S.C. Code Regs. 67-206 - Filing a Claim
A. To
file a claim, file with the Commission's Claims Department a Form 50, Form 52,
or a letter as provided below.
B.
To file a claim on a Form 50 or Form 52, mark the box at the signature line
which states "I am filing a claim. I am not requesting a hearing at this time."
(1) Address and deliver the form to the
Claims Department.
(2) Filing a
claim requires the WCC file number or the Coverage Coding Form 39 must be
included. This requirement may be waived for unrepresented claimants.
(3) Filing a claim does not request a hearing
nor is the employer's representative required to file a Form 51 or
53.
C. A letter filed
with the Commission also files a claim. The letter should include the
information listed in items (1) through (13) below:
(1) Claimant's name (and worker's name, if
different);
(2) Claimant's address
(and worker's address, if different);
(3) Claimant's home and work telephone
numbers (and worker's home and work telephone numbers, if different);
(4) Claimant's social security number (and
worker's social security number, if different);
(5) Employer's name;
(6) Employer's address;
(7) Employer's telephone number;
(8) Employer's insurance carrier, if
known;
(9) Date of
injury;
(10) The county in which
the injury occurred;
(11) Type of
injury (to which area of body);
(12) Description of the accident;
(13) The WCC file number or Coverage Coding
Form must be included.
D. Failure to include any of the information
above does not bar the claim if the information necessary to an issue in the
claim is given to the Commission upon request.
E. The Commission will notify the employer's
representative a claim has been filed. The employer's representative shall
immediately contact the claimant.
Notes
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