Workers’ Compensation Frequently Asked Questions

1. WHO IS COVERED?
2. WHEN AM I COVERED?
3. WHAT IS A JOB-RELATED INJURY?
4. WHAT SHOULD I DO IF I GET INJURED?
5. WHAT WORKERS' COMPENSATION BENEFITS ARE AVAILABLE TO ME?
   1. MEDICAL CARE AND EXPENSES
   2. TEMPORARY DISABILITY
   3. PERMANENT DISABILITY
   4. DEATH BENEFITS
6. WHAT IF MY EMPLOYER DISCRIMINATES AGAINST ME BECAUSE OF MY WORK-RELATED INJURY OR ILLNESS?
7. ADDITIONAL INFORMATION ON HEARINGS, LIMITATIONS ON FILING A CLAIM AND SETTLEMENTS
8. WHAT OTHER BENEFITS MAY I BE ENTITLED TO OTHER THAN WORKERS' COMPENSATION?
9. REPRESENTATION BY AN ATTORNEY AND ATTORNEY'S FEES

1. WHO IS COVERED?

Almost every employee in Tennessee is covered by Workers' Compensation. There are exceptions if your employer has never had more than 5 employees. Generally, if you render a service to another in exchange for wages or similar compensation (transportation expenses, living accommodations, meals, etc), you are probably a covered employee.

However, there are a few very important exceptions. Federal employees and persons covered under federal legislation have other benefit programs not covered in State Workers' Compensation. If you have a question about whether or not you are covered by the Tennessee State Workers' Compensation System, call The Law Offices of John R. Johnson, III, P.C., and an attorney will be happy to answer your questions.

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2. WHEN AM I COVERED?

Generally, coverage begins the moment you start work and continues any time you are working. Under certain very special circumstances, it can extend to the time before you start and after you finish work, as well as on your way to work and on your way home from work.

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3. WHAT IS A JOB-RELATED INJURY?

An injury may be the result of a single incident at work such as cutting your finger on a machine, falling, twisting or feeling a sharp pain when you lift a heavy object, etc.

An injury may be gradual, due to repeated or prolonged exposure to activity or substances at work. For example, if you are required to work around noisy machines, you may eventually suffer a loss of hearing; or, if you are constantly lifting heavy objects, you may begin to feel pain in your back.

An injury may be the result of a disease caused by, or aggravated by your employment, such as asbestosis from exposure to asbestos particles, or lung disease from exposure to toxic substances. Your injury may be the result of a combination of a prior injury or illness aggravated by a work-related injury or illness. FAULT IS NORMALLY NOT A CONSIDERATION IN DETERMINING WHETHER YOUR INJURY IS WORK RELATED.

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4. WHAT SHOULD I DO IF I GET INJURED?

If you get hurt on the job, tell your supervisor or foreman immediately. You need to give your employer enough information so that he or she can report it to his or her insurance carrier. It is best to give your employer a brief written letter signed by you (keep a copy!) stating the date, time and circumstances of the accident or to obtain a copy of the accident report that your employer fills out.

Failure or delay in reporting the injury may result in a delay or even denial of Workers' Compensation benefits by your employer. For example, a claim reported late may delay benefits until the cause of the injury has been investigated. NOTE: Even if you have not reported the injury (for example when it is a gradual illness or disease, or you are not aware that your injury is work-related), you may still be entitled to benefits once you are aware of the possibility it is a work-related injury.

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5. WHAT WORKERS' COMPENSATION BENEFITS ARE AVAILABLE TO ME?

Provided your injury/illness is work-related, you may be entitled to one or more of the following benefits depending on your situation.

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A. MEDICAL CARE AND EXPENSES

You are entitled to receive all medical treatment reasonably necessary to cure or relieve you from the effects of your work related injury or illness.

You are entitled only to medical care authorized by law. Doctors, hospital, chiropractors, nurses, medicine, braces, canes, hearing aids, etc., can be covered under medical care, as well as the necessary and reasonable care ordered by your authorized doctor.

Tennessee law has established that after 5 weeks your claim may be handled by a Medical Case Manager. This person is paid by your employer or insurance company to oversee your medical benefits. The Medical Case Manager has the right under the law to refer you to different health care providers other than those suggested by your doctor. For example, if your doctor wanted you to have physical therapy at one hospital, the Medical Case Manager could send you to another hospital for therapy if you can receive the same type of therapy offered by the hospital to which your doctor directed you. The Medical Case Manager should not overrule your doctor or make you do things your doctor tells you not to do.

Your employer has the right to select three doctors not associated in the same practice together for your medical care. If your employer does so, then you must choose one of these doctors. Otherwise, your medical care payments may be denied. If your employer has only sent you to the one doctor, then you may have the right to get your own doctor. Before you change doctors, it is best to consult with an attorney who handles primarily Workers' Compensation Law. At The Law Offices of John R. Johnson, III, P.C., we are thoroughly experienced in Workers’ Compensation Law. Give us a call.

In addition to treatment, you have the right to ask to be evaluated by a doctor of your choice who specializes in work-related injuries. Because this report may be used to determine your right to temporary disability, permanent disability rating, and your future need for medical care, etc., it is important that the doctor be selected with care and in consultation with your attorney. You will be responsible for the costs of this evaluation.

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B. TEMPORARY DISABILITY

This benefit is paid while you are recovering from your work-related injury or illness and are unable to return to your regular work. This should be confirmed by your treating doctor. These payments should continue until you return to work or the doctor says you have reached maximum recovery.

