South Carolina Code of Regulations › Chapter 67 - SOUTH CAROLINA WORKERS' COMPENSATION COMMISSION › Article 2 - GENERAL › Section 67-202 - Words and Phrases, Defined

Current through Register Vol. 48, No. 6, June 28, 2024
A. The definition of words and phrases used
			 in this Chapter include:
(1) Accident
			 Reporting Division: A division of the Commission responsible for receipt and
			 processing of the employer's first report of injury, Form 12A (ACORD 4) and
			 Form 12M.
(2) Certified Mail: Mail
			 including that which is certified by the U. S. Postal Service and that carried
			 by a commercial carrier that keeps proper documentation.
(3) Claimant: The party making a claim
			 including his or her attorney.
(4)
			 Claims Department: A department of the Commission responsible for managing the
			 workers' compensation file. The department reviews case files that are not
			 contested and assures compliance with the provisions of this Chapter and the
			 Act by requesting and, if necessary, assessing a fine for failure to file
			 reports required by this Chapter and the Act.
(5) Compliance Division : A division of the
			 Commission responsible for investigation and, if necessary, requests
			 prosecution of an employer who refuses or neglects to comply with the insurance
			 provisions of this Chapter and the Act. The division is authorized to request
			 and, if necessary, assess a fine for failure to file reports required under
			 this Chapter and the Act.
(6)
			 Coverage Division: A division responsible for monitoring and maintaining
			 coverage records of employers, employees, insurance carriers, self-insurance
			 funds, and the State Accident Fund's compliance with the Chapter and the Act.
			 The division is authorized to request and, if necessary, assess a fine for
			 failure to file reports required under this Chapter and the Act.
(7) Employer's Representative.
(a) The employer's insurance carrier, the
			 claims administrator for a self-insurance fund or a self-insured employer, the
			 State Accident Fund, and counsel of record for the employer and its insurance
			 carrier.
(b) If an employer is
			 operating as an unqualified self-insured, the term "employer's representative"
			 shall mean the unqualified self-insured employer and its attorney, if any, who
			 shall be directly responsible for compliance with the provisions of this
			 Chapter and the Act.
(8)
			 Federal Employer Identification Number: "FEIN."
(9) Informal Conference: Also called a
			 "viewing," an informal conference is a meeting with the claimant, the
			 employer's representative, and a Commissioner or claims mediator. At the
			 informal conference, the Commissioner or claims mediator answers questions
			 about the claim and reviews, for approval, a proposed settlement of a claim. An
			 informal conference may be held for the purpose of certifying a Form 17
			 according to R.67-505E
			 and R.67-506F.
(10) Judicial
			 Department: A department of the Commission which assigns the informal
			 conference, contested case, and Commission review docket and issues the hearing
			 notice. The department reviews the Commission's files and assures compliance
			 with the provisions of this Chapter and the Act by requesting and, if
			 necessary, assessing a fine for failure to file reports required by this
			 Chapter and the Act.
(11) Medical
			 Services Division: A division of the Commission which administratively reviews
			 physician fees and hospital charges to assure compliance with the Medical
			 Services Provider Manual and the Hospital and Ambulatory Surgery Center Payment
			 Manual.
(12) Public Affairs
			 Division: A division of the Commission responding to the general inquiries of
			 employees and employers concerning their rights, benefits, and obligations
			 under the Act. The service does not provide legal advice or offer opinions
			 concerning a particular claim.
(13)
			 Self-Insurance Division: A division of the Commission which monitors the
			 compliance of self-insured employers and self-insurance funds with this Chapter
			 and the Act. The division reviews applications to self-insure and is authorized
			 to request and, if necessary, assess a fine for failure to file reports
			 required under this Chapter and the Act.
(14) South Carolina Workers' Compensation
			 Commission: the Commission.
(15)
			 Unqualified Self-Insured Employer: An employer who refuses or neglects to
			 comply with the insurance provisions of this Chapter and the Act.
(16) Workers' Compensation Law: the
			 Act.
(17) Workers' Compensation
			 Commission's file number: the W.C.C. file number.
(18) Rehabilitation professionals:
			 coordinators of medical rehabilitation services.