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Tennessee Workers' Compensation Handbook, 6th Edition

Tennessee Workers' Compensation Handbook, 6th Edition

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Tennessee Workers’ Compensation Handbook

Your new 6th edition is now available for order!

What are your workers' compensation obligations? What do you do once an employee has filed a claim? What happens when a lawsuit is filed?

Now there's an instant-reference guide for the answers to these questions, and much more.

Packed with crucial compliance and practice guidance to help you manage the sweeping 2014 changes to Tennessee workers' comp laws, your new edition includes:

  • New administrative structure. How will the changes from a court system to an administrative system alter the way workers’ comp claims are decided?
  • New "courts." How will the Court of Workers’ Compensation Claims and Appeals Board operate?
  • Expedited hearings. When are they available?
  • Settlements. When and how will settlements be approved?
  • New language. Terms like BRC and RFA will be replaced with PBD and DCN.
  • Ombudsman program. The Ombudsman program will provide assistance to parties who are not represented by attorneys.
  • Templates. With the changes come new forms, now called templates, which will be available for download.


In plain-English, Tennessee Workers' Compensation Handbook, 6th edition:

  • Clearly explains complex issues
  • Covers all of the most recent reforms
  • Summarizes pertinent case law
  • Helps determine scope of employment
  • Clarifies medical issues
  • Outlines statutory and regulatory requirements
  • Makes you the expert in Tennessee workers’ comp management!



Fred BakerAttorney Fredrick R. Baker is a member in the Cookeville, Tennessee, office of Wimberly Lawson Wright Daves & Jones, PLLC, which he joined in 2001. His law practice includes an emphasis in workers' compensation and employment discrimination, as well as ADA and FMLA compliance. Fred is on the Advisory Board for the Tennessee Workers' Comp Reporter.  He received his Bachelor of Arts degree in Philosophy, summa cum laude, from Transylvania University and his law degree, magna cum laude, from the University of Tennessee.

 

Tennessee Workers’ Compensation Handbook

Your new 6th edition is now available for order!

What are your workers' compensation obligations? What do you do once an employee has filed a claim? What happens when a lawsuit is filed?

Now there's an instant-reference guide for the answers to these questions, and much more.

Packed with crucial compliance and practice guidance to help you manage the sweeping 2014 changes to Tennessee workers' comp laws, your new edition includes:

  • New administrative structure. How will the changes from a court system to an administrative system alter the way workers’ comp claims are decided?
  • New "courts." How will the Court of Workers’ Compensation Claims and Appeals Board operate?
  • Expedited hearings. When are they available?
  • Settlements. When and how will settlements be approved?
  • New language. Terms like BRC and RFA will be replaced with PBD and DCN.
  • Ombudsman program. The Ombudsman program will provide assistance to parties who are not represented by attorneys.
  • Templates. With the changes come new forms, now called templates, which will be available for download.

 

 


Table of Contents

 

The Law in Tennessee

• History, Purpose, and Future
• Statutory Construction
–– The Requirement of Equitable Interpretation for Injuries Prior to July 1, 2014
–– Application of the Rule for Injuries Prior to July 1, 2014
–– The Removal of Equitable Interpretation for Injuries on or after July 1, 2014
• Rule of Exclusivity
–– Generally
–– Application of the Rule
–– Limitations on the Rule


Coverage Issues

• Employer-Employee Relationships
–– The Definition of Employee
–– The Definition of Employer
–– Contract of Hire
• Exemptions to Coverage
–– Common Carriers
–– Casual Employees
–– Domestic Servants and Farm/Agricultural Laborers
–– Businesses with Fewer Than Five Employees
–– Governmental Entities
–– Volunteer Ski Patrol Persons
• Special Employment Relationships
–– Dual and Joint Employment
–– Loaned Employees
–– Independent Contractors
–– Statutory Employers
–– Individuals Engaged in Construction Industry
–– Coverage by Agreement
–– Waivers


Compensable Injuries

• Injury by Accident — Generally
–– “Arising Out of” Employment
–– “In the Course of” Employment
• Particular Applications
–– Going to and from Work
–– Traveling Employees
–– Exposure to Elements
–– Personal Comfort Activities
–– Acts of God
–– Horseplay
–– Meal and Break Periods
–– Recreational Activities
–– Emergencies
–– Assaults
–– Idiopathic Injuries
–– Telecommuters
–– Mutual benefit
• Specific Injuries and Medical Issues
–– Proof of Medical Causation — Generally
–– Proof of Permanency
–– Gradual Injuries
–– Heart Attacks and Strokes
–– Psychological and Emotional Injuries
–– Hernias
–– Aggravation of Preexisting Conditions
–– Last Injurious Injury Rule — Successive Employers and Insurance Carriers
–– Subsequent Intervening Causes

Occupational Diseases

• Statutory Requirements
• Compensation and Benefits
• Aggravation of Preexisting Conditions or Diseases
–– Determining When an Aggravation Has Occurred
–– Waivers of Compensation for Aggravation of Occupational Disease
• Last Injurious Exposure Rule — Successive Employers and Insurance Carriers
• Notice of Contraction
• Statute of Limitations
• Application to Federal Black Lung Benefits

Medical Benefits

• Employer’s Rights and Obligations
–– Generally
–– Providing the Panel
–– Failure to Provide the Panel
–– Mileage Reimbursement
–– Emergency Treatment
–– Employer’s Right to Independent Medical Evaluation
–– Pain Management
–– Settlement of Future Medical Benefits
–– Penalties
• Employee’s Rights and Obligations
• Physician’s Obligations
–– Records and Reports
–– Litigation
–– Fees and Expenses
• Reasonableness of Services and Charges
• Resolution of Disputes
–– Disputes over Ongoing Medical Treatment
–– Disputes over Future Medical Treatment
–– Disputes over Impairment Ratings
–– Disputes over Medical Bills
• Case Management Requirements
• Confidentiality of Medical Information and Medical Records

