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WORKERS COMPENSATION CLAIMS REPORTING PROCEDURES
WORKERS COMPENSATION CLAIMS REPORTING PROCEDURES
IMMEDIATE REPORTING OF ALL CLAIMS IS CRITICAL, DUE TO THE TIME LIMITS IMPOSED FOR REPORTING TO THE STATE OF TENNESSEE AND THE TIME LIMITS IMPOSED FOR RESPONSIVE ACTION IN THE EVENT OF LEGAL PROCEEDINGS.
Under the Tennessee Workers' Compensation Act, employers are required to file the Employer's First Report of Work Injury (Form C-20). Form C-20 must be filed for each and every work related accident resulting in personal injury or death and causing seven (7) days lost work time. The C-20 must be submitted to the State as soon as possible; but, not later than fourteen (14) days after the injury.
Certain other forms are required by the State, even for injuries causing less than seven (7) days lost work time. The Tennessee Department of Labor, Division of Workers' Compensation may assess fines for late submissions of any Workers' Compensation reports. It is essential that the C-20 be submitted to the TML Pool Claims Department (Public Risk Services) immediately upon notification of the injury of an employee, in order for PRS to make the necessary State filings, in a timely manner.
PANEL OF PHYSICIANS
The Tennessee Workers' Compensation Law, Tennessee Code Annotated, Section 50-6-204, (4), authorizes the use of a Panel of Physicians; "provided that the employer shall designate a group of three (3) or more reputable physicians or surgeons not associated together in practice." The injured employee then has the privilege of selecting, from this panel, his/her treating physician. Once the selection has been made the employee is required to confine treatment to that physician. Medical expenses may not be the responsibility of the employer where there is non-compliance with this section of the law.
The TML Pool recommends that municipalities appoint such panels and will assist in panel selection.
CASE MANAGEMENT
The TML Pool Claims Department actively utilizes case management in order to assure that appropriate medical care is given and that maximum medical improvement is reached as quickly as possible. Hospital pre-admission certification, alternative treatment plans and/or care settings, and vocational rehabilitation are some of the means used by case management specialists to assist the claimant in reaching a return to work status.
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