A Beginner's Guide to TN Workers' Compensation
Basic facts about the Tennessee Workers’ Compensation System For Dates of Injury ON/AFTER July 1, 2014
Basic facts about the Tennessee Workers’ Compensation System For Dates of Injury PRIOR TO July 1, 2014
What Should an Employee Do If Injured at Work?
An employee should report a work-related injury to his/her supervisor within 15 calendar days of the date of the injury or when a doctor first tells the employee that his/her injury is work-related so that the proper forms and paperwork can be completed.
Reporting your injury as soon as possible will speed up the handling of your claim.
All required forms should be completed by the employee’s supervisor. Required forms are located on the Department of Labor and Workforce Development’s website located at: https://www.tn.gov/content/tn/workforce/general-resources/forms.html.
If the injury requires emergency treatment, the injured worker should be taken to the closest hospital emergency room.
How is a Doctor Selected?
You will select your Authorized Treating Physician from a panel of three doctors that your employer gives you. That physician will provide the medical care needed to help your return to your health and to your job.
Medical treatment for your work-related injury is provided at the employer's expense. Sign an Agreement between Employer/Employee Choice of Physician (Form C-42), which should be provided to you by your supervisor, to indicate which doctor you select to become the authorized treating physician. If emergency treatment is required, the supervisor should provide the panel after the injury is stabilized.
Keep up with your records
Request and keep a copy of your signed Form C-42 for your records. If you do not sign the form, but accept medical treatment from a doctor on the form, it may be considered that you have chosen that doctor.
Benefits that Injured Employees May Be Entitled to Receive
Employees who have suffered a compensable injury, meaning that the authorized treating physician has determined the injury to be work-related, may be entitled to receive the following:
Medical treatment, at no cost to the employee
This treatment must be provided for as long as required by the authorized treating physician. Medical treatment recommended by the authorized treating physician that is denied by the insurance company's utilization review agent can be submitted to the Bureau's Utilization Review Program for additional review and consideration.
Reimbursement for mileage to and from a medical treatment may be requested if travel exceeds 15 miles one way.
Temporary Disability Benefits (Wage Replacement)
Disability begins when the authorized treating physician takes you off work. Temporary disability benefits replace lost wages and are due beginning on the eighth day of the disability. If the disability lasts fourteen (14) days or longer, benefits will be paid back to the first day of disability. Temporary disability benefits are usually two-thirds (⅔) of your average weekly wages earned during the 52 weeks prior to the injury. The Bureau of Workers' Compensation does not pay these benefits. Benefits are paid by your employer's insurance carrier.
If you are able to work, but your average weekly earnings are reduced because of work restrictions, you may be entitled to partial disability benefits.
If the authorized treating physician restricts your ability to work, such as limiting the number of hours worked or the type of work performed, it is very important that the physician's instructions and restrictions are followed at all times. Failure to report for light duty offered by your employer may terminate your temporary disability benefits.
If Your Claim is Denied
When a claim is denied, it means your employer's worker's compensation insurance adjuster believes your injury is not compensable, meaning that your injury was not caused by the work that you perform and it is not covered by workers' compensation. If the adjuster denies your claim, you have a right to challenge the decision. If a dispute regarding compensability occurs, you may seek help resolving the dispute from the Bureau. Call an ombudsman at (800) 332-2667.
Protect Your Rights
The right to receive workers' compensation benefits does not stay open forever. To protect your rights, file a Petition for Benefit Determination (PBD) form. The form is available on the Bureau's website. In most cases, the deadline to file the form is one year from:
A. The date the injury occurred; or,
B. The date the last temporary disability benefits were paid or medical benefits were provided for the injury, whichever is latest.
Can I Be Fired for Reporting a Work Injury?
It is illegal for an employer to fire an employee for reporting a work injury. If you are fired and believe it was for reporting a work injury, you may wish to consult an attorney. The Bureau of Workers' Compensation does not have authority to resolve wrongful termination claims.
Frequently Asked Questions
Do I have to pay for medical treatment for a compensable injury?
No, you are not responsible for the costs of medical treatment provided by the authorized physician for a compensable claim.
What options do I have if I disagree with the authorized treating physician's findings or recommended medical treatment?
The employer or insurance company is usually not required by law to offer a second opinion, but you can always ask for it anyway. You may, however, obtain a second opinion or additional medical treatment with any doctor at your own expense.
What if I’m not receiving the benefits I deserve?
Call a Workers' Compensation Ombudsman at (800) 332-2667 to help you. Submitting a completed Petition for Benefit Determination, available on the Bureau's website, will speed up the process.
Will I need to use sick or vacation time while off work due to a compensable injury?
It depends. An employee taken off work by the authorized treating physician for less than 14 days is not entitled to temporary disability benefits for the first seven (7) days missed. Review your company's policies about this unpaid time. If the authorized treating physician requires you to miss more than 14 days; however, benefits are due from the first day of disability.
Am I paid for the time spent attending doctor appointments during work hours?
Not unless your company has the policy to pay for this time.
Which employers must provide workers' compensation coverage for their employees?
In most industries, any employer with five or more full or part-time employees must carry workers' compensation insurance. In the construction or mining industry, however, employers must provide coverage even if there is only one employee. Construction employers may exempt themselves from the workers' compensation coverage requirements by applying for an exemption, but all employees in construction must be covered.
Information about the Workers' Compensation Exemption Registry is available at http://tnbear.tn.gov/WC/Default.aspx or by calling the Tennessee Secretary of State's office at (615) 741-2286.
Call the Ombudsman Program of the Tennessee Bureau of Workers’ Compensation at 800-332-COMP (2667) if you have any questions.
An ombudsman will assist with any questions from employees, employers and insurance companies that do not have attorney representation.
Learn more online and download forms at: