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Workers' Compensation Claims
If you have suffered a substantial on-the-job injury, you are likely entitled to workers compensation benefits under the Tennessee Workers’ Compensation Act. The purpose of workers compensation is to pay benefits for temporary and permanent disability to workers who have been injured on the job or suffer from a disease during their employment that resulted from work conditions. State rather than Federal law regulates workers compensation. The Tennessee Workers Compensation Act provides for medical benefits, past and future, salary remuneration (temporary total or temporary partial disability) and permanent disability benefits (permanent total or permanent partial). Tennessee law requires that the worker, in the event of a compensable injury, be provided medical attention and wage replacement in a timely manner.
The most common type of injuries include herniated or ruptured disks of the neck or lower back, rotator cuff tears, meniscus or ligament injuries, carpal tunnel syndrome. These injuries can occur acutely through an immediate onset or by repetitive or cumulative exertions. The presence of a pre-existing condition does not affect compensability if a work related event aggravates, accelerates, exacerbates, or combines with the pre-existing condition to cause a resulting disability. For this reason, it is critical that you be open, honest and forthright with your physicians regarding your medical history.
While the law intends to have benefits for workers compensation paid in a timely fashion, in practice, this does not always happen. Employers may dispute the claim and insurance companies may delay the payment. The Tennessee Department of Labor (TDOL) should be utilized by you in the event the employer or their carrier is refusing, or delaying, the payment of benefits or the providing of medical services. The Tennessee Department of Labor’s Division of Workers Compensation (TDOL) is a governmental entity that our legislature created to ensure that you receive substantially the benefits you are entitled to. As an alternative to court, the Department of Labor can make determinations on the compensability of claims, and even order payment of benefits. The procedures at the TDOL serve to expedite the resolution of many claims. However, the decisions of the TDOL are not final, and parties can proceed to court after exhausting these administrative remedies.
At, Skouteris & Magee our attorneys have successfully represented dozens of clients in workers compensation cases, both by settlement and judgment. To arrange a consultation to discuss your workers compensation issues, please call our office at 123-123-4567 or contact us online through our website.
What To Do When Injured?
The following steps are critical to your Workers Compensation case:
1. Report your injury immediately to your supervisor, even if witnessed. In Tennessee, a form known as the "First Report of Work Injury" must be filled out. If possible, get a copy of your report to make sure you have a record of its completion;
2. You should be given a choice of three (3) physicians not associated together in practice. You have the privilege of choosing one physician from the list of three. You are then required to accept treatment from the chosen physician and should not see any other physician unless the chosen physician makes a referral.
3. Tell your doctor the truth. Do not exaggerate your injuries or your symptoms. Physicians are see workers compensation claimants are typically biased toward the employers or their workers compensation insurance carrier. These physicians are trained to look for “red flags” of malingering through a series of examinations or techniques suggestive of symptom magnification.
4. You should also be very specific about the location, severity and type of pain or symptoms you are experiencing, and avoid general complaints such as “I hurt all over.” It is equally important to be candid about your past medical history, even if you have a pre-existing condition. You should assume the employer will discovery this information regardless of your disclosure, so be truthful. Failure to do so can result in denial of your rights to recovery.
PAYMENT WHILE OFF WORK: If a physician takes you off work for more than seven days, you may be entitled to temporary disability payments. An injured employee is not paid for the first seven (7) days of disability. On the eighth (8th) day, the employee is eligible for one day's benefits, on the ninth (9th) day, the employee is eligible for two days' benefits, and so on. If the employee continues to lose time from work through the fourteenth (14th) day, the seven-day waiting period will be picked up and the employee will be due benefits for all fourteen (14) days.
OBTAIN REPRESENTATION: Contact an attorney who knows the Workers Compensation Law. The Tennessee work comp law is complex and confusing. Unless you have an attorney who knows the laws, you will be left in the dark as to whether you are being treated fairly.
Benefits You Should Receive
Tennessee Workers' Compensation is a "no-fault" system in which the injured worker receives medical and compensation benefits regardless of how the incident occurred or if you were at fault. The criteria for compensability are that the injury arose out of and during the course of the course of employment. The available benefits can include the following:
MEDICAL TREATMENT: The employee should be given a choice of three (3) alternative physicians not associated together in practice. The list or panel of these physicians must be in or near the employee's community of residence. You are required to select one physician from the list of three. The employee is then required to provide treatment from the chosen physician, and you should not see any other physician unless the chosen physician makes a referral. If you are not happy with your treating physician your options are limited under Tennessee law. The employer or insurance carrier is not mandated to offer a second panel of physicians or a second opinion; if asked, however, many insurance carriers and employers will provide a second panel.
