SSA - POMS: DI 52120.225 - South Carolina Workers’ Compensation (WC)

A. Types of South Carolina (SC) WC payments

There are four types of WC payments for SC WC claims:

1.

Permanent Total (PT),
2.

Temporary Total (TT),
3.

Permanent Partial (PP), and
4.

Temporary Partial (TP)

SC also pays disfigurement benefits. For rules on disfigurement benefits, see DI 52120.225B.2 in this section.

B. SC Payment Provisions

1. Payment provisions

For all types of payments other than disfigurement, SC will pay two-thirds of the worker’s average weekly wages.

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The State maximum limits the payments, which change yearly. For a list of the SC State maximums, visit the website.
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The maximum period to pay for PP and TP benefits is 340 weeks.
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The maximum period to pay for all other PT and TT benefits is 500 weeks.

NOTE: Any worker who has a compensable injury and is a paraplegic, quadriplegic, or has suffered physical brain damage shall receive benefits for life.

2. SC disfigurement benefits

SC law covers disfigurement that is serious and permanent of the:

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face,
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head,
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neck, or
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other area normally exposed in employment.

NOTE: SC disfigurement benefits are offsettable as WC. Disfigurement benefits pay for a maximum of 50 weeks.

SC does not allow the payment of disfigurement benefits if the individual is receiving time loss payments, with one exception.

EXCEPTION: SC WC law allows for simultaneous payment of time loss and a disfigurement benefit for serious burns and keloid scars.

3. SC WC lump sum (LS) settlement payments

a. LS settlement agreements

A change to SC WC laws and regulations relating to LS settlements took place in July 2007.

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For injured workers who have attorney representation, the SC WC Commission no longer requires its signoff of approval. The attorney must file the settlement agreement with the SC WC Commission.
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Workers who do not have attorney representation must receive signoff approval from one WC Commissioner before they can finalize their settlement. Once finalized, we can consider this as valid proof for our offset purposes.

b. LS appeals

SC WC laws and regulations relating to LS appeals are as follows:

1.
The SC WC Commission can review the LS settlement within 14 days of the award. If not reviewed, the award will become binding in 30 days from the date of the award unless the injured worker files an appeal:
- •
  
  to the Court of Common Pleas for accidents occurring before 07/01/2007; or
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  to the SC Court of Appeals for accidents occurring on or after 07/01/2007.
2.

The Commission may review cases for up to one year from the date of the last payment of compensation when there is a change in the condition.

c. Offset procedures for LS

Keep in mind the following offset rules for LS settlements:

1.

SC law limits LS awards for PT and TT benefits to 500 weeks.
2.

SC WC Commission can award lifetime benefits to paraplegic, quadriplegic, or brain damaged individuals, but the Commission cannot pay the benefits as LS.
3.
SC orders may specify awards that exceed the 500-week limit despite the 500-week limit imposed by SC law. In these cases:
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  Impose offset based on the rate specified in the settlement documentation per DI 52150.060.
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  If the settlement specifies a life expectancy rate, use the life expectancy rate to prorate.
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  Use the gross amount before any expenses to calculate offset.

NOTE: Some SC settlement documents may indicate that the prior periodic payments are part of the overall award and request prorating at a life expectancy rate along with the LS. This language does not bind us. Only LS settlements are subject to life expectancy proration.

If a subsequent addendum stipulates a different rate than that in the initial award, refer to the policies and procedures in DI 52150.065.

C. Opt-Out statute

1. Law in effect June 18, 1996

Effective 06/18/1996, SC law requires all employers and employees to begin participation in the State’s WC system by 07/01/1997.

WC insurance is required of employers who employ four or more workers. Exceptions to this rule:

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Agricultural employees;
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Railroads;
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Railway express companies and their employees;
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Employers with a total annual payroll of less than $3000 during the previous year;
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Textile Hall Corporation; and
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Certain commission paid real estate agents.

2. Law prior to June 18, 1996

Prior to 06/18/1996, employers and employees in SC were not required to participate in the State’s WC system. Employees could elect not to participate and if injured, the employee would not receive WC benefits. The employee still held the right to sue the employer for issues such as negligence, etc.

Some companies created their own plans that provided benefits to employees injured on the job. Payments made under such a plan are not subject to offset.

D. Cost-of-living Adjustments (COLA)

SC does not provide a cost of living increase. The periodic payment amount awarded will not change for the duration of the claim.

E. Attorney fees

SC WC laws determine attorney fees on a case-by-case basis.

F. Retirement Insurance Benefit (RIB) considerations

SC WC does not offset due to the receipt of RIB.

G. References

South Carolina’s Workers’ Compensation site

DI 52150.045 Chart of States’ Maximum WC Benefits

DI 52150.060 Prorating a WC/PDB Lump Sum Settlement

DI 52150.030 Considering the RIB Option

DI 52150.050 Excludable Expenses

DI 52150.065 Complex Lump Sum (LS) Awards and Settlements

PR 02505.045 South Carolina

Social Security

Program Operations Manual System (POMS)

DI 52120.225 South Carolina Workers’ Compensation (WC)