Whether you’re an employee or an employer in Tennessee, you probably have questions about workers’ compensation insurance. Fortunately, we have answers.
The laws governing workers’ compensation claims can be found in Title 50, Chapter 6 of the Tennessee Code (commonly known as “The Tennessee Workers’ Compensation Act”). The Act was originally passed in 1919 and revised most recently in 2013.
The Tennessee Court of Workers’ Compensation Claims adjudicates disputed workers’ compensation claims.
Tennessee employers with 5 or more full-time or part-time employees must provide workers’ compensation insurance for their employees. In the construction and mining industries, employers are required to provide coverage even if they have only 1 employee.
To find out whether your employer carries workers’ compensation insurance, use the search tool created by the Tennessee Department of Labor and Workforce Development.
Aside from seeking medical care, you must provide written notice of your injury to your employer within 15 days of sustaining the injury. If you fail to notify your employer within 15 days, your claim will (in most cases) be denied.
All injuries and illnesses (including traumatic injuries and chronic injuries) are covered by workers’ compensation insurance so long as:
For example, a construction worker who is injured after falling from scaffolding while working on a construction project will likely be able to receive workers’ compensation benefits. On the other hand, a dental assistant who has a heart attack while walking into their office one morning will probably not be able to receive workers’ compensation benefits.
Some states require you to use the doctor your employer selects, while other states let you choose your doctor. In Tennessee, you can select your treating physician from a panel of 3 doctors picked by your employer.
The form used to select your doctor is the Employer/Employee Choice of Physician form (Form C-42) and it should be provided to you by your employer.
If your claim is denied, you can appeal the decision. The appeals process begins when you file a Petition for a Benefits Determination with the Tennessee Bureau of Workers’ Compensation. Your case will be assigned to a mediator who will work with you and your employer to reach an agreement.
If you don’t reach an agreement through mediation, the mediator will submit a Dispute Certification Notice (DCN) to 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, 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 or the Tennessee Supreme Court.
Your employer is prohibited by law from taking retaliatory action (including terminating your employment or reducing your hours) against you for filing a workers’ compensation claim. However, your employer may reduce your hours or change your position due to your injury.
If you believe your employer took retaliatory action against you for filing a workers’ compensation claim, consider reaching out to a workers’ compensation attorney in Tennessee.
Workers’ compensation is an “exclusive remedy,” meaning an injured employee must file a workers’ compensation claim instead of suing their employer.
However, there is one exception.
If your injury was caused by a third party (i.e., anyone other than your employer or colleague), you can file a third-party personal injury lawsuit in addition to your workers’ compensation claim.
Tennessee law doesn’t require you to hire an attorney to help you with your workers’ compensation claim. You do, however, have the right to hire an attorney. A workers’ compensation attorney can be a significant help, particularly if you are going through the appeals process.
In general, you must carry workers’ compensation if:
There are 2 types of employers who are exempted from carrying workers’ compensation insurance in Tennessee despite meeting the criteria above. These include:
Employers who don’t have to purchase workers’ compensation insurance must file the Exempt Employers Notice of Acceptance of the Workers’ Compensation Act of Tennessee with the Tennessee Department of Labor and Workforce Development.
Though Tennessee law requires that most employers provide workers’ compensation insurance for their employees, the state doesn’t require employers in the construction industry to insure themselves.
If you choose not to insure yourself, you must file a workers’ compensation exemption registry application.
Tennessee has a competitive market consisting of roughly 350 companies licensed to sell workers’ compensation insurance. Most of these companies sell their insurance through independent agents.
If you’re refused coverage by 2 or more licensed insurance companies, you can obtain coverage through the National Council on Compensation Insurance’s Workers’ Compensation (commonly called the “assigned risk plan”).
Employers who fail to maintain workers’ compensation insurance or who misclassify employees as “independent contractors” or “subcontractors” are subject to a financial penalty equal to 1.5 times the employer’s total estimated annual premium.
What’s more, employers may face additional penalties depending on the nature of their violation.
You must complete the First Report of Injury Form (Form C-20) and submit the form to your workers’ compensation insurance company within 1 day of learning about your employee’s injury.
You may learn about your employee’s injury from a written notice (injured employees are required to report work-related injuries within 15 days of the injury), through word-of-mouth, or by some other means. Regardless of how you learn about your employee’s injury, your legal obligation is to submit the Form C-20 within 1 day.
If your employee requests that you submit a Form C-20, you must do so regardless of whether or not you think your employee has a valid claim. However, if you have evidence that your employee wasn’t really injured at work, you should provide that evidence to your insurance company.
One of the benefits of workers’ compensation insurance, from an employer’s perspective, is that it’s an exclusive remedy. This means your employee generally can’t sue you in lieu (or in addition) to filing a workers’ compensation claim.