Get South Carolina Workers Compensation

This guide provides clear instructions on filling out the South Carolina Workers Compensation form online. By following these steps, users can efficiently complete the process to receive the support they need after a workplace injury.

Follow the steps to complete the South Carolina Workers Compensation form online.

1. Press the ‘Get Form’ button to access the South Carolina Workers Compensation form. Open it in your chosen digital platform.
2. Begin by entering the claimant's name in the designated field. Ensure that the name matches the legal documents.
3. Fill in the Carrier File number and Carrier Code number. These identifiers help in processing the claim efficiently.
4. Input the Employer FEIN number in the respective field. This is the Federal Employer Identification Number required for employer identification.
5. Enter the claimant's social security number (SSN). Keep this information confidential to protect personal data.
6. Provide the employer's name in the corresponding field, ensuring accuracy in business naming.
7. List the employer’s address including street address, city, state, and zip code in the specified sections.
8. Record the home phone number followed by the work phone number to facilitate communication.
9. Indicate the insurance carrier’s name in the designated area.
10. Enter your name and phone number if you are the preparer of the form.
11. Fill in the date of injury by selecting the month, day, and year appropriately.
12. Complete the section on total wages paid according to the method that applies to the injured employee, checking the appropriate box.
13. List total wages earned as reported to the Employment Security Commission from the past four quarters in the respective fields.
14. Add up the total wages paid, and record the total in the last box of this section.
15. Report the total value of other allowances made to the employee in lieu of wages.
16. Add the total wages paid and other allowances together, entering the sum in the designated field.
17. Indicate the total number of weeks the employee was paid during the four quarters prior to the injury.
18. Calculate the average weekly wage by dividing the total from the previous step by the number of weeks paid.
19. Determine the compensation rate based on the average weekly wage using the outlined calculations.
20. Ensure all sections of the form are thoroughly reviewed for accuracy before proceeding.
21. Once completed, you can save the changes, download, print, or share the form as needed.

Complete your South Carolina Workers Compensation document online for efficient processing and support.