The Official Web Site of the State of South Carolina

Renovations will begin at the Commission offices on Tuesday, January 20, 2026. Please contact the Commission if accessibility accommodations are needed. Thank you for your patience while we improve our workspace.

Advisory Notice: 2026 updated courtroom and hearing preferences for Commissioner Michael Campbell. The full advisory may be accessed here.

Advisory Notice: 2026 Maximum Weekly Compensation Rate. The full advisory may be accessed here.

Advisory Notice: 2026 Medical Services Provider Manual. The full advisory may be accessed here.

Advisory Notice: New Policy Regarding Electronic Devices in Courtrooms and Adjacent Areas. The full advisory may be accessed here.

South Carolina Workers' Compensation Commission

Self-Insurance Forms

The South Carolina Workers’ Compensation Commission offers the following forms applicable to self-insurance procedures.

If you require assistance, please contact the Self-Insurance Division

Self-Insurance Division
Telephone: 803-737-5412
self-insurance@wcc.sc.gov

6	Application to Create a Self-Insurance Fund	PDF	Doc	$250.00
6A	Application for Membership in a Self-Insured Fund	PDF		$25.00
7	Application to Individually Self-Insure	PDF	Doc	$250.00 plus $100.00 for each subsidiary
7A	Corporate Guaranty	PDF	Doc	No fee
8	SC Workers’ Compensation Commission Bond Required of Employer Carrying His Own Risk	PDF	Doc	No fee
8B	Irrevocable Letter of Credit	PDF	Doc	No fee
10	South Carolina Self-Insurance Tax Form	PDF		No fee
11	Fund Quarterly Financial Report	PDF	Doc	No fee