How do you apply for disability benefits in South Carolina?

The answer depends on whether you suffered a short-term (temporary) or long-term (permanent) injury or illness, if it happened off-the-job (non-occupational) or on-the-job (occupational), and whether you have coverage for each of these situations.

The state does not provide short-term disability for off-the-job accidents, illnesses, and pregnancy-related conditions. Therefore, SC residents must purchase this coverage on their own before the need arises.

However, most people have coverage for Workers Compensation, Unemployment, and Social Security, and can file claims when appropriate

Applying for Short-Term Disability in SC

The State of South Carolina does not require short-term disability insurance for private and public employees to address non-occupational conditions. Therefore, SC residents must purchase a policy on their own to be eligible to apply for benefits if they suffer an off-the-job accident or sickness.

Also, the coverage must begin before becoming sick, hurt, or pregnant. All private insurance companies exclude pre-existing health conditions for at least 12-months – if you are healthy enough to qualify.

Buying Coverage

Complete a new policy application as the first step in buying short-term disability in South Carolina. An agent licensed in SC will need to ask you questions about your health history along with your income and employment status.

You must be healthy and actively employed to qualify.

Request a cost quote to cover future unforeseen off-the-job accidents, illnesses, and pregnancy-related health conditions. Three factors determine the premiums you might pay each month.

  • Monthly Amount: up to 66% of income subject to a $6,500 cap
  • Elimination Period: how long before claim payments begin
    • (7, 14, 30, or 60 days)
  • Benefit Period: How long the claim payments last while unable to work
    • (3, 6, 12, or 24 months)

Filing Claims

South Carolina residents who purchased a private short-term disability policy in advance of their need can apply for benefits by completing a claim form. Contact the insurance company who issued the coverage for instructions and paperwork.

Follow the form instructions carefully to avoid delays in the processing of your claims. Make sure that you complete all sections and affix the three required signatures.

  1. Employer statement that they are no longer paying your salary
  2. Doctor report indicating the medical reason you cannot work
  3. Employee declaration that you provided truthful answers

PEBA

The South Carolina Public Employees Benefit Authority (PEBA) does not offer short-term disability. However, government workers and public school teachers can apply for income support if their medical condition will last longer than 90 days.

Employees who enroll in PEBA health insurance also get basic long-term disability coverage included at no additional cost. Furthermore, participants can elect a supplemental plan, which boosts the basic benefit above the smallish $800 maximum monthly about. However, both programs have a 90-day elimination period, which rules out many transitory conditions such as maternity leave.

File the claims paperwork with the Standard Insurance Company1.

Workers Compensation

Workers Compensation law in South Carolina requires temporary disability coverage for public and private employees who suffer an on-the-job accident or illness.

Report all injuries at work to your employer right away and request medical care, if necessary. Your employer should report the occupational incident. If not, submit Form 50 (Notice of Claim and or Request for Hearing) or Form 52 (Death Case) to the commission2.

You may be eligible for several benefits

  • Temporary income replacement
    • 2/3 previous earnings
    • Maximum $846 weekly in 2019
  • Medical treatment that is likely to lessen your disability
  • Reimbursement for travel expenses for medical care

Unemployment Compensation

South Carolina unemployment law allows residents to collect compensation after recovering from a temporary disability – if they terminated their job due to a “compelling family circumstance.”

You may be eligible to file a claim for benefits once you are physically able to work, available to return to a job, and actively seeking new employment. The SC definition of “compelling family circumstance” includes these key phrases relating to why the claimant separated from work3.

  • Because of the illness or impairment of the individual
  • Due to the disease or impairment of an immediate family member

Applying for Social Security Disability in SC

Applying for Social Security Disability in South Carolina follows an entirely different playbook. This federally mandated entitlement works very differently from plans issued by private companies or required by SC state law.

  • Most people pay FICA taxes, have coverage, and can file a claim
  • People with pre-existing conditions are eligible
  • Addresses permanent (long-term) conditions not temporary
  • Covers non-occupational incidents not on-the-job (workers compensation)

Licensed Lawyers

Do not hesitate to contact disability lawyers licensed in South Carolina before completing your application. Attorneys do charge for their services. However, paying for legal advice can improve your chances of approval and minimize potential delays.

SSDI denies 67% of initial claims and 87% of reconsiderations – which can linger on for years. These long delays make it hard to survive while waiting for approval. Therefore, hiring a lawyer could help many applicants in this regard – as many take a percentage of your award as compensation.

Determination Services

The Disability Determination Services unit of the South Carolina Department of Vocational Rehabilitation processes claims for the two main Social Security programs4.

  • Supplemental Security Income (SSI) covers disabled adults and children who have limited earnings and resources
  • Social Security Disability Income (SSDI) pays benefits to you and individual family members if you worked long enough and paid FICA taxes

Applicants can follow up on claims through one of the Disability Determination Services offices, located in Greenville, Columbia, and Charleston. However, SC residents should initially apply for SSI or SSDI at a local Social Security Administration office, or online at ssa.gov.

Sources:

  1. PEBA
  2. Workers Compensation
  3. Unemployment Law
  4. Department of Vocational Rehab
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