue a claim because they may think that you will give up when you are initially denied. This is a prime example of the reason you need qualified legal representation to prove your right to compensation after a work-related injury.

Seek a Free Legal Consultation from a Workers’ Compensation Attorney

The attorneys at Elrod Pope Law Firm have the experience and expertise to help you through the difficult, demoralizing, and often confusing process of appealing for workers’ compensation benefits when you have been unfairly denied.

If you are wondering why your claim was denied when you are rightfully entitled to compensation and benefits for a work-related injury, contact our skilled work injury claim lawyer in Rock Hill, SC for a free 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.