Governor Henry McMaster signed HB 3163 on May 15, 2026, adding stroke to the list of conditions presumed to arise out of employment for South Carolina firefighters. The bill passed the House 103-0 and the Senate 41-3 before reaching the governor’s desk. Under the new law, any heart disease, stroke, or respiratory disease resulting in disability or death for an eligible firefighter is presumed work-related unless the employer demonstrates otherwise with competent evidence.
Who It Affects
The law covers firefighters in municipal, county, state, port authority, and fire control district departments across South Carolina. Self-insured cities, counties, and special fire districts that fund workers’ comp obligations from their own balance sheets take the full impact of expanded compensability without an insurer buffer.
To qualify for the presumption, a firefighter must have been under age 37 at hire, passed a pre-employment physical showing no evidence of the condition, and developed the condition while actively engaged in firefighting, technical rescue, or strenuous training (or within 24 hours of that service). Clerical and administrative duties are excluded. These eligibility filters narrow the exposed population, but the remaining pool is the group most likely to file high-severity claims.
The Reserve Mechanism: Burden of Proof Flips Frequency and Development
Before HB 3163, a firefighter filing a stroke-related WC claim in South Carolina had to prove causation: medical expert testimony, employment exposure documentation, and often a contested hearing. Many claims were denied or settled at a discount. That friction suppressed both reported frequency and average case reserves.
The presumption reverses that dynamic. Once a qualifying firefighter presents a stroke claim meeting the statute’s criteria, the employer or its claims administrator must rebut the presumption with competent evidence that the condition is not work-related. In practice, stroke claims that previously sat in a “prove causation” category (low acceptance, long litigation cycle) shift to a “rebut presumption” category (high initial acceptance, shorter cycle). The effect is twofold: expected frequency rises because fewer claims are denied on causation grounds, and the development pattern steepens as claims are accepted and reserved earlier rather than lingering in litigation.
South Carolina joins a growing 2026 cohort of states expanding occupational disease presumptions. Colorado’s SB 184 added Parkinson’s disease to firefighter presumptions. Wisconsin’s reform package added a PTSD presumption for EMS providers. Connecticut’s PA 26-12 expanded assault coverage for teachers and healthcare workers. California extended PTSD and cancer presumptions to airport firefighters through SB 230. Each expansion follows the same actuarial logic: shifting the burden of proof raises claim acceptance rates and compresses the time from injury to reserve establishment. From reviewing these expansions across multiple states, each new condition added to a presumption statute tends to produce a measurable uptick in claim frequency within the first 18 months of implementation.
The South Carolina Workers’ Compensation Commission stated it could not determine the premium impact of HB 3163. The Municipal Association of South Carolina warned the change may increase claims and costs for local governments.
What This Means for Your Next Review
If your entity operates or funds a fire department in South Carolina, bring HB 3163 to your next reserve study. Ask your actuary whether the IBNR for firefighter class codes reflects the expanded compensability, and whether your case reserving protocol distinguishes between presumptive and non-presumptive occupational disease claims. A presumptive claim should carry a higher initial case reserve given the shifted burden of proof. Watch the leading indicators over the next 12 months: if claim report lag shortens and acceptance rates jump on stroke filings, the frequency adjustment is real.