Workers' comp claim denied in South Dakota: what to do next

Call the insurance adjuster to try to work it out, then call the Division of Labor and Management. Either side can ask the Department for free, voluntary mediation by phone or at a local office.

Your employer's insurer, not the state, usually decides first. If they deny or delay, the free help listed here can explain your options.

Checked against official sources: October 31, 2026.

Deadlines are strict. If you are near one, call the state agency or free help today.

If your claim is denied or delayed in South Dakota

Who decides

South Dakota Department of Labor and Regulation, Division of Labor and Management

First step

Call the insurance adjuster to try to work it out, then call the Division of Labor and Management. Either side can ask the Department for free, voluntary mediation by phone or at a local office. If mediation does not work, or you skip it, file a Petition for Hearing.

Law: 605.773.3681

Form

Petition for Hearing

Deadline

A Petition for Hearing must be filed within 2 years after the insurer notifies you and the Department in writing that it is denying the claim (in whole or in part). If benefits were paid, a claim for more must be filed within 3 years after the last payment.

Medical disagreements

The employer or insurer can contest whether treatment is reasonable and necessary, and can require you to see a practitioner it selects for examination at its expense. For a disputed medical claim of $8,000 or less after the Department has already established your right to benefits, you can file a Small Claims Petition for Hearing.

Small Claims Petition for Hearing

Appealing the decision

Circuit court, then the South Dakota Supreme Court.

Source: notice of appeal within 30 days after notice of the Department's final decision

Call the insurance adjuster and explain the problem; keep notes.
Call the Division of Labor and Management to discuss the problem.
Request free mediation with the Department; it usually happens 2 to 4 weeks later.
File a written Petition for Hearing with the Department within 2 years after the written denial. Medical disputes of $8,000 or less, where your right to benefits was already established, can use the Small Claims Petition for Hearing (no filing fee, telephone hearing).
The Department holds a hearing and issues a decision.
Either side may appeal to circuit court within 30 days after the Department serves notice of its final decision.

Law: SDCL §§ 62-7-12, 62-7-35, 62-7-35.1, 1-26-31

Source: dlr.sd.gov

Sources

The official sources for South Dakota are listed on the South Dakota page.

National rules that may also matter

Not covered by state workers' comp?

These federal programs and laws cover some groups of workers instead of, or in addition to, state workers' compensation. If one of them may apply to you, check its rules and deadlines too. They are different from your state's.

Federal Employees' Compensation Act (FECA): Civilian employees of the federal government, including Postal Service employees. Official page

Longshore and Harbor Workers' Compensation Act (Longshore Act): Maritime workers such as longshore workers, harbor workers, ship repairers, shipbuilders and ship-breakers, hurt on navigable waters of the United States or on an adjoining pier, wharf, dry dock, terminal or other area used to load, unload, repair or build ships. Some groups are excluded. Official page
Longshore maximum and minimum for October 1, 2026 to September 30, 2027 (fiscal year 2027): maximum $2,163.92 a week, minimum $540.98 a week.

Law: 33 U.S.C. 906(b); DOL Longshore NAWW table

Defense Base Act: Civilian employees working outside the United States on U.S. military bases or under a contract with the U.S. government for public works or national defense. Claims are handled by the Longshore program. Official page

Federal Black Lung Program: Coal miners who are totally disabled by black lung disease (pneumoconiosis) from coal mine work, and survivors of miners whose deaths were caused by it. Official page

Energy Employees Occupational Illness Compensation Program: Current or former employees of the U.S. Department of Energy and its contractors and subcontractors, and certain uranium miners, millers and ore transporters, who became ill from toxic exposures such as radiation, beryllium or silica at covered work sites, and their survivors. The program is set up by the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Official page

Railroad workers (Federal Employers' Liability Act): Employees of railroads in interstate commerce. Instead of a workers' compensation claim, a federal law lets an injured railroad worker sue the railroad for damages caused by its negligence.

Seamen (Jones Act): A seaman injured in the course of employment may bring a lawsuit against the employer, with the right to a jury trial, under the same federal rules that apply to railroad workers.

National help

Your state workers' compensation agency answers questions about claims. Many have a free help line, an ombudsman or information officers for injured workers.

The Legal Services Corporation funds 129 nonprofit legal aid organizations in every state, D.C. and the territories. Enter your address on its website to find one near you. You can also look up legal information and free forms at LawHelp.org. Whether a local program handles workers' compensation cases varies.

LawHelp.org