If you’ve filed for workers compensation and been turned down, you’re probably wondering what to do when your workers comp claim is denied. Fortunately, you always have the right to appeal a denied claim. That’s one of the biggest benefits of working with an attorney, as well, because they are generally used to denied claims. They know where to go from that point, so they can work with you on getting your claim approved. Here’s what to consider if your claim gets denied.
Reasons a Claim Could Have Been DeniedThere are a lot of reasons why your claim may have been denied. When you’re wondering what to do when your workers comp claim is denied, the first thing you should know is what caused the denial. Common reasons can include:
- Not reporting the injury to your employer within the first 90 days after occurrence.
- The injury didn’t happen when you were actually at work.
- You had a problem as a result of a pre-existing condition.
- You hurt yourself at work on purpose.
- Someone else hurt you on purpose.
- The injury happened as the result of your own misconduct.
What to Do Next?When you’re wondering what to do when your workers comp claim is denied, there are specific steps you can take.
- You’ll want to appeal the decision, and that will lead to a hearing.
- At the hearing, your appeal will be heard by a single member of the state’s workers compensation commission, who will then make a ruling on your case.
- If your claim is still denied, you can appeal to have the case heard before the full commission, instead of just one person.
- A denial from the entire commission can happen, and if it does the next step will be to file a lawsuit. You have only 30 days to file with the appeals court, and a denial there allows you to file with the South Carolina Supreme Court.