Wcc Form 18 PDF Details

When navigating the complexities of workers' compensation in South Carolina, the WCC 18 form plays a pivotal role. Positioned at the heart of the Workers’ Compensation Commission's procedural framework, this document serves a multifaceted purpose. It meticulously records crucial details about a worker's compensation claim, ranging from the claimant's personal information to specifics about the compensation received. This includes the claimant’s Social Security Number, both the employer’s and the injured worker’s addresses, and contact details, as well as comprehensive data on the injury itself—such as the date of injury, the total weeks of compensation paid, and the type of compensation. Additionally, it requests information about the first payment date and the total amount paid, covering compensation and medical expenses alike. Critical to the form’s utility is the section where employers can request an informal conference, providing a structured pathway toward resolving disputes or ambiguities in the claim process. With bi-annual filings required from the date of the alleged injury until the Commission's file is closed, the form remains an essential tool for ensuring continuous communication and proper handling of workers' compensation claims in South Carolina. Presented in a format encouraging clarity and precision, the WCC 18 form exemplifies the state's commitment to safeguarding the well-being of its workforce through administrative diligence.

QuestionAnswer
Form NameWcc Form 18
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesClaimant, Commissions, yyyy, TP

Form Preview Example

South Carolina Workers’ Compensation Commission

 

 

 

 

 

 

 

 

 

 

 

 

WCC File #:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Carrier File #:

 

 

 

 

 

1333 Main Street, Suite 500

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.O. BOX 1715

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Carrier Code #:

 

 

 

 

Columbia, SC 29202-1715

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(803) 737-5723

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer FEIN #:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claimant's Name:

 

 

 

 

 

SSN:

 

-

-

 

Employer's Name:

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

State:

 

Zip:

City:

 

State:

Zip:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home Phone:

 

Work Phone:

 

 

 

 

 

 

 

Insurance Carrier:

 

 

 

 

 

 

 

 

 

 

Preparer’s Name:

 

 

 

 

Law Firm:

 

 

 

 

 

 

Preparer’s Phone #:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Date of injury:

 

 

 

 

 

 

 

2. Total Weeks Compensation Paid:

 

 

 

 

 

(m/d/yyyy)

 

 

 

 

 

3.

Type of Compensation Paid (TP or TT)/Periods of Payment:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(m/d/yyyy)

 

 

(m/d/yyyy)

 

Type:

 

 

 

 

From:

 

 

To:

 

 

 

Type:

 

 

 

 

From:

 

 

To:

 

 

 

Type:

 

 

 

 

From:

 

 

To:

 

 

4.

Date of First Payment:

 

 

 

 

 

 

 

 

 

 

 

(m/d/yyyy)

 

 

 

 

 

5.

Total Amount Paid

(a) Compensation:

 

$

 

 

 

 

 

(b) Medical (Include Nursing, Hospital, Drugs, Etc.):

 

$

 

 

 

6. Informal Conference is Requested:

Yes

No (check one)

Use these lines to send a memo to the Commission:

Employer’s Representative

 

Phone

 

Date

Type or print all information. File this form six months after the alleged injury date and each six months until the Commission’s File is closed. Form 18 must be filed whether or not compensation is ongoing. Check “yes” after Number 6 to request an informal conference. Refer to R.67-

413, R.67-507, and R.67-804 for further information.

WCC Form # 18

18

Periodic Report

Rev. Date 3/96

 

 

 

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Completing this document requires attention to detail. Ensure that all required blanks are filled in accurately.

1. The south carolina worker's compensation form 18 will require specific information to be typed in. Ensure that the subsequent blank fields are complete:

Simple tips to prepare Preparers stage 1

2. Your next part is to submit these blank fields: Type, From, Date of First Payment, mdyyyy, Total Amount Paid, a Compensation, b Medical Include Nursing Hospital, Informal Conference is Requested, Yes, No check one, Use these lines to send a memo to, Employers Representative, Phone, and Date.

Writing part 2 of Preparers

People who use this form often get some points wrong when filling out From in this part. Be sure to double-check whatever you enter right here.

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