by Jenny Newman
COLUMBIA, SC – Whether the claim is one you recently inherited or one that has recently become ripe for closure due to a claimant abandoning their claim, closing the file as soon as possible becomes extremely important. This allows for internal claim closure as well as eliminating the need for additional compliance filings with the state. For example, in South Carolina, a Form 18 must be filed every six months to avoid a $200.00 fine assessment, until the Commission closes their file. Closure of a claim can be confirmed by a review of the Commission’s ecase, where the report will state, in red writing, the claim is closed.
As you know, statutes and regulations vary from state to state regarding the procedure to close a claim with any given state’s Workers’ Compensation Commission. Closing a file at the South Carolina Workers’ Compensation Commission requires specific forms be processed to achieve file closure. These forms are mandatory due to statutes and regulations under the SC Workers’ Compensation Act. These forms depend upon the length of time between notice of the accident and present day- especially if temporary benefits (TTD and/or TPD) were paid in a claim. This is due to the requirements of S.C. Code §42-9-260, dictating when and how temporary benefits can be terminated.
Pursuant to §42-9-260, TTD/TPD benefits can be terminated by filing a Form 15, section II. You must file the Form 15 within 150 days’ notice of an accident. The date for notice of the accident can be found on the 12A (FROI) in the box titled, “Occurrence/treatment” on the far righthand side of the form. However, if you are attempting to close a file after the 150 day deadline, and temporary indemnity benefits were paid to the claimant, the claim can be difficult to close. After 150 days’ notice of an accident, S.C. Code §42-9-260(F) requires either: (1) a Form 17, signed by the Claimant is filed with the Commission; or (2) an Order from the SC Commission, certifying the Form 17 has been granted. If the claimant has abandoned their claim and is no longer responding to correspondence, securing a signed Form 17 is likely impossible. Therefore, defendants must file for a hearing to certify the Form 17. This requires retaining a lawyer as a Form 21 must be filed with the Commission.
When determining what forms need to be filed in South Carolina to obtain Commission file closure, the following questions need to be answered:
(1) Am I within 150 days’ notice of the accident? This is slightly less than 5 months.
a. If so, the claim can be closed by filing a form 19, with correspondence to the claimant with a brief explanation as to why the claim is being denied. A simple sentence stating they have abandoned their claim will suffice. You will need to provide a copy of this letter to the SC Commission, along with the Form 19. You will need to mark the box “Case Denied” on the lefthand side of the Form 19 (in the middle of the form) as you are denying the claim due to claimant’s abandonment. You will need to sign and date the Form 19 as the employer’s representative, but you do not need the claimant’s signature.
b. If not, but no temporary benefits were paid (TTD/TPD), then you can file the Form 19 as described in 1(a) above.
(2) Were temporary benefits paid (TTD or TPD)?
a. If not, you can file the Form 19, according to 1(a) above.
b. If so, confirm a Form 15, section I was filed with the Commission noting the date TTD/TPD payments began. Then confirm a Form 15, section II was filed with the Commission confirming the date TTD/TPD stopped and the reason why, using the boxes located in section II of the form. If these forms were not filed, but you are within 150 days of notice of the accident, you can still file these forms with the SC Commission. Please note, you will need to sign the Form 15, section II and provide a copy of the same to the claimant as service. You can then file a Form 19, according to 1(a) above.
c. If so, and you are outside of the 150 day deadline, confirm either a signed Form 17 was filed with the Commission. If there is no Form 17, signed by the claimant, a Form 21 must be filed with the Commission to certify a Form 17. This will require retaining a lawyer.
Knowing which forms to file for any jurisdiction can be tiresome. If you have questions regarding how to close a SC Workers’ Compensation file and which forms are required, contact Jenny Newman at [email protected] or 803.227.2889.