Employer Responsibilities Part 2 of 3: How does it work?
COVERAGE REPORTING REQUIREMENTS Employers subject to the TWCL’s coverage requirements must file written evidence of compliance with the Division, or, if self-insured, with the Tennessee Department of Commerce and Insurance. The evidence of compliance is due within 30 days of procuring or renewing a workers’ compensation policy, or, if the employer is self-insured, within 30 days of qualifying as a self-insurer.
INJURY REPORTING REQUIREMENTS When an employee reports a work-related injury, the employer must report it to the insurance carrier (if applicable) within one business day. The employer must also notify the Division of any injury by filing an Employer’s First Report of Work Injury or Illness. The first notice is due to the Division as soon as possible, but:
* If the employee has not returned to work within seven days of the injury due to the work-related condition, the first notice is due no later than 14 days after the employer had knowledge of this; or
* If the employee returns to work within seven days or fewer, the first notice is due no later than the 15th day of the month following the month in which the injury occurred.
PHYSICIAN PANEL AND MEDICAL EXPENSES As soon as possible, but no later than five days after a workplace injury, employers must provide an injured employee with a list (also referred to as a panel) of at least three independent medical treatment providers who can provide treatment for the injured employee. The medical care providers on the list must practice within the employee’s community. The law does not define “community,” but it indicates that if no physicians are available in the employee’s community, the panel physicians may be located within 100 miles of the employee’s residence. The panel must be established using the “Agreement Between Employer/Employee Choice of Physician” form. Employees must choose a provider from the panel, or they risk losing coverage under the TWCL.
The TWCL requires employers to cover the cost of any procedure that an injured employee’s treating physician determines is reasonable and necessary to treat the work-related injury. All medical expenses must be paid within 45 days of receiving a bill or invoice. Employers must also provide copies of any medical records upon an employee’s request.
PAYMENT OF BENEFITS Employers (or their insurance carriers, if applicable) must pay compensation for an injured employee’s lost work time within 15 days after receiving notice of the disability. Ongoing disability benefits must be paid thereafter on a semi-monthly basis.
CLAIM REPORTING REQUIREMENTS The TWCL requires employers to provide the following notices to the Division. Failure to comply with the filing requirements can result in penalties.