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Tennessee Workers’ Compensation Law: Quick Reference for Adjusters, Powered by AI

13 Aug, 2025 Frank Ferreri

                               
CategoryKey InformationLegal Reference / Source
Coverage RequirementsEmployers with 5+ employees must carry workers' comp insurance. Construction and coal mining employers must carry coverage regardless of employee count.TN.gov Workers' Comp Bureau
Definition of InjuryIncludes accidental injuries, mental injuries, occupational diseases, and cumulative trauma. Must arise primarily out of and in the course of employment.T.C.A. § 50-6-102(12)
Claim ReportingEmployers must report injuries to their adjusting entity within 1 business day. Adjusters must file Form C-20 for any injury requiring treatment or causing work restrictions.Carr Allison Cheat Sheet
Medical BenefitsEmployers must provide free medical care reasonably necessary due to the injury. Must offer a panel of 3+ independent providers within 3 business days. Injured workers select an Authorized Treating Physician (ATP) who manages care and referrals. Adjusters must respond to treatment requests within 4 business days. If treatment cannot be approved, it must go to Utilization Review (UR). UR decisions must be made within 7 business days. Only TN-licensed physicians of similar specialty may deny treatment. Appeals of UR denials must be filed within 30 days using Form C-35A. Travel reimbursement is required for round trips over 15 miles.T.C.A. § 50-6-204; TN Bureau of Workers' Compensation UR Rules
Disability Benefits- TTD: 2/3 AWW until MMI or 450 weeks
- TPD: 2/3 of wage difference
- PPD: Impairment × 450 × 2/3 AWW
- PTD: Paid until retirement age or 260 weeks if near retirement		T.C.A. § 50-6-207
Death Benefits- No dependents: $20,000 to estate
- With dependents: 2/3 AWW to dependents
- Burial expense: $10,000		T.C.A. §§ 50-6-209–210
Adjuster CertificationVoluntary program by TN Bureau. Certified adjusters demonstrate higher proficiency, ethical standards, and communication skills. Includes training and final exam.TN Adjuster Program
Dispute Resolution- MOST Program: Mediation for unrepresented parties
- Court of Workers’ Comp Claims: Adjudicates disputes
- Appeals Board: Reviews decisions post-July 1, 2014		TN.gov Workers' Comp Bureau
Forms Adjusters Must Know- C-20: First Report of Injury
- C-22: Notice of First Payment
- C-23: Denial of Claim
- C-29: Final Report of Payment
- C-31: Medical Waiver & Consent
- C-35A: UR Appeal Form		Carr Allison Cheat Sheet

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About The Author

  • Frank Ferreri

    Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law. Frank encourages everyone to consider helping out the Kind Souls Foundation and Kids' Chance of America.

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