What You Need To Know To Reopen a Workers’ Comp Claim in SC

Learn how to reopen your workers’ comp claim if your injury gets worse so you can get the full benefits you deserve

If you’ve been hurt on the job in South Carolina, workers’ compensation benefits can provide a vital safety net, covering your medical expenses and lost wages while you recover. 

But what happens when your injury worsens after your case is closed or new medical treatment becomes necessary? 

Workers who find themselves in these situations often wrongly assume they’re out of luck, but this isn’t always the case. The good news is that in South Carolina, there are circumstances where workers’ comp claims can be reopened and workers can get additional benefits. In this article, we’ll explain when you may be eligible to reopen your claim and what the process involves so you know what to expect.

If you’re struggling with ongoing medical challenges or have questions about your workers’ comp case after your benefits have stopped, reach out to the experienced Columbia work injury lawyers at Chappell, Chappell, and Newman for a free consultation.

When can you reopen a workers’ comp claim in South Carolina?

In South Carolina, you may be able to reopen your workers’ compensation claim if your original work-related injury or occupational disease worsens after your case has been resolved.

For example, if you initially believed your back injury was improving but later experienced a relapse or worsening symptoms after resuming your regular work duties, you might qualify to reopen your case for additional benefits. However, this isn’t always guaranteed, and whether you can reopen your claim depends on a number of factors, including how it was resolved.

What factors determine if you can reopen a SC workers’ comp claim?

If your work-related injury or condition worsened after your case was resolved, you might be able to reopen your workers’ comp claim in South Carolina, but whether or not reopening is possible depends on several important factors, which we’ll discuss below.

Medical evidence and doctor’s opinion

One key aspect to reopening your claim is proving that your condition has worsened and that further medical treatment is necessary. It’s not enough to simply claim that your condition has gotten worse. You’ll need to provide convincing evidence that your current medical issues are directly tied to the original workplace injury, disease, or illness. 

Typically, you’ll need a detailed medical opinion from your treating doctor or another authorized health care provider. Their statement should clearly link your worsened condition to the original workplace injury or condition and explain how further treatment could help you resume your work duties. Without this medical evidence, your request to reopen is unlikely to succeed.

Type of settlement

How your claim was originally resolved will also determine whether or not it can be reopened. For example, if your case was settled through an agreement using Form 16A, which allows for continued medical treatment, you may retain the right to reopen your claim if your condition worsens.

On the other hand, if you signed a “full and final” settlement agreement—often called a clincher—you cannot reopen the claim. Clincher agreements close the case completely, including your right to future medical care.

If a workers’ compensation commissioner made the decision on your case, they may have included provisions for future medical treatment in the ruling. These provisions may allow you to reopen your case if your condition changes as long as you meet the required conditions.

If you’re not sure how your claim was originally settled, you should reach out to a local Columbia workers’ compensation attorney who can review your claim and explain your legal options.

Filing deadline

In South Carolina, you generally have 12 months from the date of your last compensation payment to reopen your claim. If you wait too long, you will likely lose the opportunity to pursue additional benefits.

What steps do I need to take to reopen my workers’ comp claim in South Carolina?

Reopening a workers’ comp claim can feel overwhelming, but taking these necessary steps to prepare yourself can make the process smoother and less intimidating.

1. File the necessary forms

To officially begin the process of reopening a closed workers’ comp claim, you’ll need to file a formal request with the South Carolina Workers’ Compensation Commission. This typically involves completing the required forms, such as “Form 50” for workplace injuries, indicating your intent to reopen the claim.

Remember, you need to file your claim within 12 months of your last compensation payment. Also, make sure the form is accurate and includes all relevant details about your condition and how it has gotten worse.

2. Compile evidence supporting your claim

Next, you’ll need to gather strong evidence to prove your original condition has deteriorated and additional medical treatment is necessary to help you recover and return to work or resume your regular duties. This may include:

• Updated medical records and test results.
• A written opinion from your treating doctor explaining how your condition has worsened and why further treatment is required.
• Any other documentation, such as reports from specialists or imaging studies, that support your case.

Presenting strong and thorough evidence can make all the difference in getting your claim approved.

3. Prepare for a hearing with a workers’ compensation commissioner or judge

Once the required forms are submitted, the South Carolina Workers’ Compensation Commission may schedule a hearing to review your case. During this hearing, you’ll need to present medical evidence that demonstrates:

• A clear connection between your current condition and the original workplace injury, disease, or illness.
• How your condition has changed since your claim was resolved.
• Why additional benefits or medical care are necessary for your recovery or ability to work.

Your employer or their insurance company may challenge your claim, so it’s crucial to have a well-prepared case that addresses potential objections.

An experienced work injury attorney knows what evidence is most compelling to support your claim. They can work with your treating doctor to obtain the necessary medical opinions and compile all relevant documentation so they can craft a clear and persuasive argument to present to the commissioner or judge.

If your claim is contested, your attorney will advocate on your behalf, countering the arguments of your employer or insurer to ensure your case is fairly heard.

Where can I find the best Columbia workers’ compensation attorney to help reopen my claim?

Reopening a workers’ comp claim in South Carolina takes careful planning and attention to detail. By taking the time to accurately fill out the necessary forms, gather solid evidence, and prepare for the hearing, you can greatly improve your chances of securing the benefits you need to move forward.

For more than 30 years, the knowledgeable Columbia workers’ compensation attorneys at Chappell, Chappell, and Newman have been helping workers who have been hurt on the job in South Carolina cut through the red tape so they can get the compensation they deserve.

Find out more about how we can help with your claim by scheduling a free consultation with Chappell, Chappell, and Newman today.