Disability Benefits

• The Definition of “Maximum Weekly Benefit” and “Average Weekly Wage”
–– Maximum Weekly Benefit
–– Minimum Weekly Benefit
–– Average Weekly Wage
• Temporary Total Disability
–– Generally
–– The Period of Disability
–– Maximum Medical Improvement/Ability to Return to Work
–– State Filing Requirements
–– Resolving Disputes
–– Enforcement of Penalties
–– Interaction of Temporary Disability and Unemployment Compensation
• Temporary Partial Disability
• Permanent Partial Disability for Injuries before July 1, 2014
–– Scheduled Injuries
–– Body as a Whole Injuries
–– Statutory Multipliers
• Permanent Partial Disability for Injuries on or after July 1, 2014
• Permanent Total Disability
–– Generally
–– Period of Disability
–– Social Security Offset
–– Reconsideration of Permanent Total Disability Status
• Relationship to Death Claim
• Maximum Total Benefit
• Set-Offs


Death Benefits

• Generally
• Presumed Dependency
–– Surviving Spouse
–– Children Under 16 Years of Age
–– Prima Facie Dependents
• Actual Dependency
• Partial Dependency
• Distribution of Benefits
–– No Dependents
–– Actual Dependents
–– Partial Dependents
–– Periodic or Lump Sum Payments
–– Deductions in Case of Death
• Modification and Termination of Benefits

Second Injury Fund

• Purpose and Policy
• Application and Apportionment
–– Second Injury Fund Liability under TCA § 50-6-208(a)
–– Second Injury Fund Liability under TCA § 50-6-208(b)
• Procedures and General Considerations in Claims Against the Second Injury Fund

Claims and Defenses

• Notice of Injury
–– Statutory Requirements
–– Sufficiency of Notice
–– Timeliness of Notice
–– Reasonable Delay or Excuse
–– Waiver and Estoppel
• Statute of Limitations
–– Statutory Requirements
–– Tolling the Statute
––  Reasonable Delay or Excuse
–– Waiver and Estoppel
–– Second Injury Fund
• Willful Misconduct and Willful Failure or Refusal to Use Safety Device
• Intentional Self-Inflicted Injury
• Intoxication or Illegal Drug Use
• Willful Failure to Perform a Duty Required by Law
• Recreational Activities
• Misrepresentation
• Unavailable Defenses

Subrogation and Third-Party Actions

• Generally
–– Subrogation Liens
–– Employer’s Credit
–– Attorney’s Fees
–– Limitations of Actions
• Actions by Employer Against Third Party
• Third-Party Claims Against Employer
–– In General
–– What Is a “Third Party”?
–– Exceptions to Employer Immunity

Practice and Procedure

• Jurisdiction
–– Generally
–– Extra-Territorial Jurisdiction
–– Election of Remedies
• Filing Claims for Workers’ Compensation Benefits
–– Injuries before July 1, 2014
–– Injuries after July 1, 2014
• Settlements
–– Injuries before July 1, 2014
–– Injuries on or after July 1, 2014
• Ombudsman
• Evidence and Burden of Proof
–– Generally
–– Medical Testimony and Records
–– Vocational Disability
–– Affirmative Defenses
• Attorneys’ Fees and Costs
• Judgments
–– Modifications, Motions to Set Aside, and Reconsideration of Awards
–– Assignment of Benefits
–– Interest
–– Refund of Benefits Pursuant to Workers’ Compensation Specialist’s Order
–– Evidence of Workers’ Compensation
Specialist’s Order
• Lump Sum Awards
• Appellate Review
–– Injuries before July 1, 2014
–– Injuries on or after July 1, 2014

Insurance Coverage and Related Issues

• Coverage Requirements and Penalties
–– Generally
–– Certificate of Compliance
–– Policy Provisions
–– Premiums and Credits
–– Penalties
–– Misclassification by a Construction Services Provider
• Claims Management Regulations
–– Generally
–– Claim Reporting
–– Acceptance or Denial of Claim
–– Claim Investigation
–– Benefit Payments
–– Settlement
–– Penalties
• Safety Committees and Grants
• Workers’ Compensation Fraud Act
–– Generally
–– Remedies and Penalties
–– Disclosure of Information
–– Anti-Fraud Plans
• Drug-Free Workplace Programs
–– Generally
–– Notice and Policy Provisions
–– Types of Testing and Related Issues
–– Testing Procedures
–– Important Miscellaneous Testing Provisions
–– Confidentiality
–– Training
• Uninsured Employers Fund

Interaction of Tennessee Workers’ Compensation Law and Employment Laws

• Overview of Pertinent Employment Laws
–– Overview of the FMLA
–– Overview of the Americans with Disabilities Act
• Interplay Between Definitions
–– Definitions of Disability
–– Definition of Essential Functions
• Interplay in the Pre-Employment Process
–– The Pre-Offer Phase
–– The Post-Offer Phase
• Interplay Between Attendance and Leave Issues
–– Interaction of Workers’ Compensation and FMLA Leave
–– Interaction of FMLA and ADA Leave
–– Interaction of ADA and Workers’
Compensation Leave
• Interplay Between Return to Work and Reinstatement Issues
–– Fitness-for-Duty Certifications
–– Reasonable Accommodation
–– Reinstatement
• Interplay in Termination Issues
–– Under the FMLA
–– Under the ADA
–– Under Workers’ Compensation

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