Workers compensation in Tennessee is entirely statutory, which means that the legislature has attempted to put together a framework for handling a work related injury that is fair for everyone. In fact, in many ways it is fair to no one. However, it's what we have until someone changes it.
To cover all of the workers compensation laws in a page or two is impossible so I will try to cover the major points and areas that frequently cause problems. If you have further questions, please contact me so that we can discuss them.
Please note this discussion pertains to Tennessee workers compensation only. Each state will have its own unique set of laws.
Click on the links below to view the answers:
Do I have a workers compensation claim?
If I have a workers compensation claim, what do I do?
What benefits am I entitled to?
What happens when I am done treating with the doctor?
What is my case worth?
Can I be fired for reporting a work injury?
Do I have a workers compensation claim? TOP You are entitled to workers compensation benefits if you suffer an injury arising out of your employment. The injury must also occur in the course and scope of your employment. The "arising out of" requirement refers to the cause of the injury. "In the course of" refers to the time, place, and circumstances of the injury. Generally, an injury arises out of and in the course of employment if it has a rational connection to the work and occurs while you are engaged in the duties of your employment. Any question as to whether or not the injury arose out of the employment is to be resolved in favor of the employee, or in other words if it is 50/50 as to whether it is a compensable claim, the employee is supposed to win.
If I have a workers compensation claim, what do I do? TOP
You should report the injury in writing to the employer immediately, but no later than thirty (30) days after the injury! This is important. The employer must have actual notice of the injury so don't just assume that because your co-workers know then you have fulfilled the requirements of providing notice. Many claims are denied because the employee didn't tell the employer as soon as they realized they had a claim. At that point, the employer should fill out the proper forms. Note: The employer should report the injury or illness to the insurance carrier even if it is not clear the claim is valid. The insurance carrier has the authority to decide if the claim is compensable.
What benefits am I entitled to? TOP
Disability Benefits: 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. The amount of the disability benefits varies. An employee is entitled to benefits equaling two-thirds (2/3) of his or her average weekly income, but neither more than the maximum nor less than the minimum allowed by law. The employer should submit a wage statement to the insurance carrier with gross earnings for the past fifty-two (52) weeks prior to the date of injury. The statement should show all earnings, including overtime. Gross earnings are totaled, then divided by 52. The result is the employee's average weekly wage. The average weekly wage is multiplied by 66 2/3%. The result is the employee's weekly compensation rate. Medical Benefits: Your employer is to provide, free of charge, a panel of three physicians from which you will select one for treatment. The physician chosen then becomes the authorized treating physician. This physician will direct all medical treatment for your workers' compensation injury. If you refuse these physicians without good cause, you will be responsible for the costs of any treatment by an unauthorized treating physician. If a specialist is required, the physician may refer you; or, the employer may offer another panel of specialist from which to choose. Medical treatment should continue for as long as required by the authorized treating physician. If appropriate, your treating doctor will provide you with off-work excuses and light or restricted duty limitations. It is very important that you follow the authorized physician's instructions and restrictions at all times. Remember that you are always allowed to seek an independent medical opinion from an unauthorized physician, however this opinion/treatment will be at your own expense. In addition, your employer is not required to follow any instructions from this unauthorized doctor.
What happens when I am done treating with the doctor? TOP
When your injuries have healed, you will have reached maximum medical improvement (MMI). At this point your doctor will release you from their care. Your doctor may assign you a permanent impairment rating if your injuries don't heal completely. (This is covered in more detail in another section on this page)
Once you have reached MMI, your benefits stop. Your employer will then have a decision to make as to whether there is a position which you can perform based on any permanent restrictions your doctor may assess. If for some reason your employer cannot return to you to your prior employment at the same or greater rate of pay then this is a factor that is taken into consideration in the final settlement.
It is very important to note that workers compensation law allows medical benefits for the life of the employee. However, this lifetime benefit is restricted to the treatment resulting from the work-related injury. This isn't a form of general health insurance.
What is my case worth? TOP
This is probably the most confusing areas of workers compensation law. Not by coincidence it is one of the most important. Let me put you into a certain frame of mind so that you can better understand what is discussed below. Think of it this way, workers compensation law treats you like a machine. There is absolutely no compensation for pain, suffering, loss of enjoyment of life, mental anguish, etc. I have had countless clients tell me how much their injuries hurt or how it has affected their personal life. That simply isn't factored into the value of a workers compensation claim. To further illustrate my point, there is actually a Tennessee statute that lists parts of a persons body and tells you the maximum value for those parts. It's like reading a parts list for a car, an arm is worth so much, an eye is worth so much, etc.
Should you lose a part of your body in a work-related accident, you are entitled to receive so many weeks of compensation depending on the injury. Please note that for you to receive the full amount listed, you must lose that part of your body entirely. If this certain part of your body is only impaired and not lost entirely, then there will be further calculations that are discussed below.
How much you receive per week of compensation varies. See the discussion on disability benefits to determine how much you are entitled to for one week and then multiply that amount times the number of weeks provided for that part of your body. Here is a partial list of the parts: First or index finger 35 weeks
Great toe 30 weeks
Hand 150 weeks
Arm 200 weeks
Foot 125 weeks
Leg 200 weeks
Eye 100 weeks
Hearing (one ear) 75 weeks If you have not completely lost a part of your body, then it may be that your injury has healed and the injured part of your body has not recovered completely. If this is true, then your doctor will assign a permanent impairment rating (PIR) rating to that part of your body. For example the doctor may determine that you have a permanent impairment rating of 10% to the upper extremity (arm). The question then becomes to what extent this impairment rating affects the injured employee's ability to work. Based on these vocation factors, this PPD rating may result in a permanent disability settlement from the workers' compensation insurance company.
Whew!!! I assure you that there are countless quagmires in the field of workers compensation. There are entire volumes of books which discuss the value of workers compensation claims. I urge you to consult with legal counsel prior to accepting an offer from an insurance company. Of course, I would be happy to talk with you about it. Can I be fired for reporting a work injury? TOP It is unlawful for an employer to fire an employee for making a workers compensation claim. Should this occur, you have a claim for wrongful termination. Understand that this is different than when an employer determines it cannot find a job that meets an injured employees permanent restrictions | 
