When a Claim Is Denied
After a work injury, most people expect the system to work fairly—you report your injury, see a doctor, and start receiving benefits. But many South Carolina workers are surprised when their claim is denied.
A denial doesn’t necessarily mean you don’t qualify for benefits. It often means the insurance company wants more proof or is challenging part of your story.
Common reasons for denial include:
The injury wasn’t reported quickly enough
The employer claims the injury didn’t happen at work
There’s no medical evidence connecting the injury to your job
You had a pre-existing condition
The insurance company disputes your doctor’s opinion
Understanding Your Rights After a Denial
Under South Carolina law, you have the right to appeal any denial of workers’ compensation benefits. The first step is usually a hearing before the South Carolina Workers’ Compensation Commission.
During the hearing, you or your attorney present evidence showing:
How and when the injury happened
Medical documentation connecting your injury to your job
Proof that you reported the injury properly
Any witness testimony or records that support your claim
An experienced lawyer can also negotiate directly with the insurance company to try to resolve disputes before the hearing, which often leads to faster results.
FAQs About Denied Workers’ Comp Claims
How long do I have to appeal a denial?
You generally have up to two years from the date of your injury to file a claim, but if your claim was formally denied, you should appeal as soon as possible to preserve your rights.
Can I still get medical treatment if my claim is denied?
You can continue treatment using your own health insurance, but your workers’ comp insurer may later be ordered to reimburse you if your appeal succeeds.
Will I need to go to court?
Most cases start with a hearing before a commissioner, not a judge in a traditional courtroom. However, the process is still formal, and legal representation is strongly advised.
What if my employer says I’m not eligible for workers’ comp?
You should never take their word for it. South Carolina law covers most employees, and many “independent contractor” classifications are incorrect.
Free Consultation for Injured Workers
If your claim has been denied, don’t assume that’s the end of the road. Martin & Martin, P.A. has helped injured workers across South Carolina turn denials into approvals through strong evidence and expert legal advocacy.
📞 Call today for a free consultation to review your denial letter, understand your appeal options, and get your claim back on track.