How Does Workers Comp Work in SC? SC Workers’ Compensation Guide

Hurt on the job in South Carolina? If so, you may be wondering: How does workers’ comp work in SC, exactly? Does it pay you to go to the doctor, or just reimburse you for that visit? Can you get paid time off to recover from your work-related illness or injury? And for how long?

Our complete guide below should answer all your questions, including how to get a free, no-obligation claim consultation.

How Does Workers’ Comp Work in SC: Key Takeaways

• Workers’ compensation insurance is required by law for South Carolina employers with four or more employees. If your employer has it, you’re covered starting from your first day at work.
• Once you accept workers’ comp benefits, you cannot sue your employer. You also have a limited amount of time to reopen a closed claim after you’ve settled your case (12 months).
• Injuries and illnesses qualify for workers’ compensation in South Carolina only if they happen under the course and scope of employment. For example: If you get into a fight with a coworker, workers’ comp won’t pay to check for a concussion.
• If you see a doctor before reporting your accident to your supervisor, you may have to pay for that visit yourself. Your employer chooses which doctor you see, and going elsewhere may put your chance for benefits at risk.
• You cannot get pain and suffering money for a work-related injury in SC, according to state law. Instead, workers’ comp in SC mainly pays for medical expenses, lost wages, and permanent disability benefits.

Which SC Employers Must Have Workers’ Compensation Insurance Coverage?

State law requires all South Carolina businesses with at least four employees to carry workers’ comp coverage. This includes full-time and part-time workers starting on day one of employment. The law also covers any relatives working for a family-owned business, even if they receive no job wages. However, some small business owners automatically exempt from this requirement may choose to purchase workers’ compensation insurance.

In addition, the law excludes certain types of employees from this automatic coverage requirement.

Coverage Exemptions Under South Carolina Workers’ Compensation Laws

If any of the following describes your job, you likely do not have workers’ comp coverage:

• Agricultural employees and sellers of agricultural products
• Casual employees
• Certain real estate agents
• Federal employees
• Independent contractor/gig economy workers (i.e., Lyft and Uber drivers, some Amazon delivery drivers and warehouse workers, or anyone who receives a 1099 instead of a w2 at tax time)
• Limited liability corporation (LLC) members and partners
• Railroad and railway express company employees
• Sole proprietors (i.e., people who are self-employed and have no employees)
• Workers employed by companies with less than $3,000 in total annual payroll

Steps for Injured Employees Filing South Carolina Workers’ Compensation Claims

You can confirm whether your employer has insurance using the online workers’ compensation coverage verification search tool. Then, follow the steps below to file for SC workers’ comp benefits:

1. Report your work injury to your employer immediately and ask which doctor is authorized to treat you.

South Carolina workers’ compensation laws give your employer the right to direct your medical care. So, you must tell your manager before you see a doctor unless your life is in danger. If you fail to report your work-related injury within 90 days, you may lose your right to SC workers’ comp benefits.

Important: For life-threatening injuries only, go to the nearest ER or urgent care clinic for medical care.

2. Seek medical treatment from a healthcare provider authorized to treat you by your employer’s insurance carrier.

If you see your own doctor without prior approval, then you may have to pay those medical bills out of your own pocket.

3. Your employer then notifies their insurance company and files Form 50 with the South Carolina Workers’ Compensation Commission to start your claim.

If your employer fails to do this, you can file it with the Commission yourself by emailing it to claims@wcc.sc.gov. Be sure to check box 15 that reads “I am filing a claim” when filling out Form 50 before you sign it. Failing to submit Form 50 to the Commission within the two-year statute of limitations may put your benefits at risk.

Important: To make sure your employer takes this important step, ask for a copy and keep that somewhere safe. You can also call the Commission directly at 1-803-737-5700 to confirm they have your completed form.

4. If the physician clears you to go back to work immediately, then workers’ comp only covers your medical expenses.

Alternatively, the doctor may tell you that you must take time off for your work injury or go back with certain work restrictions.

5. If you’re temporarily written out of work for medical reasons, your first 7 days off are usually unpaid.

Once you’re out for 15 days or more, workers’ compensation pays partial lost wages for that first week you missed work. And if your employer offers you light duty work, you will lose your benefits if you turn it down.

6. Denied benefits? You can also file Form 50 with the Commission’s Judicial Department to appeal that decision.

In this case, you’ll need to check box 16 that says “I am requesting a hearing. A $50 fee is required.” You’ll also need to pay the $50 fee to the Commission to request a hearing and resolve any disputes:

How Does Workers’ Comp Work in SC for Federal Employees?

