Header
Form identifier, Commission case number (if available), and filing type (initial claim, amendment, settlement). A clear header helps Commission clerks route the document correctly.
A correctly completed Commission filing preserves benefit rights, shortens adjudication, and supports medical authorization. Complete forms reduce delays, limit disputes about compensability, and create a clear record for hearings or settlement negotiations under South Carolina law and Commission rules.
The filing is used by employees, employers, medical providers, and legal representatives to start or respond to a workers' compensation claim with the South Carolina Workers' Compensation Commission.
Each party has specific sections and deadlines; follow Commission instructions and retain copies of submitted documents for your records.
Form identifier, Commission case number (if available), and filing type (initial claim, amendment, settlement). A clear header helps Commission clerks route the document correctly.
Full legal name, SSN, contact information, occupation, and employment dates. Accurate claimant data enables timely benefit calculations and contact for hearings.
Employer legal name, address, insurer information, and employer representative contact. Carrier identification ensures benefits or denials are processed by the correct party.
Concise factual account of the injury event, date, location, and body parts affected. Clear narratives reduce follow-up questions and expedite preliminary determinations.
Treatment dates, provider names, diagnostic codes, and functional status. Medical documentation supports compensability, work restrictions, and estimate of disability.
Claimant, employer representative, and preparer signatures with dates. Signed forms establish consent and attribution under ESIGN and UETA frameworks when e-signed appropriately.
| Field | Configuration |
|---|---|
| Signature Field | Require signer name and date; allow typed or drawn signatures |
| Authentication | Use email + SMS or stronger ID verification for sensitive filings |
| Routing | Set sequential signing order: claimant → employer → carrier |
| Retention | Automatically save signed PDF and audit trail for required period |
Ensure the platform supports secure PDF uploads, audit trails, and required authentication modes before e-filing with the Commission.
Choose a solution that preserves an audit trail (timestamps, IP addresses) and supports long-term storage and retrieval consistent with regulatory retention obligations.
Notify employer as soon as possible after injury; delays can complicate benefits.
File initial claim per Commission guidance; exact deadlines depend on claim facts.
Request prior authorization for ongoing treatment when required by insurer.
File requests for hearings per Commission rules and scheduling windows.
Observe appellate deadlines after Commission decisions to preserve rights.
A laborer slips and fractures a wrist on-site, reported same day
An administrative employee reports progressive wrist pain from repetitive tasks, reported after weeks of symptoms
| Criteria | Workers' Comp Claim | Employer Accident Report |
|---|---|---|
| Purpose | formal claim for benefits | internal incident record |
| Commission Filing | ||
| Medical Evidence Needed | optional | |
| Public Record | often yes | typically internal |
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | 7-day free trial | Varies by vendor | Varies by vendor | Varies by vendor | Varies by vendor |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |
| Envelope Cap | No cap | 100 envelopes/user/year | Varies by plan | Varies by plan | Varies by plan |
A claims examiner or adjuster signs employer responses and acknowledgements on behalf of the insurer. Their signature confirms receipt of evidence, coverage position, and procedural communications during claim administration.
An authorized employer representative or HR official may sign employer filings and attest to payroll and employment facts. Signature authority should be documented to ensure Commission acceptance.