South Carolina Law Adds Workers’ Comp Stroke Presumption for Some Firefighters

By | May 21, 2026

Municipal workers’ compensation insurance pools in South Carolina now have another firefighter health condition presumption to consider, after the state’s governor signed House Bill 3163 into law.

The law, which took effect upon Gov. Henry McMaster’s signature last week, adds stroke to the list of conditions presumed to be work-related for some firefighters in the state.

“…Any impairment or injury to the health of a firefighter caused by heart disease, stroke, or respiratory disease resulting in total or partial disability or death is presumed to have arisen out of and in the course of employment, unless the contrary is shown by competent evidence, if the firefighter is at the time of such impairment or injury a bona fide member of a municipal, county, state, port authority, or fire control district fire department in this State,” the law reads.

The presumption is rebuttable and does not appear to cover older firefighters. The existing wording of the law, on the books for years, notes that to be eligible for a presumption, a firefighter must be under the age of 37, must have passed a physical examination upon entering service, the examination failed to reveal any evidence of the condition, and the condition developed while on duty or within 24 hours from the date of last service.

Over the last three decades, most states have provided heart disease presumptions for firefighters. North Carolina, Mississippi, Delaware and Arkansas are the exceptions. All states now provide some type of cancer presumption or supplemental program for firefighters, according to the International Association of Fire Fighters.

With HB 3163, South Carolina has become one of the few states to specify stroke as a presumed compensable condition, the IAFF reported.

The bill, which had multiple sponsors in the South Carolina House of Representatives this year, does not define stroke. Merriam Webster’s dictionary defines it as a “sudden impairment or loss of consciousness, sensation, and voluntary motion that is caused by rupture or obstruction (as by a clot) of a blood vessel supplying the brain, and is accompanied by permanent damage of brain tissue.”

The law may increase the number of workers’ compensation claims by firefighters, but the state Workers’ Compensation Commission cannot determine the impact on comp premiums, reads a legislative analysis of the bill. One South Carolina county and the Municipal Association of South Carolina said the change may result in more claims and higher workers’ compensation insurance costs.

Topics Workers' Compensation South Carolina

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