New Laws Effective July 1, 2014 Dramatically Cut Benefits For Injured Workers
Under the new law which took full effect on July 1, 2014, both benefits and remedies available to injured workers have been dramatically scaled back. However, for injuries occurring before July 1, 2014, we can still provide assistance to most employees injured on the job, and we remain able to assist with serious cases occurring on or after July 1, 2014 involving brain or spinal cord injury, amputation, severe burns, occupational diseases and other conditions that may result in permanent and total disability.
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Two-thirds of average weekly wage, up to a maximum of $976.80 per week for temporary benefits (TTD) due to an injury occurring after July 1, 2016. (the TTD rate is somewhat lower for each preceding year). No income benefits are payable for the first 7 days, but benefits for the first week are paid retroactively after 14 days of disability. Income benefits are supposed to be paid within 15 days after notice of the injury, and must be paid at least twice monthly. Temporary total disability (TTD) benefits generally continue until maximum medical improvement (MMI) has been reached, as long as the employee remains disabled. If the injury is permanent, the employee will be entitled to permanent partial disability (PPD) benefits, at a maximum rate of $888.00 per week (for injuries after 7/1/2016) based on the extent of vocational disability, after maximum medical improvement is reached. Benefits can continue for 60 days past MMI, but the employer will be entitled to credit against the PPD award. Death benefits for a surviving spouse are limited to 50% of the average weekly wages of the employee. If there are dependent children, the benefit increases to two-thirds of the employee’s average weekly wage.
Permanent Partial Disability and Settlement of Cases
For injuries on or after July 1, 2014, if the injured worker returns to work at the same or greater wage, permanent partial disability benefits are set at an amount equal to the impairment rating. If an injured worker does not return to work with any employer at the same or greater wage than before the injury, then he or she is eligible for additional benefits. The additional benefit is determined by multiplying the initial benefit by all of the following that apply:
- Factor of 1.35 because of loss of job or pay;
- Factor of 1.45 if no high school diploma or GED;
- Factor of 1.2 if employee is older than 40 years of age;
- Factor of 1.3 if unemployment in county where employed is greater than two points above the state average for the year prior to initial period of compensation.
In cases of permanent and total disability, weekly benefits are not limited to 450 weeks, but instead are paid until the worker is eligible for Social Security Old Age benefits. In any serious injury case, the injured worker should seek experienced legal counsel as soon as possible after the injury. The law is complicated and creates traps for the unwary.
The Employer must furnish a panel of 3 physicians, plus a chiropractor if a back injury is involved. 100% of necessary medical expenses incurred under the direction of an authorized treating physician are covered. Medical expenses include the employee’s travel to and from health care providers outside his/her hometown.
No benefits available, but medical case managers assigned to coordinate medical care for the insurance company in certain cases.
Compulsory as to all employers of five or more, but not including local governments, unless they elect to participate in the system. The requirements are different for the construction industry as the legislature keeps changing the rules, but generally every employee on the site should be covered, even employees of subcontractors, with fewer than five workers. General contractors can be held liable for workers compensation benefits in many cases if a subcontractor fails to have insurance. Farm laborers are not covered.
The employer is entitled to notice of an injury on-the-job, and until such notice is given, the employer is not responsible for any benefits. Notice must be given within 30 days.
Grounds for Denial
Compensation is not allowed for willful misconduct or self-inflicted injury, injury due to intoxication by alcohol or drugs, or injury due to willful failure or refusal to use a safety appliance. Compensation may be denied for refusal to submit to a drug test.
The Tennessee workers’ compensation system is administered by the Department of Labor & Workforce Development, Bureau of Workers’ Compensation.
20% contingency fee, subject to approval of the Bureau of Workers’ Compensation