Steps in the Workers’ Comp Appeals Process
There are several levels in the process of appealing your workers’ compensation claim denial.
Informal conference.
When you receive your initial denial, your first step should be to meet with your employer and/or the employer’s insurance company to see if the denial is due to a minor issue like a typo or other clerical error that can be corrected without SCWCC intervention.
SCWCC hearing request.
If an informal meeting does not resolve the problem, you may submit a hearing request and a $25 fee to the SCWCC. Your hearing will be held before one commissioner in the county where your injury occurred. You might be required to see an SCWCC-recommended doctor, who will also testify at your hearing. Then, the commissioner will issue an order stating the SCWCC’s decision.
Commission review.
If you disagree with the order, you have 14 days to appeal by submitting a Request for Commission Review, along with a $150 fee. At this second level of appeal, three commissioners will hear your case and make their decision, which is called an “award.” You will be notified of the award with an explanation of the Commission’s rulings on the facts of your case.
SC Court of Appeals.
If you disagree with the award that results from your Commission review, you have 30 days to file a lawsuit in the South Carolina Court of Appeals. When you file the suit, you must explain your reasoning, citing mistakes you feel the SCWCC has made in interpreting the facts of your case and/or applying the law. While this appeal is pending, your employer is required to pay you weekly cash benefits, and the insurance company must cover your ongoing medical care.
SC Supreme Court.
If you are not successful at the Court of Appeals level, you still have one more option. You may take your claim to the South Carolina Supreme Court, which will evaluate your case and decide whether to hear your final appeal. The Supreme Court chooses which cases it will hear and has no obligation to hear each one.
Have You Been Injured On The Job?
If you've been hurt at your job you can speak with a workers' compensation lawyer. Please contact us online or call our Charleston, South Carolina office directly at 843.488.2359 to schedule your consultation. We are also able to meet clients at our Conway, Florence, Myrtle Beach, Murrells Inlet, Mt. Pleasant, North Myrtle Beach or North Charleston office locations.
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