5 steps to filing a workers’ compensation claim in the Volunteer State
Workers’ compensation is a type of insurance that provides benefits to workers who are injured on the job. In this article, we’ll discuss the steps you need to take in order to file a workers’ compensation claim in Tennessee.
Let’s jump right in.
Step 1: Get medical treatment
Your top priority should be your health. If you suffer an injury at work that requires emergency medical attention, don’t hesitate to call an ambulance.
In Tennessee, you’ll be reimbursed for the emergency care you receive prior to filing your workers’ compensation claim so long as the injury is covered and the treatment was needed immediately.
Step 2: Report your injury to your employer
Under Tennessee law, you must report your work-related injury to your employer within 15 days of the date of your injury. If you fail to do so, you will be prohibited from receiving any benefits (except in rare cases, such as an injury that results in a coma lasting for more than 15 days).
How should I report my injury to my employer?
The Tennessee Workers’ Compensation Act requires that you provide notice of your injury to your employer in writing. When doing so, there are 2 things to keep in mind:
- The notice must include your name and address; the time, place, nature, and cause of the accident; and your signature. Include the required information in plain and simple language, but stick to the facts and avoid going into too much detail. Remember, anything you include can be used by the insurance company to accept or deny your claim.
- Send your letter via certified mail with return receipt requested so that you have proof your employer received notice.
Step 3: Make sure your employer files the proper form
Once an employer becomes aware of an injury that may be covered by workers’ compensation, the employer has 1 business day to complete and submit the First Report of Injury Form (Form C-20) to their workers’ compensation insurer.
It’s a good idea to check the status of your Form C-20 after giving your employer a couple of days to submit the form. Though it’s no excuse, employers make mistakes. Checking in with your employer to make sure they filed the Form C-20 may save you time and trouble down the road.
Step 4: Wait to hear if your claim is accepted or denied
Once your employer’s workers’ compensation insurance company receives the Form C-20, they’ll do 3 things:
- File a copy of the Form C-20 with the Tennessee Department of Labor and Workforce Development Bureau of Workers’ Compensation,
- Send via first class mail (within 2 business days of receiving the Form C-20) a copy of the Form C-20 and a copy of The Beginner’s Guide to Tennessee Workers’ Compensation to your last known address, and
- Have a claims adjuster contact you by telephone or mail to introduce themselves and investigate the facts of the claim.
Your employer’s workers’ compensation insurance company must accept or deny your claim within 15 days of receiving the Form C-20.
Step 5: Start the appeals process
Workers’ compensation claims get denied for lots of reasons. For example, the adjuster may believe that your injury didn’t occur at work, or someone may have simply made a mistake when filing your paperwork.
Here are the steps you should consider taking if your claim is denied:
- Talk to your employer’s insurer to find out why your claim was denied or why you didn’t receive the benefits you thought you should receive. Mistakes happen and you might be able to resolve the issue easily with a telephone call.
- File a Petition for a Benefits Determination with the Tennessee Bureau of Workers’ Compensation. This petition must be filed within 1 year from the date of your injury. Once this form is filed, your case will be assigned to a mediator who will work with you and your employer to reach an agreement without having a hearing before a judge.
- If you’re unable to reach an agreement with the mediator, the mediator will issue a Dispute Certification Notice (DCN). You have 5 business days to request that the mediator add information to the DCN.
- After 5 business days, the mediator will file the DCN with the Tennessee Workers’ Compensation Court. You then have 60 days to request a hearing before a judge (called a “Compensation Hearing”).
- At the Compensation Hearing (which may be expedited or regular depending on what you choose), the judge will issue a decision.
If you’re not satisfied with the decision, you can appeal the decision to the Workers’ Compensation Appeals Board within 30 days (or 7 days if your hearing was expedited) or appeal directly to the Tennessee Supreme Court.
Bonus step: Finding a workers’ compensation attorney
Tennessee law doesn’t require that you hire an attorney to help you with your workers’ compensation claim. You do, however, have this option. For many people, hiring an attorney helps resolve their case more quickly and more favorably.
When searching for a workers’ compensation attorney, keep in mind that workers’ compensation is a highly specialized area of law. Be sure to find an attorney who dedicates most (if not all) of their practice to workers’ compensation claims. Additionally, be sure the attorney represents injured workers and not insurance companies.
Not sure where to start looking for an attorney? Try our free online directory.