Can an employer fire an employee for filing a workers’ compensation claim?
No. An employer cannot terminate or otherwise penalize an employee for reporting an injury at work or for filing a workers’ compensation claim. Workers’ compensation is intended to help injured workers receive compensation for their injuries. If employees feared termination or discipline from their employer then the employees would likely not file a workers’ compensation claim. If an employee is terminated for filing a workers’ compensation claim, the employee will need to pursue a wrongful termination legal claim to protect the worker’s rights. The Tennessee Workers’ Compensation Bureau does not handle wrongful termination claims.
Even though an employee cannot be terminated for filing a workers’ compensation claim, an employer may take other action with respect to the employee’s job. Notably, the employer does not have to keep the injured employee’s job open until the employee can return to work. What is more, if the employee can no longer perform the essential job functions of the position after recovering from the injuries the worker may not have the right to return to the employer.
What steps does an employee need to take if they suffer an injury at work?
If an employee suffers an injury or illness during the course of employment, the worker should report the injury to the employer immediately. Under Tennessee law, an injured employee is required to report the injury or illness to one’s employer within 30 calendar days of the injury or illness. Failure to timely report an injury or illness may preclude the injured employee from receiving workers’ compensation insurance benefits. It is best practice to submit the notice of injury to the employer in writing. Notably, if immediate medical attention is required, the injured employee should seek medical attention at the nearest emergency hospital.
The employer is then required to complete Tennessee Employer’s First Report of Work Injury or Illness (Form C-20) within one working day of knowledge of the injury or illness. Insurance carriers and self-insured employers must also file a From C-20, which should be done as soon as possible, but can be done no later than 14 days after knowledge of the injury or illness. The insurance carrier or self-insured employer is required to pay workers’ compensation insurance benefits to the injured employee.
Is there a time limit within which the injured employee has to file a workers’ compensation claim?
Yes. An employee injured at work must act diligently in order to protect one’s right to receive workers’ compensation insurance benefits. Under Tennessee law, an injured employee has one year to file a claim for workers’ compensation insurance benefits. When the one-year time period commences depends on whether the injured worker has received any benefits from the employer. If the injured worker has not received anything from the employer then a workers’ compensation claim must be filed within one year following the accident causing the injury. If the employer has voluntarily paid benefits to the injured worker then the one-year time period does not commence until the latter of the date of the last authorized treatment or the time the employer ceased to make payments of compensation to or on behalf of the employee.
The one-year time period may be tolled (or delayed) until the injured worker first discovers the injury. The employee, however, may not unreasonably delay in discovering the injury. Rather, the employee must exercise reasonable diligence and care to discover the injury. In addition, if a worker suffers from mental or physical incapacity then the one-year time period does not commence until the incapacity ceases. For minors, the one-year time period starts when the minor turns the age of 18 years.
Which employers are required to obtain workers’ compensation insurance?
It is important for workers to know that not all employers are subject to Tennessee Workers’ Compensation Reform Act. Instead, only certain employers are subject to the Act and required to obtain workers’ compensation insurance benefits for employees. In general, employers that employ five or more employees must obtain workers’ compensation insurance benefits for their employees. The definition of employee includes family members, part-time workers, and corporate officers. Sole proprietors, partners and members of LLC, however, are excluded from the definition of employees. Notably, a corporate officer may be excluded from the definition of employee, but only if the corporate officer is not paid or does not receive compensation.
Some employers that do not employ more than five employees are still required to obtain workers’ compensation insurance benefits. For example, employers in the coal mining industry have to obtain coverage for their employees even if they just have one employee. Furthermore, some employers are exempted from the requirements of the Tennessee Workers’ Compensation Reform Act. State and local governments and those employing farm laborers or domestic do not have to obtain workers’ compensation insurance benefits for their employees.
Finally, even if an employer is not required to obtain workers’ compensation insurance benefits, the employer may still voluntarily elect to obtain coverage for its employees. Employers can secure workers’ compensation insurance benefits either through purchasing a policy from an insurance carrier or by qualifying as a self-insured employer with the Department of Commerce and Insurance.
How can employees find out if their employer is required to obtain workers’ compensation insurance for its employees?
Most, but not all, employers in Tennessee are required to obtain workers’ compensation insurance benefits for their employees. Every employer subject to Tennessee’s Workers’ Compensation Reform Act is required to display the Tennessee Workers’ Compensation Insurance Notice. This notice must be displayed at a conspicuous location at the place of business that is easy for the employees to view. The notice must contain contact information of the employer that allows the employee to confirm if the employer is subject to the state’s workers’ compensation law. In addition, the notice must contain the employer representative’s telephone number and physical address that should be notified in the event of an injury. The notice also lists what an employer must do in the case of an injury. The employer must complete a First Report of Work Injury form and send it to the workers’ compensation insurance company or the third party administrator. The employer must also offer the employee a list of physicians who will treat the employee.
Who is entitled to receive workers’ compensation benefits?
