10 Common Workers’ Compensation Claim Mistakes

If you or a loved one was hurt on the job, you may be wondering how to optimize your claim. As award-winning workers’ compensation attorneys with decades of combined experience, we’ve seen firsthand how simple mistakes can lead to lowball offers and even denied claims. This article will discuss 10 common mistakes that lead to denied workers’ comp claims. If you have any questions or would like to hire a reputable attorney to protect your rights, give our team a call today at (803) 888-2200. We’re here and happy to help.

10 Common Mistakes Leading to Denied Workers’ Compensation Claims

1. Not Reporting the Injury Immediately

After a work accident resulting in injury, it’s critical that you report the accident as soon as possible. While you must notify your employer within 90 days of the accident, the sooner the better. You should always provide a written report to your supervisor or administrator and keep a copy for your records.

Reporting the accident and resulting injuries does a few things for your claim:

• Establishes an official record, with dates and proper documentation.
• Allows you to seek medical attention promptly.
• Helps prove delayed injuries, for example if your symptoms worsen over time.
• Ensures you meet the legal time requirements to file a claim and get compensation.

Many employers have time limits for reporting accidents. Failing to follow these can hurt your claim and even lead to a denied claim.

2. Waiting Too Long to See a Doctor

Getting medical attention immediately following any accident is critical. Your health is the top priority and adrenaline can mask injuries, so always seek medical attention after an accident, even if you feel okay at first.

Seeking prompt medical attention is also helpful should you decide to file a claim later on because it establishes a clear connection between the accident, your injuries, and your medical care. If you do not see a doctor after an accident and your injuries worsen over time, your employer’s insurance company may argue that your injuries were not work related.

3. Not Following the Doctor’s Orders or Attending Follow Up Appointments

Following your doctor’s care plan and instructions is essential for your health and recovery. In addition, failing to follow your doctor’s orders could signal to the insurance company that you are not as injured as you’re claiming to be. Always follow your doctor’s orders and attend your follow up appointments.

4. Returning to Work Too Soon or Not Returning on Light Duty

While you may be anxious to get back to work, returning to work against your doctor’s recommendation can not only hurt your case, it can also aggravate your injury. 

Make sure you are following your doctor’s orders when it comes to when and how you return to work.

In South Carolina, if you’re out of work for 7 days or more due to a work-related injury, you are entitled to receive temporary compensation. This compensation usually continues until you return to work in the same capacity as before the accident. 

Your treating doctor will determine once you’ve reached maximum medical improvement (MMI). This is a legal term meaning that you’ve recovered to your fullest potential after an injury. Many times, at this point, you are fully healed and ready to return to work as usual. 

During your healing process, your doctor may clear you to return to work but with restrictions, often referred to as “light duty.” This can include changing your schedule, conditions, and duties. It’s important that you return to work on light duty when your doctor approves it and if your employer can accommodate it. Failure to do so can hurt your claim.

If the accident resulted in permanent impairment, you will receive an impairment rating evaluation (IRE) determining your level of impairment on a 1-100 percent rating scale. This number can be used to determine whether you will receive permanent partial or qualify for permanent total disability benefits. Your lawyer will help you understand what this means for your case and future compensation.

5. Not Providing Medical Evidence

Medical records are a key part of all injury claims, including workers’ compensation claims. Make sure you organize and submit all of your related records. Our law firm has a dedicated medical records coordinator who can keep track of your records for you.

6. Posting on Social Media

Posting on social media during your workers’ compensation claim can be risky. Why? In many cases, your employer’s insurance company will be monitoring your activity to identify any behaviors that contradict your claim. Even innocent posts like dancing at a wedding or working out can be used as a reason to minimize your injuries and reduce or deny your benefits. 

7. Issues With Your Workers’ Compensation Forms

Another common mistake that can lead to denied claims is issues with your paperwork. Oftentimes, this includes submitting inaccurate information, missing key details, or missing deadlines.

8. Not Filing Your Workers’ Compensation Claim In Time

Ideally, you or your lawyer should file a workers’ compensation claim within 10 days of giving notice to your supervisor. While it’s in your best interest to act fast, most injured employees have two years from the date of the accident/injury to file a claim.

9. Giving Recorded Statements Without Legal Counsel

In many work injury cases, the insurance adjustor will ask you for a recorded statement. Oftentimes, they’ll be looking to uncover inconsistencies in your story and may ask misleading questions and use other tactics in an attempt to decrease the value of your claim.

Remember, in South Carolina the workers’ compensation system runs on a no fault system, meaning that you can still recover compensation regardless of your own percentage of fault for the accident.

If you’re asked for a recorded statement, it’s always a good idea to politely decline and give yourself some time to figure things out. You’ll want to have a good understanding of your injuries, future treatment, medical expenses, and a timeline with evidence before going into an interview. In many cases, you can choose to submit a written statement instead.

10. Not Speaking with a Workers’ Compensation Attorney

The South Carolina workers’ compensation system is designed to help injured workers; yet, far too often, injured workers come to us in pain, out of work, and struggling to get the justice and support they deserve from the system. 

Our team is here to help you navigate the South Carolina workers’ compensation process. It’s what we do for our clients every single day. If there’s anything we can help you with, reach out to our team today at (803) 888-2200.

Navigating the Appeals Process for Denied Claims

Typically, denied claims are due to:

• Missed deadlines
• Failure to follow the rules
• Off-the-job injury arguments
• Misclassification of employment status
• Pre-existing injury arguments
• Inadequate proof of injury

That said, we’ve seen insurance administrators deny valid claims for no reason at all. If you believe your claim was wrongly denied, give our team a call today at (803) 888-2200. We can help you fight the denied claim, including handling the paperwork and litigation process on your behalf.

Speak With a South Carolina Workers’ Compensation Attorney Today

If you’ve been injured on the job, our award-winning legal team is here to fight to get you the best outcome possible for your case and future. We’re here to protect your rights, put you and your goals for the case first, and help you understand your options under South Carolina law. 

At Cavanaugh & Thickens, LLC, you can speak to an award-winning workers’ compensation for free by calling (803) 888-2200 or emailing [email protected]. We are available for you via phone 24/7.

With decades of combined experience and hundreds of 5-star reviews, you can trust that our team will have your back throughout your case and beyond. Our firm has offices in Columbia and Charleston, and our attorneys travel to and represent clients throughout the state of South Carolina. If you are looking for an out-of-state referral, reach out to our team today. We’re happy to help.

Client Focused. Results Driven.

Disclaimer: This article is presented for informational purposes only and is not legal advice.

Author: Nicholas J. Skorzewski