A Guide To Workers' Compensation

Who Is Eligible

     Generally, an employee is eligible for workers' compensation benefits if employed by the state and receiving a state payroll check.  Persons compensated through a contract with the state are not eligible.

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 CorVel 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 CorVel at 1-866-245-8588.
   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 TCRS disability office at 1-800-922-7772 for additional information.

Who to Notify When an Accident Occurs

  Employees experiencing an on-the-job accident or injury or job-related property damage should immediately or as soon as reasonably practicable report the incident to their supervisor stating exactly what happened, how it happened, who witnessed the incident, and whether injury occurred as a result of the accident. If you are a witness to a work related accident where a fellow employee is injured severely enough that the involved employee cannot notify his/her supervisor, you should attempt to notify the supervisor for him.
     Examples of incidents which may occur include, but are not limited to the following:

• Accidents involving state-owned vehicles;
• Accidents and mishaps involving state-owned machinery or equipment;
• Accidents caused by state employees acting within the scope of their employment;
• Accidents on state-owned or state controlled property; and
• Injuries to state employees incurred within the scope of employment (workers compensation).

Injuries Not Covered

Compensation shall not be allowed for an injury or death due to any of the following reasons:

1. Willful misconduct;
2. Intentional self-inflicted injury,
3. Intoxication, and
4. Willful failure or refusal to use safety devices or perform a duty required by law.

Documentation of Accidents

     The supervisor or employee should immediately contact the Environmental Health and Safety at 931-221-6103 once an accident has been reported. Close coordination will be required to ensure required forms are completed on a timely and accurate basis. In the event that the employee is unable to work due to the work related injury, The Environmental Health and Safety should be contacted at 931-221-6103.
     The employee is responsible for providing information from the treating physician to his/her supervisor regarding his/her ability to return to work. Should the employee elect to receive sick and annual pay rather than temporary total disability benefits, the employee should sign a statement that this is a voluntary election on their part and realize that they will not be eligible to receive temporary total disability benefits during this period. CorVel will provide benefits to the employee until he/she is released from the doctor's care.

Vehicular Accidents

   If you are involved in an auto accident, follow these instructions.

Limitation of Time

   The agency/institution will be penalized if an employee does not call the 24/7 nurse line before seeking treatment (except for life threatening emergencies).  If reported in 0 – 1 days, the agency/institution is in compliance.  If reported in 2 days, the agency/institution will receive a warning.  If reported after 2 days or more, they agency/institution will be issued a $100 penalty. 

Attorney Fees

     The party employing the attorney must pay the attorney's fees. The law allows an attorney to charge up to 20 percent of the payments received. CorVel should be notified in writing of the name and address of the employee's attorney.

Death Benefit Claims

     Should an employee's compensable injury result in death, survivors are eligible for certain death benefits under the workers' compensation program. To receive these benefits, the surviving spouse (or other surviving dependent) should contact The Office of Environmental Health and Safety at 931-221-6103. The Office of Environmental Health and Safety will then forward requested information to CorVel. Once the information has been filed and any requested documentation has been provided, CorVel will be able to to determine if the employee's death was work related, and, if approved, payment to survivors will begin.