Tennessee Worker's Compensation - Help For Injured Tennessee Workers

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  1. #1
    Join Date
    Nov 2010
    Posts
    12

    Default Lifetime Medical Benefits

    It was my understanding that the law had changed and the IC had to keep medical open for three years before they could offer to close the medical on a work injury which would come from the IC to you in the form of an offer. My case is not even close to being settled and will be over the three year anniversary of injury date before this happens. So with this being said, I will have a whole person disability rating and at this point I am not able to work at all. When the time comes for settlement will they close out my medical and am I not going to have the option of keeping the medical open? I would not want to close the medical because I am in pain management and counseling for depression/anxiety and in my opinion at this time I will have to continue this for a long time if not for the rest of my life. So to clarify the question:
    Once a settlement is offered, will I be able to accept a settlement and keep the medical open for my injury or will I have to close the medical when the settlement is agreed on?

    I just needed clarity on this due to the different answers and different situations that are talked about in this forum. Thank you for your help.

  2. #2
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: Life Time Medical

    Trmjones, these are the links I could find in regards to your question of FM in TN. The way I read it is the OLD laws apply to ALL claims opened prior to June 6, 2011. You said your claim is nearing three years so I would think that this revised legislature does not apply to you. Also, (and please do NOT hold me to this as it has been a good while since I had cause to review TN WC statues.), I believe the three year limit was to be from the time of settlement NOT the DOI/Date Of Injury.

    I could very well be wrong and your absolute best source of information would of course come from an experienced and well regarded attorney that is VERY familiar with WC statues in TN. Or even by calling the TN Department of labor and asking if a specialist or ombudsmen could answer your question.

    http://www.tn.gov/labor-wfd/wc_2011legislation.pdf

    TDD 1-800-848-0299Electronic Mail: WC.Info@tn.gov


    2011 WORKERS’ COMPENSATION LEGISLATIVE CHANGES


    This is a general overview of workers’ compensation legislation passed by the107


    th General Assembly. For a complete, detailed review of this information and all workers’compensation bills introduced in this legislative session, please go to www.legislature.state.tn.us.


    MAXIMUM & MINIMUM BENEFIT CHANGES


    Temporary Benefits –


    The maximum weekly benefit rate for injuries occurring July 1, 2011through June 30, 2012 is $867.90 or 110% of the state’s average weekly wage.


    Permanent Benefits –


    The maximum weekly benefit rate for injuries occurring July 1, 2011through June 30, 2012 is $789.00 or 100% of the state’s average weekly wage.


    Minimum Weekly Benefit –


    The minimum weekly benefit rate for injuries occurring July 1,2011 through June 30, 2012 for both temporary and permanent benefits is $118.35.


    FUTURE MEDICAL BENEFITS,


    OVERSTREET, REDEFINITION OF INJURYPublic Chapter 416


    (HB1503/SB0932) makes various revisions to the workers'compensation law. This bill allows the parties to a workers' compensation case to settle a claim,subject to the approval of a trial judge or a workers' compensation specialist, without future medical benefits. It modifies the Overstreet communication procedures regarding contact between the authorized treating physician and employers on the workers' compensation injury. This bill clarifies the definition of an injury and occupational disease. It clarifies that hearing loss, carpal tunnel and repetitive injury claims are compensable only if the condition primarily arises out of and in the scope of employment. This bill is effective for injuries occurring on or after June 6,


    2011.

    http://www.lexisnexis.com/hottopics/tncode/

    Title 50 Employer And Employee
    Chapter 6 Workers' Compensation Law

    At the lexisnexis link just clink on the I agree block in blue, there will be a brief pause before the information will load, then arrow down to Title 50 & click on the box. Additional index links will appear and you can search ALL of the TN WC statues from there.

    Also the first link on this post is to the newly adapted statues from 2011.

    (And this is all I could find in regards to the Overstreet communication procedures. I see nothing in that article that refers to the length of time the IC is required to hold open medical in an otherwise settled case.)

    http://definitions.uslegal.com/o/overstreet-law/
    Overstreet Law Law & Legal Definition




