Work Injury Information Request
Use this online form to request verification of prior Tennessee work injuries under T.C.A. § 50-3-702(b). Records provided from this search include the Date of Injury (DOI), State File Number, and Settlement Status (if applicable).
Requirements and Guidelines
- Processing Time: Results are typically returned within 24–48 hours, excluding weekends and holidays. Requests are processed in the order received.
- Cost: $10 per SSN search. Invoices are issued after records are provided and sent at the beginning of the following month.
- Required Information: A complete SSN is required to complete a search. Searches are based on SSN only. Do not submit multiple names or aliases for the same SSN.
- Date of Request: The system automatically generates the date of request. This is the date used to process the request. Rush orders are not available.
- Duplicate Submissions: Submitting the same request more than once may result in duplicate charges. If you have questions or do not receive results within the stated timeframe, email wc.claims@tn.gov and include the request date and one or two names from the submission.
- Signature: By submitting this form, you certify that the request is made pursuant to T.C.A. § 50-3-702(b).
Contact Information
- By Email: wc.claims@tn.gov
- By Phone: Beth Holtz: 615-532-9495; Cathy Dodd: 615-253-2050
- Business Hours: Monday–Friday, 8:00 AM–4:30 PM (CT)
Submit a Request by Fax
If you are unable to use the form above, you may download the PDF version of this form and send it by fax to 615-532-8546. If you receive a fax error, contact our office to confirm receipt before resending, as duplicate submissions may result in duplicate charges.