An employee who suffers a work-related injury or illness may be entitled to receive workers’ compensation benefits from their employer. While most employers are required to obtain workers’ compensation insurance benefits for their employees, not all employers are subject to the requirements of the Tennessee’s Workers’ Compensation Reform Act. Generally, employers who employee five or more employees are required to obtain workers’ compensation insurance for its benefits. If, however, an employee suffers a work-related injury for an employer who is not subject the Tennessee’s workers’ compensation requirements then the employee will not be entitled to receive workers’ compensation insurance benefits. Instead, the employee will need to explore other legal avenues to obtain compensation.
What types of injuries are covered under workers’ compensation?
An employee who suffers an “injury” at work may be entitled to receive workers’ compensation insurance benefits. Under Tennessee law, an “injury” means “an injury by accident, a mental injury, occupational disease including diseases of the heart, lung and hypertension, or cumulative trauma conditions including hearing loss, carpal tunnel syndrome or any other repetitive motion conditions, arising primarily out of and in the course and scope of employment, that causes death, disablement or the need for medical treatment of the employee.”
What workers’ compensation insurance benefits can employees recover if they are injured?
Workers’ compensation insurance benefits help an employee defray the expenses associated with suffering a work-related injury. In particular, workers’ compensation insurance benefits cover medical expenses and provide wage replacement benefits. Injuries from work-related accidents can result in significant medical expenses. Fortunately, if the employee’s treating physician provides authorization for a medical expense then workers’ compensation insurance will cover the medical costs. Workers’ compensation may cover medical expenses, such as medical/surgical treatment and supplies, medicine, crutches, nursing or psychological services.
Workers’ compensation insurance benefits also help cover a portion of an employee’s loss of wages from having to take time off work. If the work-related injury keeps the employee out of work for more than seven days then the employee may be entitled to temporary disability benefits while the employee is recovering from the injuries. Temporary disability benefits are paid at the rate of 66 ⅔ percent of the employee’s average weekly wages. In addition, an employee may be entitled to permanent disability benefits if the work-related injury prevents the employee from returning to work or from finding any job on the market. These permanent benefits are paid at the rate of 66 ⅔ percent of the employee’s average weekly wages.
Finally, if the employee dies as a result of the work-related injury then the employee’s estate or descendants will be entitled to compensation. These benefits include burial expenses up to $7,500 and compensation for loss of wages. If the deceased employee does not have any surviving dependents then the estate may receive $20,000. If there are dependents of the deceased employee then the dependents are entitled to receive a portion of the wages that the employee would have received. For example, a surviving spouse receives 50 percent of the employee’s average weekly wages, up to 400 weeks. If there is a surviving spouse and dependent children then the surviving spouse and children will be entitled to 66 ⅔ percent of the employee’s average weekly wages.
How is a doctor selected?
After an employee reports an injury to the employer, the employee’s supervisor should provide the employee with a list of at least three doctors who are willing and able to provide workers’ compensation medical treatment. The employer will provide the employee with this information a Form C-42 “Agreement between Employer/Employee Choice of Physician”. The employee will select a doctor who will become the authorized treating physician. The physician will provide medical treatment. The medical treatment should then be provided at the expense of the employer.
Notably, if the employee needs immediate medical treatment then the employee should first visit the emergency room at a local hospital. The employer will then provide a list of approved physicians to the employee after the employee’s injury is stable. An employee must comply with the doctor’s prescribed medical treatment. Failure to follow the doctor’s treatment at all times may preclude the injured employee from receiving workers’ compensation benefits.
Do employees have to be employed for a minimum amount of time before they are entitled to seek workers’ compensation benefits?
No. Tennessee’s Workers’ Compensation Reform Act does not require that an employee be employed for a certain period before the employee can claim workers’ compensation insurance benefits. Once the employee is hired by and starts working for the employer, the employee is entitled to claim workers’ compensation insurance benefits if the employee suffers a work-related injury or illness. In this respect, Tennessee’s workers’ compensation law treats all employees the same. Tennessee law does not distinguish between employees who were just hired and employees who have been working for a number of years. If a newly-hired employee suffers a work-related injury or illness on the first day of employment, the injured employee will be allowed to submit a claim for workers’ compensation insurance benefits.
Can part-time employees still file for workers’ compensation?
Yes. An employee does not have to be employed full-time in order to file for workers’ compensation benefits. Both full- and part-time employees are entitled to file for workers’ compensation benefits, as long as the employer is subject to Tennessee’s Workers’ Compensation Reform Act. Temporary workers may also be entitled to benefits. Even though both full- and part-time employees may seek workers’ compensation insurance benefits, they will not necessarily receive the same benefits. For example, temporary and permanent disability benefits are determined in relation to the employee’s wages. These wage replacement benefits are defined as a percentage of a worker’s weekly wages. Therefore, a full-time employee who works more weekly hours than a part-time employee will be entitled to greater wage replacement benefits.
