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 | FREQUENTLY ASKED QUESTIONS TENNESSEE WORKER'S COMPENSATION | ||||||||||||||||||||||||||||||
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WHO IS COVERED? Every employer with 5 or more full of part-time employers. Employers engaged in the mining and production of coal and subcontractors in the construction industry must have coverage if they have 1 or more employees. Certain employers, such as farm labor, domestic help, and governments are exempt, but may elect workers’ compensation coverage. WHO PAYS WORKERS’ COMPENSATION BENEFITS? Benefits are paid by the employer or the employer’s insurance carrier. The Tennessee Department of Labor does not pay workers’ compensation benefits. WHAT SHOULD I DO IF I AM INJURED AT WORK? Report all injures immediately to your employer. Notice of the injury to the employer is required by law within 30 days of the date of injury. Written notice to the employer is recommended. When an employee reports to work, the employer completes a First Report of Injury and offers the employee a panel of 3 medical providers for treatment. The employer selects one of the providers, who becomes the authorized treating physician and provides the treatment at the employer’s expense. WHAT AM I ENTITLED TO? Employees who have suffered a compensable work injury are entitled to receive the following: A. DISABIILITY Weekly temporary total disability benefits are paid if the authorized physician finds that the employee is temporarily totally disabled from working due to the injury. Compensation begins on the eighth (8th) day of disability from work following the injury. The date of the injury and the first seven (7) days following are a waiting period and no benefits are payable unless the disability period lasts at least fourteen (14) days; then, weekly temporarily total disability benefits will be calculated beginning with the day following the injury. Temporary total disability benefits are based on 66 2/3% of the employee’s gross average weekly wage for the last 52 weeks worked prior to the injury, subject to the minimum and maximum benefits as provided by the Workers’ Compensation Law. B. MEDICAL BENEFITS The employer is to provide, free of charge, a panel of three physicians from which the employee selects one for treatment. This is the authorized treating physician. This physician will direct all medical treatment for the employee’s workers’ compensation injury. If a specialist is required, this physician may offer another panel of specialists from which to choose. Medical treatment extends for as long as required by the authorized treating physician. If appropriate, this physician will provide the employee with off work excuses and light or restricted duty limitations. It is very important that the authorized physician’s instructions and restrictions be followed at all times. WHAT IF I AM UNHAPPY WITH THE PHYSICIAN I HAVE SELECTED FROM THE EMPLOYER’S PANEL? Under Tennessee Law the employer or insurance carrier is not required to offer a second panel of physicians or a second opinion. However, if asked, many insurance carriers and employers will provide a second panel. The employee may always seek a second opinion or obtain treatment with any physician at his/her own expense; however, only the restrictions of the authorized physician must be followed by the employer. WHAT IF THE AUTHORIZED PHYSICIAN ORDERS LIGHT OR RESTRCITED DUTY? If the authorized physician returns the employee to work with specific temporary restrictions (light duty) and the employer can provide a job within the restrictions, the employee must return to work. The employee may qualify for temporary total disability benefits if the employer cannot provide a job within the restrictions given by the authorized physician. The employee MUST report for work and attempt the light duty. The authorized physician determines what duty is appropriate for the restrictions. The physician should be contacted for clarification if the employee believes the work is beyond the restrictions. Failure to report for light duty may terminate disability benefits. SHOULD THE INJURED EMPLOYEE RECEIVE DOCTOR’S BILLS? A health care provider should not bill or sue the injured employee for all or part of the costs of health care services provided to the injured employee unless: (1) The injury is found by the court not to be compensable; (2) The physician, who was not authorized by the employer at the time the services were rendered, knew what he/she was not an authorized physician; or (3) The employee knew the physician was not authorized and it was not an emergency. CAN I BE FIRED FOR REPORTING A WORK INJURY? It is unlawful for an employer to terminate an employee for reporting a work injury. Wrongful termination is not enforceable under Tennessee Workers’ Compensation Law. The employee may wish to consult an attorney to pursue this cause of action though the court system. IS THE INJURED EMPLOYEE PAID FOR DOCTOR APPOINTMENTS DURING WORK HOURS? Generally no, unless it is company policy. PERMANENT DISABILITY AND FINAL SETTLEMENT When the injury has healed, the injured employee will be released from the physician’s care. If the injured employee does not recover completely, the employee will reach maximum medical improvement (MMI) and the physician will assign a permanent partial disability (PPD) rating. This PPD rating, combined with vocational factors, may result in a permanent disability settlement from the worker’s compensation insurance company. Not all injuries result in a permanent impairment. STATUTE OF LIMITATIONS Generally the right to workers’ compensation benefits is barred unless within one (1) year after the injury occurred or the injured worker was informed his condition is permanent and related to his employment workers’ compensation benefits are paid or a claim for workers’ compensation is filed with a court of competent jurisdiction. SCHEDULED INJURIES
500 Chickamauga Avenue PO Box 876 Rossville, GA 30741 tel. (706)-866-8021 fax (706)-866-7437 | |||||||||||||||||||||||||||||||