South Carolina Workers’ Compensation Benefits Claim Process

Every state has its own unique process in place for handling workers’ compensation claims. Anyone in South Carolina who gets hurt or sick on the job should follow the steps below to apply for workers’ compensation. You can also skim our chart showing the South Carolina workers’ compensation program statistics from 2015 to 2019.

Which Employers Must Provide South Carolina Workers’ Compensation Coverage?

The South Carolina Workers’ Compensation Act provides coverage for all employers with at least four full-time or part-time employees. (This coverage also applies to small family-run businesses that only employ their own relatives.) In addition, subcontractors should have coverage under a general contractor’s policy unless they elect to purchase their own coverage individually.

However, state law automatically exempts the following workers from this automatic coverage:

• Federal employees (i.e., postal workers, VA employees)
• Railroad/railway express workers
• Independent contractors
• Sole proprietors
• Agricultural workers as well as agricultural product salespeople
• Casual/temporary employees that only work on an “as needed” basis (i.e., seasonal workers, tutors, etc.)
• Licensed real estate agents working on commission for a broker
• Partners and/or members of a limited liability company (LLC)
• People working for any employer whose annual payroll was less than $3,000 the previous year

Related: South Dakota Workers’ Compensation Process

Does Covid-19 Qualify for Workers’ Comp Benefits?

In December 2020, South Carolina state legislators introduced House Bill 3192 (HB3192) to address this issue. The bill seeks to amend South Carolina’s workers’ compensation law to establish presumptive entitlement to benefits for first responders. The bill aims to provide certain employees the automatic right to claim workers’ compensation benefits for Covid-19:

• Correctional officers
• Healthcare providers
• First responders (i.e., EMTs, firefighters, paramedics, police officers)

How to Apply for South Carolina Workers’ Compensation Benefits

According to the South Carolina Workers’ Compensation Commission, follow these steps to apply for benefits:

1. Notify your supervisor about your workplace injury or illness before you seek medical attention. You must report it within 90 days or lose your right to claim workers’ comp benefits. However, the statute of limitations to file a South Carolina workers’ compensation claim is two years from your injury date.
2. Your employer must tell you which doctor, hospital, or healthcare provider network is authorized to provide your medical care. If you see your doctor after a workplace accident, your employer doesn’t have to pay those medical bills.
3. If your employer doesn’t notify the Commission within 10 days, then you can file the claim paperwork yourself. To do this, fill out Form 50 and check box 13 that says, “I am filing a claim.” (Otherwise, the Commission thinks you’re requesting an appeals hearing for your case.)
4. Workers’ compensation won’t pay you to take time off work until after your first seven days. State law says that first week is always unpaid time off until after the 14^th day you cannot work. If your workers’ comp doctor says you’re unable to work that long, your employer must cover that first week off. South Carolina workers’ compensation pays no more than $903.40/week for up to 500 weeks in 2021.
5. If your employer’s insurer denies you benefits, you have 14 days to appeal. Complete Form 50 and check box 14 to request a hearing, then pay $50 to file it with the Commission. It currently takes 30 days to process appeal request and 89 days to docket a hearing, on average.

Since each South Carolina workers’ compensation claim is different, your own experience may vary.

South Carolina Workers’ Compensation Statistics, 2015-2019

The Bureau of Labor Statistics (BLS) includes nearly every U.S. state and territory in its annual workers’ compensation statistical report. This yearly report shows the total workers’ compensation claims filed, how many employees changed jobs or missed work, and each job sector’s individual claims data. See how the South Carolina workers’ compensation program changed from 2015-2019 below:

As you can see, total claims changed very little over this five-year period. Each year, service-industry employees make up nearly 3 in 5 workers’ comp claims filed in this state (55%, on average). It’s also striking that most injured workers applying for South Carolina workers’ compensation also qualified for lost-wage benefits. If you don’t need more than a week to recover after your accident, your employer only pays your medical bills. However, 56% of workers’ comp claimants qualified for weekly lost-wage payments during this five-year period.

You May Qualify for Legal Assistance

Under South Carolina state law, you must return for light-duty work if the doctor orders you to do so. If you refuse, then your employer’s insurer doesn’t have to pay you any workers’ comp benefits. Even if going back to work makes your injury or illness worse, you cannot turn work down. You also cannot switch doctors without the insurance company’s permission. If they say no, then you must pay $50 and wait 90 days for a hearing before the Commission. And if you have any pre-existing health conditions, you’re also much less likely to qualify for workers’ comp!

These are just a few reasons we strongly recommend talking to a local workers’ comp attorney about your case. Sign up for a free phone call today to get confidential claim advice without leaving your home. Every attorney we can match you with works on contingency. That means if you don’t win a cash settlement, then you pay $0 for legal assistance. And if you do win, then you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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