S.C. Code Regs. 67-804 - Informal Conference

A. Appearances at Informal Conferences.

(1) A claims mediator may appear on behalf of a Commissioner at an informal conference when the purpose of the informal conference is to:

(a) review a proposed Form 16 or Form 16A settlement when the total amount of medical benefits paid is below the threshold amount established by the Commission; or

(b) certify a Form 17.

(2) A Commissioner shall preside over an informal conference when the purpose of the informal conference is to:

(a) approve a settlement in the form of a full and final Agreement and Release made pursuant to Section 42-9-390; or

(b) approve a proposed Form 16 or Form 16A settlement when the total amount of medical benefits paid meets or exceeds the threshold amount as established by the Commission.

The Commissioner may, in the Commissioner's discretion, preside over an informal conference that does not fall under items (a) or (b).

(3) An insurance adjuster licensed by the South Carolina Department of Insurance in accordance with Chapter 47 of Title 38, South Carolina Code of Laws, may appear on behalf of an employer or insurance company at an informal conference when the purpose of the informal conference is to:

(a) review a proposed Form 16 or Form 16A settlement when the total amount of medical benefits paid is below the threshold amount as established by the Commission; or

(b) certify a form 17.

(4) An attorney licensed in this State or admitted in accordance with R.67-1201C shall appear on behalf of an employer or insurance company at an informal conference when the purpose of the informal conference is to:

(a) approve a settlement in the form of a full and final Agreement and Release made pursuant to Section 42-9-390; or

(b) approve a proposed Form 16 or Form 16A settlement when the total amount of medical benefits paid meets or exceeds the threshold amount as established by the Commission;

The Commissioner may deem it prudent for an attorney to appear at an informal conference that does not fall under subsections (a) or (b) according to the Commissioner's discretion.

B. An informal conference is defined in R.67-202(8).

C. Requesting an Informal Conference.

(1) A party requesting an informal conference shall (a) write the Commission's Judicial Department requesting that an informal conference be set, and (b) upload an updated Form 18 or the EDI equivalent Sub Annual (SA) Periodic Report showing the status of payment of temporary compensation, if any, and medical expenses.

(2) Upon receipt of a request for an informal conference the Commission shall review the Commission's file for required reports. The employer's representative must ensure that the following reports are in the Commission's file before the informal conference is held, or the employer's representative may be subject to a fine.

(a) Form 14B, if applicable; and

(b) Form 15, if applicable; and

(c) Form 17, if applicable; and

(d) Form 20, if applicable; and

(e) All medical reports required by R.67-1301; and

(f) An authorized health care provider's report stating the claimant has reached maximum medical improvement and an impairment rating, if any; and

(g) An amputation chart, if applicable.

D. The claimant may request an informal conference by writing the Commission's Judicial Department and stating whether the parties propose to settle the claim on a Form 16, a Form 16A, or by Agreement and Final Release.

E. An informal conference may be held with less than thirty days' notice to the parties. The conference shall be held at a hearing site as designated by the jurisdictional commissioner. If the parties request in writing to convene the conference at a different hearing site, all parties agree, and the request is received before the hearing notice for the conference is issued, the request may be approved administratively.

F. Only a Commissioner is authorized to approve a Form 16, a Form 16A, or an Agreement and Final Release.

G. When the claimant fails to appear at an informal conference, the Commission shall reschedule the conference.

(1) If the claimant fails to appear twice, the claim shall be removed from the informal conference roster and administratively dismissed.

(2) The claimant may request the Commission to schedule another informal conference and the Commissioner assigned to the claim may, if a good cause is shown, allow the claimant to proceed with his or her claim.

H. If the employer's representative or an attorney, if any, fails to appear at the informal conference, the Commission shall reschedule the conference. The Commissioner assigned to the claim may assess against the employer's representative or an attorney, if any, the actual costs of the conference as established by the Commission.

I. If the parties fail to reach an agreement at the informal conference, or the proposed Agreement and Final Release is not approved, the Commission shall set the claim on the contested case hearing docket. A Form 50 or Form 52 is not required, but if filed, the opposing party must respond pursuant to R.67-603.

J. Either party may request postponement of the informal conference by writing either the Commissioner whose name appears on the informal conference notice or the Judicial Department. The Commissioner may reschedule the conference during the term the Commissioner is in the district. If the Commissioner cannot reschedule the conference during his or her term in the district, the Commission must reschedule the conference, unless otherwise agreed to by the parties or ordered by the Commission.

Notes

S.C. Code Regs. 67-804

Amended by State Register Volume 20, Issue No. 5, eff May 24, 1996; State Register Volume 21, Issue No. 4, eff April 25, 1997; State Register Volume 22, Issue No. 6, Part 3, eff June 26, 1998; State Register Volume 34, Issue No. 2, eff February 26, 2010; State Register Volume 42, Issue No. 02, eff. 2/23/2018.