Mount Pleasant Workers Compensation Lawyer

The Claims Process: What to Expect

Filing for workers’ compensation in South Carolina is a structured process—but it’s not always straightforward. Each step must be handled carefully to preserve your right to benefits and to prevent unnecessary delays. Even minor mistakes can create major setbacks. Here’s a closer look at what you can expect during the claims process and how we help guide you through every phase.

Report the Injury Immediately

You have 90 days from the date of your injury to report it to your employer. However, waiting that long is rarely a good idea. Delays can create suspicion or give the insurance company a reason to challenge your claim. As soon as possible after your injury, notify your supervisor in writing and keep a copy for your records. Verbal notifications are often disputed later. Prompt reporting helps build a clear timeline and demonstrates that you took the injury seriously from day one.

Seek Medical Treatment Through the Proper Channels

Once your injury is reported, your employer (or their insurance company) should direct you to an approved medical provider. This doctor will be responsible for diagnosing your condition, prescribing treatment, and determining whether you can work or need time off. It’s critical that you follow their recommendations, attend every appointment, and complete any therapy or follow-up care. If you see an unauthorized provider, you may be on the hook for the bill. If you feel your assigned doctor isn’t listening or addressing your symptoms, we can help you request a second opinion or challenge the findings.

File a Claim with the Workers’ Compensation Commission

If you’re not receiving benefits, or if the insurance company delays or denies your care, you’ll need to file a formal claim. This is done using Form 50, which is submitted to the South Carolina Workers’ Compensation Commission. Filing a claim officially opens your case and gives you access to legal remedies such as a hearing or mediation. At Lanier Law Group, we prepare and file these forms on your behalf, ensuring that all required information is complete, accurate, and submitted on time.

Prepare for a Hearing If Necessary

If your employer or their insurance provider contests any part of your claim—such as the cause of injury, the extent of your disability, or your treatment plan—a hearing may be scheduled. This hearing functions like a trial, where both sides present evidence and a Commissioner makes a ruling. Having an experienced attorney represent you during this phase is essential. We organize medical records, coordinate witness testimony, and craft legal arguments tailored to your situation. Our goal is to present your story clearly and convincingly so the Commission understands exactly why your claim is valid.

Continue Documenting and Communicating

Even after your benefits begin, it’s important to stay engaged in your case. Keep a detailed journal of your symptoms, treatment progress, and how the injury impacts your daily life. Save every piece of paperwork related to your claim. If you receive any letters, calls, or forms from the insurance company or employer, contact your attorney immediately before responding. At Lanier Law Group, we help you stay organized, respond to developments quickly, and adjust your claim as your recovery evolves.

By following these steps and having the right team by your side, you’ll be in a much stronger position to receive the care and compensation you need. The process can be intimidating—but you don’t have to go through it alone.

Why Claims Are Often Denied—and How We Push Back

Even with clear medical documentation and honest intentions, many workers’ compensation claims are denied or reduced by insurance companies looking to protect their bottom line. Understanding the reasons behind these denials can help you avoid pitfalls—and having the right legal team in your corner can make all the difference.

Alleging the Injury Happened Outside of Work

One of the most common denial tactics is claiming that your injury did not occur in the course of your job duties. Insurers may argue that you were injured at home, during your commute, or while on a break. If the timing or location of your injury raises questions, it’s vital to have witnesses, surveillance footage, or time-stamped reports to support your version of events. Lanier Law Group gathers this evidence quickly and strategically to demonstrate a clear connection between your work environment and your injury.

Arguing That a Pre-Existing Condition Is to Blame

Insurance carriers often attempt to link your symptoms to a past injury or health condition. They might claim that your back pain, for example, is due to an old sports injury or prior surgery—not the warehouse accident that aggravated it. But the law protects workers whose conditions are worsened by job duties. We work closely with medical providers to document how your work activity contributed to your current health issues and differentiate between old injuries and new damage.

Disputing the Severity of Your Injury or Your Work Restrictions

Another common tactic is minimizing your injury’s seriousness. Adjusters may suggest that you’re exaggerating symptoms, that your treatment is excessive, or that you’re capable of returning to work earlier than your doctor recommends. In some cases, they may rely on biased medical evaluations arranged by the insurer. At Lanier Law Group, we consult with independent physicians and specialists to validate your diagnosis and support the work restrictions prescribed by your treating doctor.

Claiming You Didn’t Report the Injury on Time

Failing to report your injury promptly gives the insurer an easy excuse to deny your claim. South Carolina law gives you 90 days to notify your employer—but waiting even a few days can invite scrutiny. The sooner you report the injury and begin treatment, the stronger your case becomes. We help clients file official notice, secure supporting documentation, and demonstrate compliance with all deadlines.

Delaying or Denying Medical Treatment

Sometimes insurers use stall tactics—delaying approvals for procedures, second opinions, or physical therapy. These delays can prolong your recovery or force you back to work too soon. We push back against these tactics by demanding timely authorizations and appealing denials through the Workers’ Compensation Commission if needed. Your health comes first, and we don’t allow red tape to stand in the way of treatment.

Surveillance and Social Media Misuse

Insurers sometimes hire investigators to follow claimants or scour social media for anything that might undermine a claim. A short walk outside or a smiling photo at a family gathering can be twisted to suggest you’re not as injured as you say. We advise clients on how to protect their credibility during the life of the claim and proactively address attempts to discredit them.

Lowball Settlement Offers

After a claim is approved, insurers often offer quick settlements that don’t reflect the full extent of your losses. These offers may fail to account for future treatment, permanent limitations, or vocational retraining. Accepting a low settlement could leave you without the resources needed to manage long-term consequences.

At Lanier Law Group, we know how to counter these tactics. We collect medical evidence, work records, and expert testimony to show exactly how your injury occurred and what its impact has been on your life and livelihood. Our experience means we can spot the red flags early—and

respond with the documentation and advocacy needed to protect your claim

Your Responsibilities as an Injured Worker

While you have rights, you also have responsibilities under the law.Failure to meet your obligations can harm your case or reduce your benefits, so it’s important to keep these factors in mind.

• Follow All Medical Advice. You must attend all medical appointments and follow the treatment plan prescribed by your authorized physician. Missing appointments or ignoring medical advice can give the insurer a reason to question your commitment to recovery.
• Stay Within Work Restrictions. If your doctor releases you to return to work with restrictions, it’s important to comply. Refusing a suitable light-duty position may affect your eligibility for continued wage replacement benefits.
• Be Cautious With Social Media and Surveillance. Insurance companies often monitor injured workers through surveillance or by reviewing their online activity. A single photo or post taken out of context can be used to challenge the legitimacy of your injury.

We’re in Your Corner—Start With a Free Consultation

You don’t have to face the aftermath of a workplace injury alone. At Lanier Law Group, we’ve helped countless workers across South Carolina—including in Mount Pleasant—recover the benefits they’re entitled to after an on-the-job injury. We know the system. We know the opposition. And we know how to fight.

Call us today at 919-682-2111 or contact us online to schedule a free consultation. We’ll review your case, explain your rights, and help you take the next step toward recovery with confidence.