Can employees recover workers’ compensation benefits even if they had a pre-existing injury?
Yes. To be entitled to benefits under Tennessee’s Workers’ Compensation Reform Act, an employee must suffer an injury by accident during the course of one’s employment. The injury must cause disablement or death and includes mental injuries. Even if an employee has a pre-existing injury prior to the accident, the pre-existing injury does not necessarily preclude an employee from seeking workers’ compensation benefits. The key to recovering workers’ compensation benefits, despite the existence of pre-existing injury, is being able to show that the work injury advances the severity of the pre-existing injury. Or the employee must show that the work injury is distinct and separate from the pre-existing work injury. Notably, increased pain of the pre-existing injury alone does not entitle an employee to recover workers’ compensation benefits.
What is a third-party liability claim?
Generally, workers’ compensation is the sole form of remedy that an injured employee may have against one’s employer. Workers’ compensation insurance benefits is a no-fault remedy that is intended to help an injured worker handle the medical expenses and loss of wages that may result from suffering a work-related injury. Unfortunately, workers’ compensation insurance benefits do not fully compensate an injured worker for the medical expenses and loss of wages that result from suffering a work injury.
An employee, however, may be able to obtain additional compensation if a third-party acted negligently and contributed to the employee’s injuries. The employee will have to file a personal injury lawsuit against the third-party, which is known as a third-party claim. Common examples of where a third-party may have contributed to the worker’s injuries include a defective tool, machine, device, or equipment, a negligent driver that is not controlled by the employer, defective scaffolding, property that is negligently maintained and controlled by someone other than the employer, or negligent construction or architect designs.
An employer will not report an employee’s injury or pay their claims. What can they do?
If an employer is subject to the Tennessee Workers’ Compensation Reform Act then the employer is required to take certain actions when one of its employees suffers an injury at work. For example, once an employee reports an injury to the employer, the employer is required to complete Tennessee Employer’s First Report of Work Injury or Illness (Form C-20) within one working day of knowledge of the injury or illness. It is paramount that the employer act diligently in submitting the form, as well as submitting an injury claim to its insurance carrier or in the case of a self-insured employer, its Third Party Administrator or internal claims handling program.
Any delay by the employer in reporting an injury claim can delay payment of workers’ compensation insurance benefits to the injured employee, including medical expenses and wage replacement benefits. Tennessee’ s Benefit Review Program assists employees, employers, and insurance carriers with resolving disputes with workers’ compensation claims. If an employer does not report an injury, an employee may contact the Ombudsman at the Tennessee Department of Labor and Workforce Development’s Workers’ Compensation Division for assistance in resolving these disputes. The Ombudsman can be reached at at 1-800-332-2667 or 615-532-4812. Also, an employee may reach out to an attorney for helping resolving a workers’ compensation dispute with an employer.
What is the process for returning to work after an injury?
After an employee recovers from a work-related injury or illness, the employee is often eager to return to work in order to receive their full wages. It is important, however, not to return to work too early and to make sure that the injuries are fully healed. There are several key people who will work with the employee to help the employee to return to work. These are the employee’s treating physician, the employee’s supervisor or management, the insurance claim adjuster, and an employee’s attorney, if they have one.
During recovery, the employee’s treating physician will determine when the employee is physically able to return to work. When the employee is ready to return to work, the employee’s physician will report the information to the employee’s claims adjuster. The employee will then work with the employer to determine what job duties the employee may perform. The physician may authorize the employee to return to regular duty or light duty. If the physician recommends light duty, the employer must work with the employee to ensure that the employee does not perform any job duties beyond what the physician recommends. If the employee refuses to return to work under the prescribed job limits then the employee may be at risk for losing their workers’ compensation insurance benefits.
There are some times when the employee is not able to return to work based on the physician’s recommended limits. In these situations, the injured employee may be entitled to permanent disability benefits. The Tennessee Bureau of Workers’ Compensation recommends that the employee stay in close contact with the doctor, employer, and claims administrator to report the work performed prior to the injury, the employee’s medical condition, the work that the employee can do after the injury, and possible alternative job duties that the employee may perform while recovering.
Who pays for workers’ compensation insurance benefits?
The Tennessee Department of Labor and Workforce Development is not responsible for paying workers’ compensation insurance benefits to injured employees. Instead, the The Tennessee Department of Labor and Workforce Development manages the workers’ compensation program to ensure that employers follow the program and to ensure that injured employees receive the compensation they deserve.
If an employee is entitled to workers’ compensation benefits then the employer’s workers’ compensation insurer will be responsible for paying benefits to the employee. If the employer is self-insured then the employer’s Third Party Administrator or internal claims adjuster will be responsible for providing benefits to the employee. If the employee is having difficulty obtaining workers’ compensation benefits then the employee should reach out to the Tennessee Department of Labor and Workforce Development’s Workers’ Compensation Division for assistance by calling 1-800-332-2667 or 615-532-4812. The injured employee may also want to consult an attorney for guidance.