What Is Workers’ Compensation Insurance?
Workers’ comp insurance in Tennessee provides coverage to employees who have been injured or fallen ill due to their job. It also is responsible for providing death benefits to the families of employees who have died as a result of work-related accidents or illnesses.
Many businesses in Tennessee are required to get worker’s compensation insurance. If your business is one of them, call us today at our Memphis line: (901) 306-8100. We have years of experience in the insurance industry and can help you find the perfect plan for your needs.
How Does Workers’ Comp Work in Tennessee?
Workers’ compensation insurance works by protecting your business in the following ways.
- It provides coverage for your employees if they are injured in a workplace accident or who fall ill due to their job.
- It keeps businesses from being fined for not having the required coverage as demanded by their state.
- It protects businesses from lawsuits and devastating legal fees.
Usually, once a business purchases workers’ compensation insurance, it is underwritten by an insurance company. In some cases, it may also be underwritten by a state fund. Please note that there is no state fund for Workers’ compensation in Tennessee.
How Is Workers’ Compensation Calculated?
Workers’ compensation is calculated through payroll wages and class codes.
While class codes are quite complex, in principle, they are still fairly simple and are just three to four-digit codes that insurance companies use to estimate rates based on the risk a job presents.
What If Your Business Can’t Get Workers’ Compensation Insurance?
If you are an employer and are unable to get coverage through a private carrier, you can obtain coverage through the Workers’ Compensation Insurance Plan (WCIP), otherwise known as the Assigned Risk Plan.
What Is The National Council of Compensation Insurance?
NCCI is a rating, advisory, and data collection organization dedicated to maintaining a healthy workers’ compensation system in Tennessee and 34 other states.
It provides a number of vital services, including workers’ compensation insurance rate making.
NCCI coordinates closely with state insurance regulators.
How Much Is Workers’ Comp in Tennessee?
Employers can expect to pay $0.57 per $100 in covered wages in Tennessee.
What Tennessee Workers Comp Insurance Covers
In Tennessee, workers’ comp covers three main areas—medical care, wage replacement, and death benefits.
Medical care coverage applies to medical expenses stemming from work-related accidents or illnesses and oftentimes travel to and from treatment facilities.
Partial wage replacement applies to the income an employee receives while he or she recovers from their illness or injury.
Death benefits are paid to the dependents of an employee who has died due to a work-related accident or illness.
Workers’ Compensation Disability Benefits
Workers’ compensation also provides coverage for temporary partial disability, temporary total disability, and even permanent disability.
Temporary partial disability is when an employee either has to work reduced hours or takes up a less strenuous role to avoid making their injury worse or re-injuring themselves.
Temporary total disability, as the name implies, fully replaces an employee’s wage while they are unable to work.
Permanent disability is reserved for the most severe work-related injuries and illnesses. It implies that the employee won’t be able to work again or only work in a limited capacity. Either way, the beneficiary is entitled to receive indefinite financial restitution.
Please note that your employer’s insurance carrier is responsible for paying these benefits, not the Bureau of Workers’ Compensation.
How To File A Workers’ Compensation Claim
If you are injured or fall ill because of your job, you should report the issue to your employer quickly. The sooner you report the problem, the better.
Once you’ve informed your employer of the issue, they will need to complete a Form C-20, otherwise known as the Tennessee Employer’s First Report of Work Injury or Illness form.
Your employer is required to fill this form out within one day, even if they do not agree with the claim and wish to dispute it.
Once the form is filled out, your employer will need to submit it to their insurance company, after which a determination will be made about the validity of the claim.
Some Things To Remember When Filing A Workers’ Comp Claim
When reporting an injury or illness, you want to (1) report what happened to your employer in less than 30 days and (2) provide your employer with a physician’s note.
Quick Tip: We strongly recommend giving your report in writing. While you can certainly give a verbal report, having something on paper protects you from questions about whether or not your report was made in a timely manner.
Will I Be Reimbursed For Treatment I Receive Before My Claim Is Approved?
If an employee is injured and can’t wait for their workers’ compensation claim to get approved because they need immediate medical treatment, then usually their medical expenses will be covered.
For their coverage to apply, however, there does need to be a clear and pressing need for treatment, and the treatment that is given should be appropriate to the situation.
What To Do if Your Workers Comp Claim is Denied
The best way to respond to a workers’ comp denial is to challenge the decision.
