South Carolina Workers’ Compensation Benefits Claim Process

Important: We updated this article in October 2023 to make sure all info below is both current and correct. Every state has its own unique process in place for handling workers’ compensation insurance claims. Anyone in the Palmetto State who gets hurt or sick on the job should follow the steps below to apply for workers’ compensation. You’ll also see an interactive chart showing South Carolina workers’ compensation program statistics from 2017 to 2021.

Which Employers Must Provide South Carolina Workers’ Compensation Insurance Coverage?

State law requires all South Carolina businesses with four or more employees to carry workers’ compensation insurance. Plus, workers’ compensation insurance in South Carolina provides benefits to both full and part-time employees. (This workers’ comp insurance coverage also applies to small family-run businesses that only employ other relatives.) In addition, subcontractors should have workers’ comp coverage under a general contractor’s policy unless they elect to buy individual policies for themselves.

However, South Carolina law automatically exempts the following from workers’ compensation coverage:

• Federal employees (i.e., postal workers, VA employees)
• Railroad/railway express workers
• Independent contractors
• Sole proprietors
• Agricultural employees 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 South Carolina businesses with less than $3,000 the previous year in annual payroll spending
• Owner-operator vehicle drivers (i.e., Uber or Lyft drivers or long distance truck drivers)

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 employer about your work related 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’ comp claim is two years from your injury date.

2. Your employer choses which doctor, hospital, or healthcare provider network may provide your medical treatment. For serious or life-threatening on-the-job injuries, go to the ER or nearest hospital first instead.

If you see your own doctor after a work accident, your employer’s insurance company won’t cover those medical expenses. Seeing your company’s preferred doctor is the only way to make sure South Carolina workers’ compensation insurance pays those 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 15 where it says, “I am filing a claim.” Then, file the completed form directly with the Commission no more than 2 years after your incident date.

4. Workers’ comp insurance only pays medical benefits, not paid time off, until an injured employee misses 7 work shifts.

Workers’ compensation insurance won’t pay for your first 7 days of time off unless you miss more than 2 weeks. South Carolina law says that first week is always unpaid time off until after the 14th day you cannot work. This type of weekly compensation is called “lost time benefits.”

If your workers’ comp doctor says you’re unable to work that long, then your employer must cover that first week off. South Carolina workers’ compensation pays no more than $1035.78 per week for up to 500 weeks in 2023.

In most cases, however, you’ll receive benefits equal to 66 2/3% of the state’s average weekly wage.

5. If your employer’s insurance company denies your workers’ compensation claim, you have 14 days to appeal.

Complete Form 50 and check box 16 to request a hearing, then pay $50 to file it with the Commission. It currently takes 32 days to process appeal request and 94 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

The Bureau of Labor Statistics (BLS) includes nearly every U.S. state and territory in its annual workers’ compensation report. This yearly report shows the total workers’ compensation claims filed, how many injured workers changed jobs or missed work, and claims data for each job sector. See how South Carolina workers’ compensation changed from 2017 to 2021 below:

As you can see, South Carolina employees filed far fewer claims in 2020 and 2021 (down 13% compared to 2019’s peak). Each year, service employees make up nearly 3 in 5 workers’ comp claims filed in South Carolina. In fact, most injured workers filing for South Carolina workers’ compensation also got paid lost wages. If you don’t need more than a week off, workers’ comp coverage only pays your medical bills, not lost wages.

How to Get Free Expert Help Securing Workers’ Comp Benefits

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 insurance doesn’t have to pay you any additional compensation. Even if going back to work makes your work related injury worse, you cannot turn it 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 preexisting health conditions, you’re far less likely to qualify for benefits!

These are just a few reasons we recommend talking to a local workers’ comp attorney about your case. Sign up for a free phone call today to get answers to all your questions without leaving your home. Every attorney we can match you with works on contingency. That means if your employer doesn’t pay you a lump sum award, then you pay $0 for legal expenses. And if you do win, then you’ll only pay one small fee.

Want free expert help with your own claim? Click the button below to start your free online benefits quiz now and see if you may qualify:

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