The South Carolina workers’ compensation system provides benefits to employees injured on the job. Workers’ compensation laws specify that unless the employer is exempt from carrying insurance, any work-related injury to an employee should be covered if it occurs in the workplace or in the scope of employment. So many injured South Carolina workers with valid injury claims are shocked when their claims are initially denied. If your workers’ comp claim was denied, don’t panic, and don’t give up. Here, we’ll help you understand your legal options and how to appeal your denial.
Our attorneys at Joye Law Firm can guide you through the SC workers’ comp appeals process and pursue the full benefits available for your work-related injury. Start with a free consultation with one of our experienced workers’ comp lawyers. Even if you don’t hire us, you’ll walk away with a clearer understanding of the options available to you under the law.
Joye Law Firm handles workers’ comp denied cases throughout South Carolina and has offices in North Charleston, Columbia, Summerville, Clinton, and Myrtle Beach. We’re proud to have multiple attorneys listed in the 2025 edition of The Best Lawyers in America® for their work in the “Workers’ Compensation – Claimants” practice area. The head of our Workers’ Compensation Department, Attorney Matt Jackson, was recently named Lawyer of the Year for Workers’ Compensation in Charleston and serves on the Executive Committee for the Injured Workers’ Advocates organization. Take a look at what former clients say about the legal service they received, our team at Joye Law Firm is ready to assist you, too.
You can reach us at 888-324-3100 or fill out an online form for a free case review.
Why Would a Workers’ Comp Claim be Denied?
There are many reasons that employers and workers’ comp insurance administrators use to deny claims of injured SC workers. Unfortunately, many of these reasons are mere technicalities, which can make filing a claim a delicate process that requires a lot of care, attention to detail, and follow-up. Without an experienced workers’ compensation attorney on your side at the start, it can be easy for an otherwise valid claim to be denied. We can review the reasons workers’ comp was denied in your case and evaluate whether you have grounds to appeal.
Some of the reasons for denials that may be appealed include:
- Missed Deadlines — If you fail to notify your employer within 90 days of a workplace accident, your claim could be denied. In some cases, it may not be clear exactly when an injury developed. This is especially true with repetitive stress injuries (carpal tunnel syndrome, for example) or diseases (asbestos-related diseases, for example) that develop over time from a a workplace exposure. Many employers misread the law and advise injured workers that they are barred from benefits if they don’t report a work injury “within 24 hours” or some other period of time that is less than 90 days. If your employer claims you missed the deadline, but you believe that you gave notice to your employer in a timely fashion or there are special circumstances, then you should contact a workers’ compensation attorney to discuss your claim.
- Off-the-Job Injuries — An employer may claim that your injury was not work-related and that you should not receive benefits. Remember, there is a very broad definition of “work-related” under South Carolina workers’ comp laws. If you were doing work-related tasks of any type, or if your injury arose out of doing your job, it may qualify as a work-related injury. If your job duties involve driving, then your injuries in a car accident that occurred while you were working may be covered by workers’ comp.
- Not Seeing Your Approved Medical Provider – South Carolina law states that if you are being treated for a work-related injury, your employer has the right to select the doctor you see. If you see your own doctor, there is no guarantee your employer will agree to pay the bill or can be forced to pay the bill. Usually, the only exception is if you needed immediate emergency treatment and there wasn’t time to get approval from your employer beforehand.
- Misclassification — Workers’ compensation provides coverage only to employees. Some employers improperly classify workers as independent contractors to avoid paying workers’ compensation benefits. It’s an especially common practice in the construction industry. If this has happened to you, and we can show that your work met the legal definition of employee rather than independent contractor, then you may qualify for workers’ compensation benefits.
- Improper Behavior — Your employer may try to claim that you did something wrong and that you should not receive workers’ comp benefits as a result. It is a rare situation, however, where an employee is disqualified from receiving workers’ compensation benefits as a result of his or her own actions. Unless you intentionally hurt yourself or were intoxicated at work and the employer can prove that your intoxication was the cause of your workplace injury, you should not be disqualified based on your own actions, even if you were careless. Workers’ comp covers injuries regardless of fault.
- Pre-existing Conditions — Employers sometimes deny claims based on the fact that you had a pre-existing condition when your work injury occurred. However, you can still qualify for benefits if your workplace accident aggravated or worsened your condition. Proving the extent of your work injuries and your right to benefits is complicated in these situations, so you should consult with our South Carolina workers’ comp lawyers at Joye Law Firm for help.
- Inadequate Proof of Injury — Your employer or the insurance administrator might believe you are exaggerating your injury and contend that your injury is not as severe as you claim, especially if you do not follow through with prescribed treatment. When an employer or insurer tries to use the opinion of a doctor of its choosing to show that you shouldn’t receive workers’ comp benefits, you have the right to ask for an independent medical examination. Our attorneys at Joye Law Firm can help you locate a doctor and obtain a second medical opinion about your condition.
Attorney Ken Harrell represented Forrest, who suffered a debilitating neck injury while installing a large billboard in Bowman, S.C. On the day of the incident, Forrest was holding onto ropes as the sign was lifted into place by a crane. It was an incredibly windy day, which meant Forrest was being jerked back and forth as he held onto the ropes. At the end of the day, Forrest noticed some soreness in his neck but assumed that it was just strained muscles. However, as weeks passed, the pain intensified, and he began experiencing numbness in his left arm. Realizing the severity of his condition, Forrest reported the injury to his employer and sought medical attention. His claim was initially denied, citing the delay in reporting.
