How to File a Workers' Compensation Claim in Tennessee

Learn when and how to file your workers' compensation claim in Tennessee.

Tennessee workers’ compensation pays benefits to employees with work-related injuries or illnesses. Workers may receive medical treatment, compensation for wage loss, and other financial assistance. To collect benefits, you must meet certain requirements, including reporting your injury to your employer within a certain time frame.

How Does the Tennessee Workers’ Compensation System Work?

In Tennessee, most employers must have workers’ compensation coverage—either by purchasing a workers’ comp policy from a private insurance company or by receiving certification from the state to self-insure. (In general, only large, financially stable employers will qualify to self-insure.) The Tennessee Bureau of Workers’ Compensationoversees all workers’ comp claims in the state.

Like all other states, Tennessee has a no-fault workers’ compensation system. You do not need to show that your employer did something to cause your injury. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.

Eligible workers may receive a variety of benefits, including:

  • temporary and permanent disability benefits
  • reasonable and necessary medical care, and
  • vocational rehabilitation (training or education for a new line of work).

How Do I Report an Injury?

To start a workers’ comp claim, you must notify your employer of your injury and request workers' compensation benefits. In Tennessee, the notice deadlines vary, depending on when your injury occurred:

  • Injuries occurring before July 1, 2014: you must report the injury within 30 days of the accident or of discovering that the injury is work-related.
  • Injuries occurring on or after July 1, 2014: you must report the injury within 15 days of the accident or of discovering that the injury is work-related.

Under Tennessee law, notice may be made orally or in writing. However, written notice is best because it documents the date you reported the injury or illness. When you notify your employer, provide as much detail as possible, including:

  • when the accident happened
  • how you hurt yourself, and
  • what symptoms you are experiencing.
If you fail to timely notify your employer, you may lose some or all of your benefits. Additionally, employers and insurance companies are often skeptical of claims when employees delay in reporting their injuries. Giving notice and getting treatment right away will reduce the likelihood of a claim denial.

How Do I Get Medical Treatment?

Once you give notice, your employer should present you with a panel of physicians—listed on an Employee’s Choice of Physician form (Form C-42). You must select one of the doctors on the panel and sign the completed form. This physician will become your authorized doctor for work-related treatment. If you get treatment from an unauthorized provider, the insurance company may refuse to pay the bills.

It is important to provide the doctor with accurate information about the cause of your injuries and the severity of your symptoms. Insurance companies rely heavily on medical records of initial treatment when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits. (For more information, see Seeking Medical Treatment for a Work-Related Injury.)

What Happens After I Report My Injury?

Tennessee workers typically do not need to file a formal claim with the Bureau of Workers’ Compensation. Instead, they simply have to report the injury and request workers’ compensation benefits, as discussed above.

Your employer will then complete a First Report of Injury form (Form C-20) and send it to its insurance company. The insurance company will review your claim and determine your eligibility for benefits. Its investigation may involve:

  • reviewing your medical records
  • analyzing your work experience, education, and wages
  • ordering a medical examination to assess your condition, and
  • sending you for a functional capacity evaluation (an assessment of your ability to perform work duties).

Under Tennessee law, the insurance company must either approve or deny your claim within 15 days of notification. If your claim is approved, workers’ compensation benefits must be paid promptly. Unfortunately, insurance companies deny many workers’ compensation claims. (For common grounds for a denial, see Denied Workers' Compensation Claims.)

Appealing a Denied Workers’ Compensation Claim

You have the right to appeal a denied workers’ comp claim. To begin the process, you must file either a Petition for Benefit Determination (for injuries occurring on or after 7/1/2014) or a Request for Mediation(for injuries occurring before 7/1/2014) with the Bureau of Workers’ Compensation. In Tennessee, you must file your appeal with the Bureau of Workers’ Compensation within one year of:

  • your date of injury
  • the date your last disability payment was made, or
  • the last date medical benefits were provided.

Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer and you may be at a disadvantage if you proceed without an attorney. Tennessee also offers an Ombudsman Program that helps injured workers with their claims.

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