    The Supreme Court of Tennessee's order in Billy Overstreet v. TRW Commercial Steering Division (2008 WL 2424349) has later come to be known as Overstreet Law in Tennessee. This case revolved around the covenant of confidentiality that exists between a physician and patient in a workers' compensation case. The Overstreet court restricted the employer's and insurer's ability to communicate with the physician treating the injured employee. The case presented two issues:
    (1) if it is permissible for an employer to conduct an ex parte interview with an employee's treating physician; and
    (2) if an employer is entitled to order a medical evaluation to be conducted by a physician of the employer's choice.
    Applying the principles of Tennessee Workers' Compensation Act (T.C.A. 50-6-204(a)(1) and (2)), the court held that an implied covenant of confidentiality arises between an employee and any physician supplied by the employer. Although the employer pointed out that certain medical information is subject to discovery and therefore should be permissible to be made known to the employer, the court gave priority to the confidential nature of the relationship between the physician and patient. According to the court, any such information ought to be disclosed only through discovery procedures.
    The court also held that an employer is entitled to order a medical evaluation to be conducted by a physician of his choice. The employee can challenge the examination only if the request is unreasonable. If the trial court orders that that the examination is reasonable, then the employee has no other choice but to undergo it. If not, it may result in the dismissal of his workers' compensation claim.

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~

    I followed this link www.legislature.state.tn.us. and it lead me right back to lexisnexis so I have NO idea what to tell you to do to find the current "correct" code for TN as lexisnexis just shows the old laws as being revised, without citing the new code :/
    Hope this helps you somewhat. If nothing else it gives you some good reading
    Last edited by SteelMagnolia; 03-06-2012 at 01:35 PM.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Life Time Medical

    You don't have to accept any offer to settle your claim.... you can leave the medical open, continue to take the weekly PPD indemnity benefits until satisfied. No one can force you to accept a cash offer. And....you will never, ever see enough money to cover the potential cost of future medical to your injury.
    (Ever)
    Once a settlement is offered, will I be able to accept a settlement and keep the medical open for my injury or will I have to close the medical when the settlement is agreed on?
    A C&R/Compromise and Release is a negotiated settlement between the parties, whereby they agree on the outstanding issues to be resolved by a cash payment to the IW.
    There is little if any incentive for the carrier to cash out a claim by C&R leaving the liability for medical care open.
    As Steel provided, the law provides for the parties to settle a claim WITHOUT future medical...meaning the settlement would close the medical.
    IW's are not entitled to cash for future medical reimbursement...that's not part of a PPD award/settlement. Medical is a benefit in a comp claim. TTD is a benefit, PPD indemnity is the "settlement" you receive due to resulting impairment.
    I will have a whole person disability rating and at this point I am not able to work at all.
    Unless you have a 100%PD rating... the presumption is you are able to perform some type of work, even if sedentary, and you need VR services.
    If that's the case....anything less than 100%PD is going to provide for limited benefits, not a "life pension".

  4. #4
    Join Date
    Nov 2010
    Posts
    12

    Default Re: Life Time Medical

    Thank you both! Great information! When all you do is sit around and worry about your current situation and know that you can not keep your lawyer on the phone twenty four hours a day, having access to a forum like this to ask questions really helps. I will make note of this.

  5. #5
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: Life Time Medical

    Quote Quoting trmjones View Post
    Thank you both! Great information! When all you do is sit around and worry about your current situation and know that you can not keep your lawyer on the phone twenty four hours a day, having access to a forum like this to ask questions really helps. I will make note of this.
    Exactly what the owner/developer of this site had in mind, IMO. This is the number one site IMO, for WC information and to find not just answers to questions pertaining to the laws/rules but fantastic emotional support as well.

    Trmjones, just make sure any decision you make in regards to your WC claim are VERY well informed. Tons of information available on the web to keep you occupied learning all you possibly can about WC laws in TN. A VERY good way to occupy your down time is to educate yourself pertaining to those laws. Even with an AA the more you learn/know about the way WC works in TN the better off you will be.

    Good Luck to you.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  6. #6
    Join Date
    Mar 2011
    Location
    Tennessee
    Posts
    66

    Default Re: Life Time Medical

    Here's the short, to the point answer under Tennessee's workers' comp laws.

    As long as you pursue your rights under the law, and get a settlement of a compensable claim, your future medical treatment, so long as it's with the authorized doctor and directly related to the injury, is left open for your entire lifetime. TCA 50-6-204.

    The 3 year period deals with the window of time where there cannot be a negotiated closure of those rights. It doesn't mean that they're automatically closed after 3 years, or that you have to agree to close them at that time. It just means that 3 years after the date of any settlement, you and the insurance company can actually negotiate to try to close the medicals, IF YOU WANT TO. The IC may not want to negotiate a closure, nor may you. Either of you may want to negotiate a settlement, which you can do, as long as at least 3 years have passed between the time of your original settlement.

    There is a process for a doubtful & disputed settlement that would immediately close out the medicals on a case, but that's typically only used when there's a legal dispute about whether your injury was compensable, or that you have no permanent disability. There's a cap of just over $5000 that can be paid to settle such a case. TCA 50-6-206(b).

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