What Should You Do If Your Employer Denies Your Myrtle Beach Workers Compensation Claim?

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If you have sustained work-related injuries in Myrtle Beach, you’re entitled to South Carolina workers’ compensation benefits. However, your claim can initially be denied due to various reasons. The good news is it’s possible to appeal a denial. Contact the David Aylor Law Offices to boost your chances of getting the full compensation that you deserve.

What Can Cause Your Myrtle Beach Workers Compensation Claim To Be Denied?

Employers and workers’ compensation insurance administrators can cite several reasons for denying your claim. Your lawyer has to review these reasons to determine whether you have grounds to appeal.

  1. Inadequate Proof

The insurance administrator and employer can argue that your injury is not as serious as you claim. If the examination of a physician of their choice strengthen their claim, it’s your right to get an independent medical opinion.

  1. Improper Behavior

The employer may contend that you sustained the injury due to your carelessness. However, your own actions will rarely disqualify you from workers’ compensation benefits unless you were intoxicated or intentionally injured yourself.

  1. Off-the-Job Injuries

Your employer may say that you didn’t sustain the injury in the workplace. However, SC workers’ compensation laws look at “work-related” broadly. An injury qualifies to be work-related if it occurred when doing a work-related job.

  1. Misclassification

Workers comp only covers employees. Some unscrupulous employers (especially in the construction sector) may classify workers as independent contractors to avoid compensating injured workers.

If you sustained a work-related injury, reach out to our lawyers. You may qualify for full compensation if you are legally supposed to be an employee and not an independent contractor.

  1. Missed Deadlines

You have up to 90 days to notify your employer about a work-related injury. They may deny your claim if it’s past the deadline.

However, the development of some diseases and recurrent stress injuries take time, making it difficult to determine when you got injured. These special injuries include asbestos-related illnesses and carpal tunnel syndrome.

Due to misinterpretation of the law, some employers may bar you from benefits if you don’t alert them within 24 hours or less than 90 days. If you believe that your circumstance is special or that you notified your employer in time, contact us to discuss your compensation claim.

  1. Pre-existing Conditions

Employers may claim that you had a pre-existing condition during the accident. But if the work-related accident worsened that condition, we can help you with your case. Our workers’ compensation lawyers have experience proving the degree of your injuries and your rightful compensation benefits.

  1. Incomplete Details or Discrepancies 

Conflicting details in the documented injuries and accident report can harm your case. The same can be said about incomplete information in your application.

  1. Lack of Medical Report

If you didn’t seek medical treatment, your employer might use this reason against you. Also, they may claim that the physician you consulted was not on the certified list of providers.

The employer may list many other reasons, in an attempt to squash your case against them. Fighting against your employer, their lawyers, and the insurance administrator, can be an uphill task if you go it alone. Has your claim been denied? Then let the qualified Myrtle Beach workers’ compensation attorneys at the David Aylor Law Offices handle your case.

Steps in Myrtle Beach Workers Compensation Appeals

If the employer has denied your claim, you should get a letter giving reasons and details regarding a possible appeal. Generally, you have up to 2 years from the accident date to file the appeal. It’s good to kick-start the process sooner, lest the insurer tries to cite your delay as proof that the injury was not as severe as you claim.

Now, here’s the appeal process:

  • Informal Meeting

Maybe the denial arose from a minor issue that can be solved between you and the employer. Think clerical errors such as a typo. So, meet your employer and their insurance firm first upon getting the initial denial letter.

  • Hearing Request at South Carolina Workers’ Compensation Commission (SCWCC

Did the informal conference fail to clear the matter? Then the next step is to approach SCWCC in Horry County (where your injury occurred) and request a hearing (The fee for this request is $25).

A commissioner who will be hearing the hearing may request you seek a medical examination from an SCWCC-recommended physician. The commissioner will then state their decision.

  • Commission Review

If you don’t agree with the decision, you can submit a Request for Commission Review within 14 days of the order. You’ll pay $150 for this second appeal.

Three commissioners will hear your claim and give their order (award) based on the case’s facts.

  • South Carolina Court of Appeal

If you are unsuccessful at the Commission review level, you can file a suit in the SC Court of Appeals within 30 days. You’ll be required to explain any mistake you feel the commissioners made in applying the law or interpreting your case’s facts.

As you wait for the court’s decision, your employer and the insurer are required to pay you weekly monetary benefits and provide insurance coverage for ongoing treatment.

  • SC Supreme Court

If you are not satisfied by the Court of Appeal’s decision, you may proceed to the SC Supreme Court. After evaluating your case, this court will decide whether or not to hear it.

The whole process can be long, expensive, and tedious. Your best bet is to hire a highly qualified lawyer from David Aylor to represent you as you recover from your injury.

Myrtle Beach Workers Compensation Lawyers

At David Aylor Law Offices, we have experienced attorneys that will help you navigate through the landmines set by your employers and the insurance company. Call us today at (843) 744- 4444 or chat us online for a free case evaluation.



Can My Employer Deny My Claim For Workers Compensation Benefits?

Your employer and its insurance company may deny your claim by citing one or several reasons. These reasons include missed deadlines, inaccurate information in the application, non-job-related injuries, pre-existing conditions, and failure to see a doctor.

Do I Need an Attorney for a Workers’ Compensation Claim?

While it is not a legal requirement, having a qualified lawyer will tremendously increase your chances of getting your full compensation.

Is It Possible to Win a Workers’ Compensation Appeal?

Yes, it’s possible. Be sure to engage a lawyer who can discover legal grounds for an appeal.


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