South Carolina law entitles people who are injured at work or who develop work-related occupational diseases to benefits through our state’s workers’ compensation program. The system is intended to ensure that injured or sick workers receive medical treatment and are not left without an income, regardless of who is at fault for their injury or illness. In return for their guaranteed benefits, workers are generally prohibited from suing their employers after a workplace accident or when they develop an illness related to their work environment.

While obtaining benefits should be simple in theory, the reality is that workers often have to fight to get the benefits to which they are legally entitled. Worst of all, workers’ compensation insurers are incentivized to fight the cases involving the most money, which means that workers who need their benefits the most often have the most trouble obtaining them.   Often times, the decision to deny a claim is made by the insurance carrier for the employer, and not the employer themselves.  We understand that workers are reluctant to bring claims even when seriously injured because they believe the claim is against the employer.  However, the employer has paid for insurance that covers injured workers,

Fortunately, an experienced attorney can help South Carolinians who have been hurt at work obtain their benefits quickly and efficiently. Not every case requires the assistance of a lawyer, however. Here are some of the circumstances under which you should discuss your workers’ compensation case with an attorney.

You Are Experiencing an Unreasonable Delay in Obtaining Your Benefits

One tactic that is often employed by workers’ compensation insurers that are trying to avoid paying a claim is simply ignoring it and hoping that you will give up on trying to collect your benefits.   They may accept that you injured one part of your body but deny body parts, such as the back, which were also injured or were affected as a result.  If you have filed a claim but are getting the run around from the insurance company, you should contact a lawyer as soon as you can. A lawyer will communicate with your employer’s workers’ compensation insurance company on your behalf and will aggressively pursue the benefits you are owed. In many cases, once an attorney gets involved, insurance companies are much more willing to work with you, as they know that legal action is imminent if they do not.

Your Workers’ Compensation Claim Has Been Denied or You Anticipate It Will Be Denied

If your claim has been denied, you should call a lawyer immediately.  Being unable to work and needing medical treatment at the same time can be a recipe for financial disaster. Fortunately, if your claim has been denied, you have the right to challenge the insurance company’s determination.  The sooner that you contact an attorney after your accident, the sooner an attorney can act to obtain and evidence that supports your claim.

The process of challenging denial by a workers’ compensation carrier can be complicated for those unfamiliar with the process.  The process is form driven, subject to rules and regulations, and requires presenting evidence at an administrative law hearing.  You can be certain that the insurance company has lawyers on their side that are familiar with workers’ compensation law and who will aggressively defend the company’s decision to deny your claim.   As a result, it is imperative to contact a lawyer if your claim is denied who will aggressively represent you. Your lawyer will thoroughly investigate your claim and gather evidence that supports the position that you are entitled to benefits. In addition, your lawyer will represent you in any hearing or other proceeding that may occur. In the event that your appeal does not lead to a favorable resolution, your lawyer will likely file a lawsuit requesting that the court overturn the insurance company’s decision to deny your claim.

If You Are Seriously Injured

As mentioned above, insurance companies are incentivized to fight the highest value claims. This reason for this is simple – the workers’ compensation program requires that employers carry workers’ compensation insurance. Like any other insurance policy, they pay a monthly premium to the insurance company, and the insurance company pays benefits to any of the employer’s workers who are injured in a work-related accident or who develop occupational diseases. The insurance company’s goal is to minimize their payouts and avoid paying claims all together. As a result, if you are seriously injured and are going to require significant medical treatment, you should contact an attorney as soon as possible. Some examples of the kinds of injuries that may result in significant workers’ compensation benefits include the following:

• Traumatic brain injuries; 
• Spinal cord injuries; 
• Burns;
• Broken bones; and
• Accidental amputations.

These and other serious injuries can cost hundreds of thousands of dollars to effectively treat and may leave victims with long-term medical problems that may prevent them from ever working again. As a result, workers’ compensation claims for these kinds of injuries can often involve millions of dollars, which makes it much more likely that the insurance company will try and fight the claim. Calling an attorney before you even start the process of making a workers’ compensation claim can help ensure that you receive your benefits as soon as possible.

If You Are Confused by the Process,  Uncertain Whether You Have a Claim, or Just Want to Know Your Rights

The process of filing a workers’ compensation claim involves a significant amount of paperwork and can be extremely confusing. Fortunately, when you retain an experienced workers’ compensation attorney, he or she will handle the entire process on your behalf and ensure that your claim is filed correctly and within the applicable time limits.

Another reason to speak with an attorney is if you are unsure whether you are entitled to benefits. This often occurs when workers develop illnesses or medical conditions later in life that may or may not be related to their work. It is always a good idea to speak with an attorney regarding your situation, as there is no cost associated with a consultation and you may be entitled to benefits of which you were unaware. For example, if you are suffering from hearing loss, it is important to consider the possibility that it is related to your work rather than just a normal part of getting older.

Call The Law Offices of Steven M Krause PA Today to Schedule a Free Consultation with a South Carolina Workers’ Compensation Attorney

If you have been injured in a work-related accident or have developed a medical condition due to your work environment, you should speak with an experienced attorney as soon as possible. At The Law Offices of Steven M Krause PA, we are committed to helping workers obtain the benefits to which they are legally entitled and work hard to ensure that each case we take is resolved as favorably as possible. To schedule a free consultation with a South Carolina workers’ compensation attorney, call our office today.

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Steven M. Krause

Steven Krause is a personal injury, auto accident, and workers’ compensation lawyer who practices in Anderson, SC. He graduated form the Thomas M. Cooley School of Law and has been practicing law for 40 years now. Steven Krause believes in fighting for the injured. Learn more about his experience here.