Why Do Injured Workers in Lexington, SC Often Face Delays in Getting Compensation?
- Mateo
- Oct 8
- 5 min read
When an employee gets hurt while working in Lexington, South Carolina, they have the right to receive workers’ compensation benefits to cover medical expenses and lost wages. Unfortunately, many injured workers experience unexpected delays before getting the help they deserve.
These delays often arise from paperwork errors, slow insurance responses, or disagreements between the worker, employer, and insurer. Knowing what causes these setbacks allows injured employees to guide the process more confidently and take the right steps to ensure their claim moves forward without unnecessary obstacles.
What Common Administrative Issues Cause Delays in Workers’ Compensation Claims?
One of the most frequent reasons for delays in workers’ compensation claims is administrative error. Filing a claim requires a series of precise steps, and any small mistake can set the process back. Missing documentation, incorrect information, or incomplete forms can result in delays as the claim is returned for correction.
The South Carolina Workers’ Compensation Commission (SCWCC) is strict about following the required filing procedures. When any paperwork is incomplete or improperly filed, the processing time can be extended significantly. These minor errors can cause an already complicated process to stretch over weeks or even months. Employers themselves sometimes contribute to delays when accident reports are submitted late.
When this doesn’t happen, it causes a delay in the worker’s ability to access compensation. If you are experiencing a delay in your workers’ compensation claim, consulting with a Lexington workers’ compensation lawyer at Stewart Law Offices can help review the paperwork and provide assistance to help the claim process run efficiently and accurately. Taking quick action can reduce delays and help bring the claim to a proper resolution.
For personal assistance with your claim, consider visiting their Lexington Office located at 203 W Main St, Suite D, Lexington, SC 29072, or call 803-520-0003.
Why Do Insurance Companies Often Take Time to Approve or Deny Claims?
Insurance companies are responsible for reviewing workers’ compensation claims to determine whether they are valid. This process takes time, as the insurance adjuster must thoroughly assess the details of the claim and confirm the injury’s legitimacy.
When an injury is reported, insurers often need to verify that the accident happened during work hours and that the injury requires medical treatment. To accomplish this, they may request additional records or conduct an independent medical evaluation (IME). All these procedures, while necessary for avoiding fraudulent claims, often result in delays.
In some instances, the insurance company may dispute aspects of the claim, such as the severity of the injury or the necessity of particular treatments. These disputes can further extend the approval process.
It’s not uncommon for insurers to request more information before deciding on a claim. Without legal help, workers might find it difficult to respond to these requests or understand the implications of missing documentation. Having a Lexington workers' compensation lawyer can help you stay informed about the necessary steps and facilitate a smoother, more efficient process.
How Does Medical Documentation Affect the Timeliness of Workers' Compensation Claims?
A major factor influencing the speed of compensation is the medical evidence provided. Workers’ compensation benefits rely heavily on detailed medical documentation that proves the severity of the injury. However, delays in obtaining these reports can prevent the claim from progressing.
Many workers in Lexington, South Carolina, receive treatment or evaluations at Prisma Health Baptist Hospital, where waiting for test results or additional procedures can extend the diagnosis process. This waiting period often creates a temporary pause in the overall workers’ compensation claim.
Similarly, doctors may be unfamiliar with workers’ compensation protocols, leading to delays in submitting necessary reports or medical bills. If you’re facing such delays, a lawyer experienced in workers’ compensation claims in Lexington can help facilitate communication between you and your healthcare provider.
How Do Employer Disputes Contribute to Delayed Payments?
Employers sometimes challenge the legitimacy of the injury or argue that it didn’t happen during work hours. For example, an injury sustained during a lunch break or off-site work may be contested. In these cases, workers might need to go through a formal hearing process to determine whether the injury qualifies for workers' compensation benefits.
Disputes may also arise regarding the extent of an injury and whether the worker is entitled to ongoing treatment or Permanent Total Disability (PTD) benefits. If an employer disagrees with a doctor’s assessment, this could delay the worker’s access to necessary medical care or financial compensation.
Additionally, discrepancies in accident reports or a lack of timely reporting can complicate matters further. Without thorough documentation from the employer, the process can slow down considerably, affecting the speed at which the claim is resolved.
How Can Injured Employees Minimize Delays?
While it’s not possible to eliminate delays completely, workers can take proactive steps to reduce the likelihood of them occurring. By acting early and staying organized, workers can minimize complications and avoid unnecessary setbacks. Responding quickly and providing all necessary documents on time can prevent common delays caused by missing or incomplete information. Here are a few tips to help speed up the claims process:
1. Report the Injury Quickly
South Carolina law generally requires workers to notify their employer about a workplace injury within 90 days. The sooner this happens, the sooner the employer can begin processing the claim and submit the necessary paperwork.
2. Keep Accurate Records
Make sure to keep a record of all communications with your employer, medical providers, and the insurance company. Document the dates of any doctor visits, treatments, or other medical services. This will be important if there is any dispute regarding your treatment or the nature of the injury.
3. Seek Legal Help Early
A Lexington workers' compensation attorney provides valuable guidance throughout the process. Lawyers can assist with filing paperwork, understanding what documentation is required, and helping your claim progress. They also act as advocates, assisting you to protect your rights throughout the process.
4. Follow Medical Advice
Be sure to attend all medical appointments and follow your doctor's treatment plan. Missing appointments or failing to adhere to prescribed treatments can lead to delays in your claim or even result in a suspension of benefits.
5. Respond to Requests for Information
When the insurer or Workers’ Compensation Commission requests additional information, respond as quickly as possible. Delays in providing required documents can slow down the entire process.
Frequently Asked Questions
1. How long does it typically take to receive workers’ compensation benefits in South Carolina?
The length of time it takes to receive workers’ compensation benefits depends on several factors, including the complexity of the case, whether there are disputes, and how quickly medical documentation is provided. In general, benefits should begin within a few weeks, but contested cases can take much longer.
2. Can I choose my doctor for workers' compensation treatment?
In South Carolina, the employer or insurance company typically chooses the doctor. If the worker disagrees with the chosen doctor, they may request a change through the Workers' Compensation Commission.
3. What should I do if my employer retaliates after I file a claim?
South Carolina law prohibits retaliation for filing a workers' compensation claim. If you believe your employer is retaliating, contact an attorney to discuss your legal options