Your temporary disability payment is usually based on two-thirds of your average weekly wage up to a maximum provided by law. You must be off work for seven (7) days straight before an employer must begin these payments. If an Employer or insurance company refuses to pay temporary disability payments, Tennessee law has special rules. You may be able to make them pay penalties to you and the Department of Labor, but only after your claim is finally resolved by the court or by a Workers' Compensation Specialist employed by the Department of Labor.

If your treating doctors place you on temporary work restrictions because of your injury and there is not work available at your job within these restrictions, you are entitled to continue to receive temporary disability payments.

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C. PERMANENT DISABILITY

If your work-related injury or illness leaves you with any permanent after-effects which reduce your ability to compete in the labor market, you may be entitled to permanent disability payments. For example, your injury may have left you with an inability to do certain physical activities or be exposed to certain stressful situations or an inability to work around loud noise. Even though you are able to return to work, you may be entitled to permanent disability payments if you have a permanent disability.

This benefit is not based on your wage loss as it might be in a personal injury claim, but is based upon the extent of your disability or impairment, your age and your job duties at the time of your injury. This benefit can range from less than 1% to as much as 100%, depending on the amount of permanent impairment the doctor gives you, your age, education and work experience.

If you have any question about whether you are entitled to a permanent disability award and the amount to which you are entitled, contact The Law Offices of John R. Johnson, III, P.C. We concentrate on representing employees with work-related injuries and illnesses. Permanent disability payments are made in addition to both temporary disability benefits and medical care expenses.

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D. DEATH BENEFITS

If your work-related injury or illness results in death, benefits may be paid to qualified surviving dependents. For example, if an employee is killed on the job, or if his or her job contributed to or in any way caused the death (for example, stress on the job causing or aggravating a heart condition resulting in death), the surviving spouse, if dependent on the earnings of the deceased, may be entitled to receive this benefit paid in weekly installments.

In addition to dependent awards, there is also an allowance for reimbursement of burial expenses. Note, there is a statute of limitations on the filing of this type of case.

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6. WHAT IF MY EMPLOYER DISCRIMINATES AGAINST ME BECAUSE OF MY WORK-RELATED INJURY OR ILLNESS?

Although in Tennessee an employer can fire you for most any reason (exceptions are unions, employment contracts, teacher tenure and for exercising certain constitutional rights), under the law your employer cannot fire you for filing a Workers' Compensation claim. If you are terminated or threatened solely for filing a claim, then get independent proof and call The Law Offices of John R. Johnson, III, P.C.

If you return to your job after your Workers' Compensation claim is finished and your employer fires you or you leave work, you may be able to go back into court and receive additional Workers' Compensation benefits. To do this, you must file a new claim with the court within one year from the date you left work or were let go. The court does not always give you more benefits, however, and it will depend on your age, education and ability to work.

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7. ADDITIONAL INFORMATION ON HEARINGS, LIMITATIONS ON FILING A CLAIM AND SETTLEMENTS

Under the law in Tennessee all Workers' Compensation cases can be reviewed by a Workers' Compensation Specialist. The Specialist is a state employee who reviews your claim. The Specialist can order a hearing, called a Benefit Review Conference, to determine any benefits to which you may be entitled. The Specialist will talk to both you and your employer. Your employer's attorney can be present at the Benefit Review Conference. You also have a right to be represented by an attorney at this hearing.

The Specialist will ask questions concerning your injuries, your present condition and your work. Claims for Workers' Compensation benefits are decided or approved by a Workers' Compensation judge, or by the Workers' Compensation Specialist, if there is an agreement. There are no jury trials in Workers' Compensation. The decision reached by the judge, generally speaking, is paid on a weekly or monthly basis. In appropriate circumstances, your case can be settled by way of a Compromise and release, in which case payment is made in a lump sum. If you are notified to appear at a Benefit Review Conference, you should consult with an attorney who handles primarily Workers' Compensation Law. At The Law Offices of John R. Johnson, III, P.C., we are experienced in Workers’ Compensation Law. Give us a call.

You may want to file your claim as soon as possible so as to insure maximum recovery of benefits. Although there are many exceptions, Workers' Compensation claims should generally be filed within one year from either the date of injury or one year from the last date Workers' Compensation benefits are sent. If you are in doubt or you feel you fall within an exception, call The Law Offices of John R. Johnson, III, P.C. and speak to an attorney.

Generally a death claim must be filed within one year of the date of death. However, there are several very important exceptions to this rule. If you feel you may be entitled to this benefit, you should call The Law Offices of John R. Johnson, III, P.C., who specializes in Workers' Compensation cases.

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8. WHAT OTHER BENEFITS MAY I BE ENTITLED TO OTHER THAN WORKERS' COMPENSATION?

1. Social Security Disability Insurance Benefits
2. Private or Company Disability Insurance Benefits
3. Public Welfare Programs
4. Group Health and Accident Insurance Payments

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9. REPRESENTATION BY AN ATTORNEY AND ATTORNEY'S FEES

You have the right to be represented by an attorney of your choice in connection with your work-related injury. Further, your attorney will assist you in seeing that your benefits are properly protected.

Your employer, or your employer's insurance company, will be advised and represented by individuals experienced in Workers' Compensation cases and you should have an attorney experienced in handling Workers' Compensation claims representing you. At The Law Offices of John R. Johnson, III, P.C., we have the experience and background necessary to represent you and bring about a successful conclusion. Occasionally people are reluctant to see an attorney about claims, feeling that they don't want "to sue" or be thought of as a greedy, lawsuit happy freeloader. You should always be aware of the fact that when you do suffer a work-related injury or illness, there are benefits available for your protection and you should receive them to the extent allowed by law.

Attorney's fees for representing an injured employee are determined by the court or specialist and are paid out of the settlement or award. These fees are usually a percentage of the monetary recovery awarded to the injured employee and are set by law at a maximum of 20%.

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