PAYMENT WHILE OFF WORK: If a physician takes you off work for more than seven days, you may be entitled to temporary disability payments. An injured employee is not paid for the first seven (7) days of disability. On the eighth (8th) day, the employee is eligible for one day's benefits, on the ninth (9th) day, the employee is eligible for two days' benefits, and so on. If the employee continues to lose time from work through the fourteenth (14th) day, the seven-day waiting period will be picked up and the employee will be due benefits for all fourteen (14) days.
How much will my Temporary check be? An employee is entitled to 66 2/3% of his/her average weekly income, but neither more than the maximum nor less than the minimum. The weekly compensation rate is subject to the workers' compensation maximum and minimum rates in effect on the date the employee was injured.
COMPENSATION FOR PERMENANT INJURY: If you do not completely recovery recover from the work injury, you are entitled to receive compensation. If the injury is permanent the workers compensation physician will give a percentage of disability and state the part of the body involved. This is called a disability rating. However, not all Doctors agree on a the extent of a workers disability or even if a disability exists. If your are released by your workers compensation doctor with a small disability you should contact an attorney to see if the rating is fair. If the rating is low it will have a direct impact on the amount of your compensation. If needed, an experienced workers compensation attorney should be able schedule an independent medical examine with a separate physician to obtain a second opinion in relation to the impairment rating.
DEATH BENEFITS: When an injury results in the death of a covered employee, the widow or widower or dependent orphan is entitled to 50% of the deceased employee's average weekly wage, not to exceed the maximum per week. . If the deceased employee leaves a widow/widower and one or more dependent children, 66 2/3% of the deceased employee's average weekly wages, not to exceed the maximum per week, is due. . If a deceased employee leaves other relatives dependent on the employee for support, compensation may also be payable to those dependents. . When the deceased employee leaves no dependents, $20,000 shall be paid to his or her estate. If anyone other than your employer and/or co-worker is partly or wholly at fault for your injury you may have a 3rd party claim against that person or company. Often these cases can give the employee more compensation than the original workers compensation claim.
What If My Doctor Takes Me Off Work?
If the workers compensation doctor takes you out of work because of the injury, the Tennessee Workers Compensation act requires the employer or insurance company to pay you a check called a temporary total disability check (TTD). This check is equal to 66 2/3 of the worker’s average pay check. This is calculated by averaged the wages of the employee’s for 52 weeks prior to the injury date. It should also be noted that there are maximums and minimums for the TTD. This payment should begin 15 days after the injury and the check should be paid twice per month at the least.
Do I Need A Lawyer?
By Tennessee state law, an injured individual is permitted to represent him or herself in a workers' compensation case, just as in any other Tennessee legal proceeding. However, anyone involved in a Tennessee workers' compensation lawsuit or attempting to negotiate an out-of-court settlement should have a thorough knowledge of workers' compensation law and the Rules of Evidence.
Moreover, Tennessee employers and their insurance companies are typically represented by competent, well-paid lawyers who try to defeat the claim or at least minimize the dollar amount of compensation an injured worker will receive. Also, Tennessee law contains time limits for reporting an injury or disease to the employer and for filing a complaint for benefits (called "statute of limitations"). If a workplace injury is not reported in time, or if the claim is not filed within the applicable statute of limitations, the injured Tennessee worker can lose his or her right to receive any compensation for work injuries. Yet, despite this unfairness, Tennessee employers have no legal obligation to advise their injured employees of these workers' compensation time limits.
For these reasons, it is vital to work with an experienced Memphis attorney familiar with the Tennessee guidelines for permanent impairment assessment and with those physicians that workers' compensation insurance companies in Tennessee use. A physician who gives a low impairment will directly affect the value of your case. As such you need a workers' compensation lawyer who will recognize a low impairment and can arrange a second opinion with another doctor.
We have access to and relationships with knowledgeable and experienced physicians to perform independent medical evaluations. Our physicians will provide thorough and competent assessments of your range of motion, loss of strength, atrophy and residual pain. They will take their clinical information and determine your permanent impairment rating based on a standardized text for the evaluation of permanent medical impairment.
We will likely send you to a vocational or industrial expert as well. Tennessee law allows vocational experts to determine the nature and extent of your vocational disability based upon your education, age, job experience, training, ability to read and write, severity of injury, extent to which your injury precludes you from job opportunities in your field, and other factors.
