In any workers’ compensation claim, just as in any legal claim for damages, the person seeking compensation must satisfy the burden of proof. In general, the burden of proof is simply the degree to which a party to a legal action must establish their case. In other words, how strongly must a party prove their case in order to win? In a workers’ compensation case, the injured worker must prove that they sustained an injury by accident in the course and scope of their employment. Notice that there is no requirement in workers’ compensation to establish that the employer did anything wrong or acted negligently in causing a worker’s injury. This is a significant difference when compared to many other types of injury claims in South Carolina (such as injuries from motor vehicle collisions) when you must establish that the other party has done something negligent, or careless, in causing your injury.
In cases where the employer and insurance company “accept” the claim (in other words, when they accept responsibility for the injury), the injured worker does not need to prove anything else in order to begin receiving appropriate benefits under the law. When cases are accepted at the outset, things often run more smoothly. However, when the employer and insurance company “deny” the claim (in other words, when they do NOT accept responsibility for the injury), the injured worker has the burden of proving that their injury qualifies for benefits under the South Carolina Workers’ Compensation Act. When cases are denied from the beginning, it can often mean injured workers are in for a long, difficult fight. In all cases, but particularly in denied cases, it is important that you have an experienced and knowledgeable workers’ compensation attorney to help you establish your case sufficiently to meet your burden of proof.
While you may disagree with an insurance company’s decision to deny your case, keep in mind there are a number of legitimate reasons to deny a case. In many such situations, the burden of proof shifts to the insurance company to establish that your injury falls within one of several scenarios that would keep you from qualifying for workers’ compensation benefits. One such example is known as the “intoxication defense”. If your injury generally qualifies for workers’ compensation benefits, but your employer alleges that you were intoxicated at the time of your injury, and that your intoxication contributed to your injury, the burden of proof is on the employer/insurance company to establish those facts. If they cannot prove those facts, and no other applicable defenses exist, then your injury qualifies for benefits because they cannot prove that it shouldn’t qualify.
How Hundley Law, LLC Can Help
While establishing that you have suffered a work injury that qualifies for workers’ compensation benefits may seem straightforward, each year it seems more and more workers in South Carolina experience difficulty getting the benefits they deserve. The team at Hundley Law, LLC has the experience and knowledge to help you obtain the benefits to which you are entitled under the law. If your workers’ compensation claim has been denied, your benefits have been delayed or stopped or if you have any other questions or concerns about your work injury, contact the Law Office of Walter Hundley for a consultation. Our compassionate and experienced team has over five decades of combined experience helping hard-working people just like you.