If you’re a federal employee, then state laws do not apply to your workers’ compensation case. So, the steps shown here, dollar amounts, and benefit types will not apply to your claim. Learn what makes federal claims different and how to apply for those benefits.

Understanding South Carolina Workers’ Compensation Benefits

Which types of workers’ compensation benefits you may qualify for depends on your injury type and recovery timeline. If you can go back to work right away, you’ll only qualify for medical benefits.

Medical Care Benefits

If approved, your employer’s workers’ compensation insurance company will, at minimum, cover your medical expenses, including:

• Doctor’s visits
• Prescription medications
• Surgery and/or hospitalization costs
• Physical therapy
• Mileage and other travel costs required for you to receive proper medical care

The insurance carrier should cover your medical costs until one of the following applies to you:

• The doctor says you’ve reached maximum medical improvement (MMI)
• You’re back at work again full time

Important: After closing your case, you have 12 months to reopen your claim and get additional care if your injury worsens again.

Lost Wages

South Carolina workers’ compensation insurance pays two-thirds of your average weekly wage (AWW) if you qualify for wage loss benefits. While they don’t cover 100% of lost wages, they can help while you take time off to recover. Here are the wage-loss benefit options:

• Temporary Total Disability (TTD). If the doctor says you can’t go back to work right away, you may receive TTD benefits. These payments only last until you go back to work or negotiate a lump-sum settlement. No injured workers can receive more than 500 weeks of TTD benefits, with limited exceptions.
• Temporary Partial Disability (TPD). If you can go back to work but only part time or on light duty, you may qualify for TPD payments. They equal two-thirds of the difference between your pre-injury and post-injury income for up to 340 weeks.
• Permanent Partial Disability (PPD). Once you exhaust TTD benefits and still cannot earn the same amount as before your work-related accident, you may qualify for PPD payments. These pay the same amount as TPD benefits, but for an additional 340 weeks.
• Permanent Total Disability (PTD). These benefits pay the same as TTD payments do, but stop after 500 weeks. To qualify for PTD payments, your work-related injury or illness must make it impossible for you to ever work again.
• Lifetime permanent disability benefits. If you’re permanently disabled by a work injury, you may qualify for lifetime permanent disability benefits:

(C) Notwithstanding the five-hundred-week limitation prescribed in this section or elsewhere in this title, any person determined to be totally and permanently disabled who as a result of a compensable injury is a paraplegic, a quadriplegic, or who has suffered physical brain damage is not subject to the five-hundred-week limitation and shall receive the benefits for life.

– SC Code Section 42-9-5(C)

Permanent Injury Settlements

According to South Carolina Code Title 42, Chapter 9, Section 42-9-10, you can receive a lump-sum settlement on your claim in certain cases. This usually happens after you receive TTD benefits for six months or reach maximum medical improvement (whichever comes first). Lump-sum settlements for permanent disabilities can include all the following injuries:

• Loss of both hands, arms, shoulders, feet, legs, or hips
• Permanent loss of vision in both eyes
• Any combination of two things listed above

Important: If you are entitled to lifetime benefits, the Commission is forbidden under state law from paying you a lump-sum settlement.

Death Benefits

When an employee dies in a fatal workplace accident or from their on-the-job injury, their family may be eligible for death benefits. These can include:

• Up to $12,000 for funeral and burial expenses
• Two-thirds of the deceased worker’s AWW in death benefits paid for no more than 500 weeks to eligible survivors

How Does Workers’ Comp Work in SC if I’m Undocumented?

If you work here as an undocumented migrant, you are still eligible for workers’ comp in South Carolina. The only requirements are that you must be an eligible employee and your work-related injury must happen while working.

Sign Up Here to Get a Free Case Evaluation Today

Since you can only seek medical care from a doctor your employer chooses, the system may seem rigged against you. If you’re denied benefits, consider hiring a workers’ compensation lawyer during the average 96-day wait for your appeals hearing.

Every workers’ comp lawyer in our network offers free, confidential phone calls to discuss your case details. And these attorneys also offer some of the most affordable contingency-based legal help.

LegalASAP’s network includes hundreds of law firms throughout the United States, ready to answer your legal questions.

Ready to see if you may qualify for workers’ compensation benefits? Click below or call 1-888-927-3080 to start your free evaluation and get the help you need today: