Whenever an employee suffers an injury during the course of employment, it is important that the employee follows certain steps in order to receive workers’ compensation benefits. Failure to abide by the requirements set forth under Tennessee’s Workers’ Compensation Reform Act may prevent an injured employee from receiving any benefits. While one is not required to have an attorney in order to receive workers’ compensation benefits, an attorney can help guide an employee through the process and help defend an employee if the employer wrongfully denies benefits.
The first step in beginning the process to receive workers’ compensation benefits is to report the injury promptly to one’s employer. Typically, employees have up to 30 days from when the injury occurred or from when the employee should have known of the injury to report it to one’s employer. The 30-day timeline may also commence when a doctor first tells the employee of the work-related injury. Importantly, the notice must be given to the employer in writing. As soon as the employer is notified of the injury in writing, the employer must complete and submit a first report of work injury or illness. This form is typically completed by the employee’s immediate supervisor.
Second, the employer should provide the injured employee with a list of at least three nearby doctors who are willing to provide workers’ compensation medical treatment. If the injury is serious, the employee should seek immediate medical attention at a nearby hospital emergency room. The employer is required to provide a list of physician on an “Agreement between Employer/Employee Choice of Physician”, Form C-42. The employee will select a doctor who will become the authorized treating physician. The physician will provide medical treatment at the expense of the employer.
Third, the employee must file a Petition for Benefit Determination (PBD) form, which protects one’s right to receive workers’ compensation benefits. Generally, this form must be filed within one year after the date of the injury or within one year after the last temporary disability benefits were paid or medical benefits were provided for the injury, whichever is the latest. The failure to file this form within the prescribed time period may prevent an injured employee from receiving workers’ compensation benefits.
Often disputes arise between employees and employers regarding the payment of workers’ compensation benefits. An employer or insurance adjuster may deny workers’ compensation benefits to an employee or many not fully pay disability or medical benefits. In these situations, there is a dispute resolution mechanism in place to resolve workers’ compensation disputes.
The Court of Workers’ Compensation Claims adjudicates disputes between employees and employers regarding workers’ compensation benefits. A Workers’ Compensation Judge will preside over a dispute between the parties and issue a decision that will be binding upon the parties, unless either party files a timely appeal. The parties also have the option of resolving the dispute through the three-step Benefit Review Program. This program allows parties to resolve their disputes out of court, which can often be quicker and less expensive than resolving disputes through the court system.