South Carolina workers' compensation is governed by Title 42 of the Code. Claims and disputes go to the South Carolina Workers' Compensation Commission. South Carolina is not monopolistic. Employers insure with authorized carriers, qualify to self-insure, or join a group self-insurance fund. The standard policy, rating basics and federal programs are in the national Workers Compensation guide.

Who must be covered

• The law applies to private employers that regularly employ four or more employees (42-1-150).
• Exempt (42-1-360):
  • Employers with fewer than four employees, or less than $3,000 in total payroll the previous year.
  • Agricultural employers, unless they elect coverage.
  • Railroad employees.
  • Federal employees.
  • Real estate salespeople on straight commission with an independent contractor agreement.
• Employment that is both casual and outside the employer's business isn't covered (42-1-130).
• An exempt employer may elect coverage by written notice to the Commission, effective 30 days later (42-1-380).
• A sole proprietor may elect coverage by notifying the insurer.
• Employers and employees are presumed to accept the law (42-1-310).
• Exclusive remedy: a covered employee can't sue the employer at common law for the injury (42-1-540).

Securing coverage (42-5-20)

• Insure with an authorized carrier or qualify to self-insure.
• Group self-insurers are regulated by the Workers' Compensation Commission. They aren't protected by the P&C Insurance Guaranty Association.
• Failing to secure coverage (42-5-40):
  • A fine of $1 per employee per day, at least $10 and no more than $100 a day.
  • The employer can be sued at law and loses certain defenses.
• Workers of uninsured employers are paid by the Workers' Compensation Uninsured Employers' Fund. Since July 1, 2013 it has been administered by the State Accident Fund, and it has a lien on the employer's assets (42-7-200).

Compensable injuries

• An injury by accident arising out of and in the course of employment (42-1-160).
• Mental injury without physical injury is compensable only if the job conditions were extraordinary and unusual. Stress from routine discipline or evaluations doesn't qualify.
• Not payable for injury or death caused by intoxication. The party asserting that defense has the burden of proof (42-9-60).
• Occupational disease (42-11-10):
  • Must be peculiar to the occupation, from hazards beyond those ordinarily incident to employment.
  • Ordinary diseases of life and diseases from outside climatic conditions are excluded.

Notice and claims

• Notice to the employer: within 90 days of the accident (42-15-20).
• Filing: with the Commission within 2 years of the accident. For occupational disease, the clock starts when the employee is definitively diagnosed and told (42-15-40).
• Where to file: the state where the worker was hired, employed or injured (42-15-10).
• Early payments: an employer may pay temporary disability for up to 150 days without waiving good-faith grounds for denial (42-9-260).

Benefits

Medical care (42-15-60, 42-15-70)

• Reasonable treatment for up to 10 weeks, longer if the Commission finds it will lessen disability.
• For life for total and permanent disability.
• Refusing treatment suspends compensation.
• Malpractice by an employer-provided physician is treated as part of the work injury.

Common exam traps

• Four or more employees, and at least $3,000 in payroll, bring an employer under the law.
• Notice in 90 days; file in 2 years.
• Waiting period: 7 days, paid back once disability lasts more than 14.
• Total disability: 500 weeks. Unscheduled partial disability: 340 weeks. A hand: 185 weeks.
• Uninsured employer: the Uninsured Employers' Fund, run by the State Accident Fund, pays.
• Mental-only injury requires extraordinary and unusual conditions.