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A Guide To Workers' Compensation/Division of Claims Administration

Benefits Available
    The benefits provided under the Tennessee workers' compensation law are (1) payment of medical expenses directly related to the treatment of a compensable injury, (2) payment of temporary disability benefits to replace your salary until you are able to return to your job, (3) payment of permanent disability benefits if your compensable injury permanently lessens your ability to perform your job, and (4) death benefits which are payable to your survivors in the event your compensable injury leads to your death.

Medical Treatment/Expenses
   If an employee has an on-the-job accident which requires medical treatment, he/she must choose a provider who is authorized in the state’s workers’ compensation network. This will be the only physician authorized to treat the employee’s compensable injury. This means that the state will only accept and pay medical expenses submitted by this physician, unless the treating physician notifies Sedgwick James that they have been referred to another network physician for treatment. The state will not pay any medical expenses the employee incurs from a physician other than the treating physician or a network physician they are referred to by the treating physician. When seeking medical treatment, the employee should notify the doctor’s office that they were injured while at work and that they will be filing a claim for workers’ compensation benefits with the state.
   The state, as your employer, is responsible for payment of any reasonable medical expenses that the employee incurs in seeking medical treatment of his/her compensable injury from and authorized provider from the state’s workers’ compensation preferred provider network. This means that if the employee sprains their ankle in a work related accident, the state will pay the medical expenses associated with the treatment of the ankle. However, if the doctor also treats any other condition which is not related to the compensable injury at the same time he treats the compensable injury, then the state will only pay the portion of the medical bill which is directly related to the treatment of the ankle. The employee and/or their insurance carrier is responsible for the cost of any medical treatment which is unrelated to the compensable injury. The names of authorized physicians may be obtained from Human Resources (7433, or by calling Sedgwick James of TN at 1-800-526-2305.
   The state will not pay for any treatment rendered by an unauthorized non-network provider. If you seek treatment from a non-network provider, you will be responsible for all bills associated with that treatment.

Other Benefits Available
   Assault pay is payable to an employee who has sustained a disabling injury due to an assault arising in and out of the employee's employment.
   Members of the Tennessee Consolidated Retirement System (TCRS) who become permanently and totally disabled prior to eligibility for a service retirement allowance may be eligible for accidental disability benefits if their injury occurred in the performance of duty. Contact the Human Resources Office or the TCRS disability office for additional information.