If your workers comp claim is denied, you may believe that there is nothing more you can do to obtain benefits. But this is not true. With the assistance of a Bluffton workers comp lawyer, you can start the workers comp appeal process and may be successful.
Here is the step by step process of filing an appeal on a denied workers compensation claim.
Step 1: Request a Hearing
After your claim is denied, file an application for a hearing with the South Carolina Workers Compensation Commission (SCWCC). You will have to file several forms and explain the reasons why you believe your claim was wrongly denied and should be reanalyzed.
When the SWCC issues a notice of the hearing, you will have to fill in Form 58, also known as the pre-hearing brief. Here, you will explain why you want to appeal the denied claim. You will also attach a list of all the available evidence supporting your claim.
It is very important to fill in this form accurately and without any errors, so you should have a lawyer by your side when you prepare it.
Step 2: The Hearing before the SWCC Commissioner
Your hearing will take place before a Commissioner of the SWCC who will act as a judge. Both you and the workers comp insurance company will bring arguments and evidence supporting your respective views on the matter.
It is also possible to call witnesses, who will give their testimony and then be cross-examined by the opposing counsel. The entire procedure is similar to a civil court case, but in a more informal setting.
Step 3: Appealing the Commissioner’s Decision
The Commissioner will analyze the facts presented by both sides and issue a written decision, which you and the workers comp insurance company will receive by mail. If you are dissatisfied with this decision, you can appeal it and request a hearing before the full appellate panel.
The panel has seven members, who will analyze the existing evidence. None of the parties can introduce new evidence at this point. However, the attorneys representing each party may submit a brief and make oral arguments supporting their view of the case.
Step 4: Filing an Appeal with Court of Appeal
If you are still unhappy with the decision of the SCWCC appellate panel, your Bluffton workers comp lawyer may instruct you to file an appeal with the South Carolina Court of Appeal.
However, the lawyer will advise on this step only if they believe that you have a strong case against the insurance company.
Once again, you cannot present new evidence to support your claim. The Court of Appeal will only look for any errors of judgment made by the South Carolina Workers Compensation Commission.
Step 5: Filing an Appeal with the South Carolina Supreme Court
The last legal resort you have in the workers comp appeal process is the South Carolina Supreme Court. However, this step is rarely reached. The court will analyze your arguments very carefully before even accepting to try your case.
In general, cases where serious legal issues led to unfair decisions reach this phase. Your attorney will give you a reliable opinion on your chances to escalate the claim after it is still denied by the Court of Appeal.
Schedule a Free Case Evaluation with a Skilled Bluffton Workers Comp Lawyer!
If your workers comp claim is denied, you must seek legal advice from an experienced Bluffton workers comp lawyer at McDougall Law Firm. The workers comp appeal process is complex and, at a certain point, you can no longer present new evidence.
Thus, it is essential to have a strong case from the very beginning of the appeal process. We encourage you to reach out to us as soon as possible after your claim was denied. We offer each new client a free case evaluation, so call us at 843-920-5705!
