Wcc Form 18 PDF Details

Wcc form 18 is a document that is used to request transcripts from the college. The form can be filled out and submitted online, or in person. There are several ways to obtain a copy of your transcript, including mailing, faxing, or picking up in person. Transcripts can also be ordered online. There is a $5 fee for each transcript requested. Transcripts will not be released if you have any outstanding financial obligations to the college.

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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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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