You’ll first want to speak with your insurer and learn about why the denial was made. You’ll then want to talk to a workers’ compensation attorney who will coordinate with your medical care provider to file an appeal.
Speed of the essence in this process since you will need to file an appeal within 30 days after you receive your denial letter. Don’t delay contacting an attorney. This is important.
What Are Your Rights As An Employee?
Tennessee state law guarantees certain rights for employees who have been injured or fallen ill because of their job.
Let’s take a look at some common questions people have regarding their workers’ compensation rights.
Can An Employee Get Fired For Being Injured Or Disabled?
The answer here is somewhat nuanced.
While it is illegal for your employer to fire you for filing a workers’ compensation claim, Tennessee is an “at-will” state, meaning your employer doesn’t have to hold your position in reserve while you are recovering.
In many cases, your employer will move forward and offer the position to someone else.
This is a tricky territory with a lot of gray areas in it, so if you believe you have been let go unfairly and have questions, we would recommend contacting an attorney.
Can An Employee Be Fired For Reporting Their Injury?
Again, no. If you believe you were fired for reporting an injury or filing a worker’s compensation claim, the best thing you can do is to contact an attorney.
Medical Restrictions Due To Work Injury. What Can I Do?
If your work-related injury qualifies you as disabled, then you can request to have reasonable accommodation.
Your employer might be able to change your position or adapt your work conditions in such a way as to allow you to keep working.
If your injury or illness, however, is very serious, your employer may not be able to reasonably accommodate your needs.
In such a case, you will most likely need to have a discussion with your employer, the insurance company, and potentially your attorney to determine what the best way forward is.
Can An Employee Lose Workers’ Compensation Insurance Benefits?
Yes, it is possible to lose your workers’ compensation benefits.
To avoid this issue, you’ll want to follow your physician’s instructions to the letter and closely communicate with your employer to ensure you are working (or not working) as instructed.
Aside from ignoring your physician’s instructions, some ways you can lose worker’s compensation benefits are:
- Failing to submit a workers’ compensation form to your insurance company
- Refusing a medical treatment or a medical exam
- Committing a crime
When Do Workers’ Compensation Benefits Stop?
The answer depends on the situation.
If the injury or illness isn’t permanent, benefits will stop once the employee has recovered.
An employee might also agree to a lump sum payment known as a compromise and release (C&R) instead of an ongoing payment arrangement, in which case, they won’t receive benefits beyond a one-time payment.
Also, if a beneficiary passes away from an issue not related to their workplace illness or injury, their workers’ compensation benefits will stop.
Tennessee Workers’ Compensation Law
The state of Tennessee has strict laws surrounding workers’ compensation. Here is a look at some of the issues you’ll want to pay attention to.
What Businesses Must Provide Workers’ Comp To Employees?
In Tennessee, businesses must get workers’ compensation insurance if they have five or more employees, regardless of whether those employees are part-time or full-time. Family members are not exempt from this rule.
With that said, some businesses, such as construction companies, are required to have workers’s compensation insurance even if they only have one employee.
Tennessee looks at various factors when determining if your workers are employees or independent contractors, such as the individual’s right to control the conduct of their work, if they are free to offer services to other parties, how they are paid, who determines their schedule, if they are free to hire additional help, and if they have supplied their own tools.
Workers’ Comp: What If A Business Has Less Than 5 Employees?
If you don’t have a business with five or more employees, you can still get workers’ compensation insurance, which may be a good idea, especially if you work in a high-risk industry.
If you feel workers’ compensation would be best for your small business, the good news is that you can cancel it at any time if it doesn’t suit your needs.
To obtain workers’ comp insurance as a small business, all you need to do is submit the Exempt Employers Notice of Acceptance of the Workers’ Compensation Act of Tennessee form to the Tennessee Bureau of Workers’ Compensation.
Is There A Penalty For Not Having Workers’ Comp in Tennessee?
The penalties for not having workers’ compensation coverage in Tennessee are not to be taken lightly. Tennessee’s Penalty Program hands out stiff fines that can cost you thousands of dollars and hurt your business.
If you don’t have workers’ compensation insurance but know you need it, the best thing you can do is contact a reputable and experienced insurance agency today to get coverage.
To get started, call us anytime at (901) 306-8100. We are available 24/7.
Statute Of Limitations For Workers’ Compensation In Tennessee
People who are employed in Tennessee have one year to file a workers’ compensation claim (Form C40B).
