South Carolina workers comp form 16 is the official agreement used to settle permanent disability or disfigurement pay for injuries that happened before July 1, 2007. The employer or its insurance carrier and the injured worker (the claimant) fill it out and sign it together. Once the South Carolina Workers’ Compensation Commission approves it, the agreement becomes binding. If you were hurt years ago and your claim is still open, this form may matter to you. This guide explains it in plain English.
What the South Carolina Workers Comp Form 16 Is For
After a work injury, treatment usually ends at some point. Your doctor then decides whether you have lasting damage. That lasting damage is called permanent disability. A scar or visible mark from the injury is called disfigurement. In most cases, South Carolina law pays extra money for these lasting losses. The south carolina workers comp form 16 puts that payment in writing. It lists the body part, the rating, and the amount both sides agree on.
The form applies only to older injuries. Typically, the date of injury controls which agreement form is used. If you were hurt on or after July 1, 2007, a newer version of the agreement applies instead. Signing does not happen automatically. However, a signed agreement is not final until the Commission reviews and approves it. As a result, it is worth taking time to read every line before you sign.
| Item | Details |
|---|---|
| Form number | Form 16 |
| Form title | Agreement for Permanent Disability / Disfigurement Compensation (injuries before July 1, 2007) |
| Who files | Employer/carrier and claimant |
| Where filed | South Carolina Workers’ Compensation Commission |
| Fee | $50 if the claimant is represented |
| Official PDF | South Carolina Workers Comp Form 16 (official PDF) |
Who Files the South Carolina Workers Comp Form 16 and When
The south carolina workers comp form 16 is a joint form. The employer or its insurance carrier usually prepares it. Then the injured worker reviews and signs it. In most cases, the carrier sends the completed form to the Commission. However, you still have a say. You do not have to sign an agreement you think is wrong. You can ask questions first, ask for changes, or request a hearing instead.
Timing usually depends on your medical status. For example, the form is typically prepared after your doctor says you have reached maximum medical improvement. That means your condition is not expected to get much better. The doctor may then give you a permanent impairment rating. That rating often drives the payment amount on the form.
If your injury happened before July 1, 2007, older rules may still apply to your case. That is one reason this separate form exists. To learn more about filing basics, see our guide on how to file a South Carolina workers comp claim.
How to Fill It Out and Where to Send It
The south carolina workers comp form 16 asks for basic claim facts. These typically include your name, the employer, the carrier, the date of injury, and the claim number. It also lists the body part, the disability rating, the weekly rate, and the number of weeks paid. Any disfigurement award is listed too. Finally, both sides sign and date it. If you have a lawyer, the lawyer’s details go on it as well.
Common reasons an agreement gets sent back or delayed include:
- Missing signatures from the worker or the carrier.
- A date of injury on or after July 1, 2007, which needs the newer form.
- Math that does not match the rating or weekly rate.
- No medical report attached to support the rating.
- The $50 fee missing when the claimant has a lawyer.
Completed forms go to the South Carolina Workers’ Compensation Commission. The Commission offers forms and filing guidance on its official South Carolina Workers’ Compensation Commission forms page. Check there for current e-filing or mail instructions. You can download the blank form directly as the official south carolina workers comp form 16 PDF. Always use the current version from the Commission’s site.
What Happens After You File
After the south carolina workers comp form 16 is filed, the Commission reviews it. Typically, staff check that the form is complete and the numbers make sense. If something is missing, the form may be returned for correction. Once approved, the carrier generally pays the agreed amount under the terms on the form. Keep a copy of the signed agreement and the approval for your records.
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If you disagree with the rating or amount, you are not stuck. In most cases, you can refuse to sign and ask the Commission for a hearing instead. To understand who decides disputes, read our guide to the South Carolina workers comp board. You can also review the South Carolina workers comp requirements employers must follow. Questions about your specific case are best directed to the Commission and a licensed attorney.
Frequently Asked Questions
Do I have to sign the south carolina workers comp form 16?
No. Signing is your choice, and you should only sign if you agree with the terms. If the rating or payment looks wrong, you may ask for changes or request a hearing before the Commission.
Is there a fee to file the south carolina workers comp form 16?
There is a $50 fee if the claimant is represented by a lawyer. If you have no lawyer, confirm with the South Carolina Workers’ Compensation Commission whether any fee applies to your filing.
What if my injury happened after July 1, 2007?
Then the south carolina workers comp form 16 is not the right form for you. A newer version of the agreement is used for those injuries. Check the Commission’s forms page or ask a licensed attorney which form fits your date of injury.
South carolina workers comp form 16: Quick Recap
If you remember one thing about south carolina workers comp form 16, make it this: the rule is set by the state (or the federal program), not by the insurer, and the official source is linked above. Every figure on this page about south carolina workers comp form 16 should be confirmed with the agency before you act on it.
Questions about south carolina workers comp form 16 that this page does not answer are usually answered for free by the state workers’ comp agency’s information line — and, for a disputed claim, by a licensed attorney in a first consultation.
See your state’s exact numbers
What you are owed depends on your state’s benefit caps and deadlines. Start with your state’s settlement and claim guides for the exact figures.
Sources & How to Verify
The figures on this page come from official government and industry sources. Workers’ comp benefit caps, deadlines, and rules change, so always confirm the exact figure with your state’s workers’ comp board or a licensed attorney before acting. Settlement estimates are illustrative, and every case is different.
- Your state workers’ comp board, division, or commission: the official source for your state’s exact caps, deadlines, and forms — search “[your state] workers compensation board”
- U.S. Department of Labor (OWCP): dol.gov — federal workers’ compensation overview
- NCCI: ncci.com — workers’ comp rating and benefit data
- Social Security Administration: ssa.gov — benefit-cap and SSDI offset data
- Insurance Information Institute: iii.org — neutral workers’ comp background
Content last reviewed October 2026. If you notice an outdated figure, please contact us.
Related Guides
- South Carolina Workers Comp Board
- How to File a South Carolina Workers Comp Claim
- South Carolina Workers Comp Requirements
- Workers Comp Settlements by State (All 50)
- Workers Comp Claims by State (All 50)
- More in This Category
- Settlements by Injury
- Benefits Explained
- Workers Comp Glossary
Informational only — not legal, medical, or financial advice. Workers Comp Explained is an independent educational resource, not a law firm, insurer, or medical or financial advisor, and this page does not provide legal, medical, or financial advice. Workers’ compensation benefits, deadlines, and rules vary by state and change over time, and settlement estimates are illustrative only. Always confirm the exact figure and any deadline with your state’s workers’ compensation board and a licensed attorney before you act.