At Cardinal Law Partners, Kristin Henriksen has experience representing individuals in South Carolina workers’ compensation claims and has helped claimants whose claims have been denied by insurance companies and employers. Claims are sometimes denied for reasons that do not hold up under the law.
Why Do Claims Get Denied?
Claims get denied for several reasons. Some of the more common reasons are outlined below:
- Your employer claims that you are an independent contractor and not an employee. Workers’ compensation benefits are only available to employees. There is an analysis to determine whether someone was actually an independent contractor or an employee, sometimes the employer’s classification as an independent contractor may not be accurate.
- Sometimes employers and insurance companies fight claims by alleging that the injury occurred as a result of the intoxication. The Defendants do not have to provide workers’ compensation benefits if the injury was caused by the intoxication of the employee. However, the Defendants have the burden of proof that the employee was intoxicated and that the intoxication caused the injury.
- Insurance companies also deny claims due to the claimant’s prior medical history. If the workplace injury results in a back injury, and the employee admits to receiving prior medical treatment for their back, the insurance company will often deny the claim due to a preexisting condition. However, if the work place injury aggravated the pre-existing condition, it may still be compensable.
What Should Employees Do After Their South Carolina Claim Is Denied?
In South Carolina, denied claims can be disputed before the South Carolina Workers’ Compensation Commission. The Workers’ Compensation Commission hears disputes and decided on issues between the parties. Initially, claims are heard before a single South Carolina Workers’ Compensation Commissioner. Appeals after a hearing are taken to a three member panel at the Full Commission. Finally, decision from the Commission can be appealed to the South Carolina Court of Appeals.
An attorney can help an injured worker with a denied claim initially negotiate the issues with the insurance company. The attorney then can represent the injured worker before the Commission and then the Court of Appeals.
Contact Cardinal Law Partners Today!
Kristin Henriksen at Cardinal Law Partners handles South Carolina workers’ compensation claims. We can help with unfair workers’ compensation denials by getting in on the claim early. If you are looking for help with workers’ compensation claim, do not hesitate to schedule a FREE case evaluation with Kristin Henriksen who handles South Carolina Workers’ Compensation claims.