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Name: Employer's Name: Address: Address: City: State: Home Phone: Zip: City: Work Phone: State: Zip: Carrier: Preparer s Phone #: Preparer's Name: A claim for workers compensation benefits is made based on the following grounds: Injury Illness Repetitive Trauma 1. Compensation Rate: 2. AWW: $ Date of Injury: 3. Type of injury and body part(s): 4. Facts in controversy: 5. Legal issues involved: 6. Unusual aspects: 7. Witnesses (designate if expert):* 8. Exhibi.

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If you are entitled to temporary total compensation you will receive 66 2/3% of your average weekly wages based on the four quarters prior to your injury but no more than the maximum average weekly wage determined yearly by the South Carolina Department of Employment and Workforce.

Permanent Partial Disability (PPD) The length of time for which you may receive PPD benefits for lost wages (two-thirds of your salary) depends on your specific disability: Loss of up to 49% of the use of your back: 300 weeks. Loss of one arm: 220 weeks. Loss of one leg: 195 weeks.

The report [PDF] shows a downward trend in employers' overall workers' comp costs. The costs per $100 in covered wages decreased in every state between 2016 and 2020....The highest workers' comp rates by state jurisdiction are: Wyoming: $1.78. Alaska: $1.74. Hawaii: $1.69. Montana: $1.64. South Carolina: $1.55. Idaho: $1.47.

Exemptions: Casual employees; businesses employing less than 4 employees or businesses with an annual payroll of less than $3,000.00; agricultural employees; a state and county fair association; railroads and railway express companies; and federal employees.

Compensation Rate . , “salary rate”, or “pay rate” shall mean a set dollar amount used as the basis for compensating an employee for working a given period of time.

How to File for Workers' Compensation in South Carolina Step #1 – Report All Injuries Immediately to Your Employer. Step #2: Ask Your Employer to Cover Your Medical Treatment and File a Workers' Comp Claim. Step #3: Consider Filing a Claim or Requesting a Hearing with the South Carolina Workers' Compensation Committee.

Once you have the average weekly rate, you need to multiply it by 66 ⅔ percent to get the compensation rate. So in our example, Worker x makes $500 as his average weekly rate, so we need to multiply that by 66 ⅔ percent. So: $500 x 66 ⅔ percent = $333, rounded to the nearest dollar.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232