Claims Kit

Penalties for Late Reporting  0800-02--01-.10  0800-2-14-.04 50-6-118 (2)

 The Bureaus will assess and collect civil penalties as defined in the Bureau'sRules.  A violation of any Workers' Compensation Rule included in Chapters 0B00-02 without a defined penalty may result in a civil penalty of not less than $50.00 nor more than $5,000, per violation. The bureau of workers' compensation will by rule promulgated pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, establish and collect penalties for  late filing of accident reports 

Posting Requirements 50-6-407 

Every employer subject to the Workers’ Compensation Law is required to display the Tennessee Workers' Compensation Insurance Notice. This posting notice should be posted conspicuously in the place of business for easy viewing by all employees and must contain the business’:

• Name
• Telephone number
• Physical address of the employer representative that can be used to confirm if the employer is subject to the workers' compensation law and, if so, to obtain the name of the employer’s workers' compensation insurance carrier
• The employer representative’s telephone number and physical address that should be notified in the event of an injury.   If the employer has multiple locations, a separate Posting should be posted at each location.

Tennessee Workers' Compensation Insurance Posting Notice

Tennessee Workers' Compensation Insurance Posting Notice Spanish

Reporting of Claim by Employer  50-3-702

HB 1694 

Amends TCA Section 50-3-702 to make a consistent, uniform period of 14 days for electronic filing purposes for filing the First Report of Injury (FROI) electronically with BWC.

Reports of accidents that result in death or personal injury of a nature that the injured person does not return to the person's employment within 7 days after the occurrence of the accident must be submitted to the bureau of workers' compensation as soon as possible, but not later than 14 days after the accident. Reports of all accidents causing 7 days of disability or fewer must be submitted to the bureau of workers' compensation on or before the 15th day of the month following the month covered by the report.

The WCIO has updated the Injury Description Tables that are used by the IAIABC to reflect specific coding in response to COVID-19.
A new Cause of Injury Code (DN0037) - 83 for “pandemic” and a new Nature of Injury Code (DN0035) - 83 for “COVID-19” were approved. The codes are anticipated to be used for the reporting of claims effective December, 2019 or later. The IAIABC recommends that EDI reporting and collection systems be modified to recognize these new codes by April 1, 2020. The new Injury Description Tables may be found on the WCIO website, Injury Description Table page at: https://www.wcio.org/Document%20Library/InjuryDescriptionTablePage.aspx.

TNBWC will be ready to accept these new codes in R1.0 as recommended by the IAIABC on April 1, 2020.

Face-to-Face Meetings Temporarily Waived for Case Managers

During this time, when theface-to-face meeting cannot be accomplished, please note the reason on the Form C-34(CM Closure).

Penalty assessments are suspended.

Physician Selection 0800-02-01.06 0800-02-31     50-6-204

Most Tennessee employers are required by law to provide a panel of physicians within three business days of receiving notice of a work-related injury. This ensures that employees receive the medical treatment needed to help them recover while allowing the employer to have some control over the claim.

This panel, or list of physicians, should name at least three physicians located in the employee’s community who are willing to treat the injured worker and is typically developed with the assistance of the employer’s insurance adjuster.

Once the form has been given to the injured worker, he or she chooses which of the doctors listed becomes the treating physician. The injured worker then sends the completed form back to the employer.

 That physician becomes the “authorized treating physician” or ATP.

When an authorized treating physician is selected from the panel by the employee, that physician will be in charge of the injured employee’s medical care for as long as it is necessary or appropriate.

Employers can now offer injured workers the option to seek medical treatment in a quicker, more convenient manner. New Telehealth Rules for many work-related injuries went into effect Tuesday, October 19th. Telehealth allows injured workers to connect with their caregivers from anywhere — including their homes.

Upon the report of a workplace injury, an employer should provide the employee, the C-42 Agreement Between Employer / Employee Choice Of Physician

The form should include:

• At least three independent physicians;
• Not practicing at the same location; and
• Within the community of the injured employee.  If three physicians cannot be located within the community of the injured employee, the employer may create a list of three independent physicians within a 125-mile radius of the community of the injured employee.