50-6-101. Short title.

This chapter shall be known and may be cited as the "Workers' Compensation Law." 

[Acts 1919, ch. 123, § 1; Shan. Supp., § 3608a137; Code 1932, § 6851; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-901.]

50-6-102. Chapter definitions.

As used in this chapter, unless the context otherwise requires: 

(1) "Administrator" means the chief administrative officer of the division of workers' compensation of the department of labor and workforce development; 

(2) "AMA Guides" means the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment, American Medical Association. In the event of a release of a new edition of the publication in a given year, the new edition shall be deemed to be the most recent edition on January 1 of the year following its release. The edition that is in effect on the date the employee is injured is the edition that shall be applicable to the claim; 

(3) (A) "Average weekly wages" means the earnings of the injured employee in the employment in which the injured employee was working at the time of the injury during the period of fifty-two (52) weeks immediately preceding the date of the injury divided by fifty-two (52); but if the injured employee lost more than seven (7) days during the period when the injured employee did not work, although not in the same week, then the earnings for the remainder of the fifty-two (52) weeks shall be divided by the number of weeks remaining after the time so lost has been deducted; 

(B) Where the employment prior to the injury extended over a period of less than fifty-two (52) weeks, the method of dividing the earnings during that period by the number of weeks and parts thereof during which the employee earned wages shall be followed; provided, that results just and fair to both parties will thereby be obtained; 

(C) Where, by reason of the shortness of the time during which the employee has been in the employment of the employee's employer, it is impracticable to compute the average weekly wages as defined in this subdivision (3) regard shall be had to the average weekly amount that, during the first fifty-two (52) weeks prior to the injury or death, was being earned by a person in the same grade, employed at the same work by the same employer, and if there is no such person so employed, by a person in the same grade employed in the same class of employment in the same district; 

(D) Wherever allowances of any character made to any employee in lieu of wages are specified as part of the wage contract, they shall be deemed a part of such employee's earnings; 

(4) "Benefit review conference" means a nonadversarial, informal dispute resolution proceeding to mediate and resolve workers' compensation disputes as provided in this chapter; 

(5) "Case management" means medical case management or the ongoing coordination of medical care services provided to an injured or disabled employee on all cases where medical care expenses are expected to exceed a threshold; 

(6) "Commissioner" means the commissioner of labor and workforce development; 

(7) "Construction design professional" means: 

(A) Any person possessing a valid registration or license entitling that person to practice the technical profession of architecture, engineering, landscape architecture or land surveying in Tennessee; 

(B) Any corporation, partnership, firm or other legal entity authorized by law to engage in the practice of any such technical profession in Tennessee; or 

(C) Any person, firm or corporation providing interior space planning or design in Tennessee; 

(8) "Department" means the department of labor and workforce development; 

(9) "Division" or "division of workers' compensation" means the division of workers' compensation of the department of labor and workforce development; 

(10) (A) "Employee" includes every person, including a minor, whether lawfully or unlawfully employed, the president, any vice president, secretary, treasurer or other executive officer of a corporate employer without regard to the nature of the duties of such corporate officials, in the service of an employer, as employer is defined in subdivision (12), under any contract of hire or apprenticeship, written or implied. Any reference in this chapter to an employee who has been injured shall, where the employee is dead, also include the employee's legal representatives, dependents and other persons to whom compensation may be payable under the Workers' Compensation Law, compiled in this chapter; 

(B) "Employee" also includes a sole proprietor or a partner who devotes full time to the proprietorship or partnership and elects to be included in the definition of "employee" by filing written notice thereof with the division at least thirty (30) days before the occurrence of any injury or death, and may at any time withdraw the acceptance by giving notice of the withdrawal to the division; 

(C) The provisions of this subdivision (10), allowing a sole proprietor or a partner to elect to come under the provisions of the Workers' Compensation Law, compiled in this chapter, shall not be construed to deny coverage of such sole proprietor or partner under any individual or group accident and sickness policy the sole proprietor or partner may have in effect, in cases where such sole proprietor or partner has elected not to be covered by the provisions of the Workers' Compensation Law, for injuries sustained by such sole proprietor or partner that would have been covered by the provisions of the Workers' Compensation Law had such election been made, notwithstanding any provision of the accident and sickness policy to the contrary. Nothing in this section shall require coverage of occupational injuries or sicknesses, if such are not covered under the terms of the policy without reference to eligibility for workers' compensation benefits; 

(11) In a work relationship, in order to determine whether  an individual is an "employee," or whether an individual is a "subcontractor" or an "independent contractor," the following factors shall be considered: 

(A) The right to control the conduct of the work; 

(B) The right of termination; 

(C) The method of payment; 

(D) The freedom to select and hire helpers; 

(E) The furnishings of tools and equipment; 

(F) Self scheduling of working hours; and 

(G) The freedom to offer services to other entities; 

(12) "Employer" includes any individual, firm, association or corporation, or the receiver, or trustee of the same, or the legal representative of a deceased employer, using the services of not less than five (5) persons for pay, except as provided in § 50-6-113, and, in the case of an employer engaged in the mining and production of coal, one (1) employee for pay. If the employer is insured, it shall include the employer's insurer, unless otherwise provided in this chapter; 

(13) "Injury" and "personal injury" mean an injury by accident arising out of and in the course of employment that causes either disablement or death of the employee and shall include occupational diseases arising out of and in the course of employment that cause either disablement or death of the employee and shall include a mental injury arising out of and in the course of employment; 

(14) "Maximum total benefit" means the sum of all weekly benefits to which a worker may be entitled; and 

(A) For injuries occurring between July 1, 1990, and June 30, 1991,  the maximum total benefit shall be one hundred nine thousand two hundred dollars ($109,200); 

(B) For injuries occurring on or after July 1, 1991, and before August 1, 1992, the maximum total benefit shall be one hundred seventeen thousand six hundred dollars ($117,600); and 

(C) For injuries occurring on or after July 1, 1992, the maximum total benefit shall be four hundred (400) weeks times the maximum weekly benefit except in instances of permanent total disability; 

(15) (A) "Maximum weekly benefit" means the maximum compensation payable to the worker per week; and 

(i) For injuries occurring between July 1, 1990, and June 30, 1991, the maximum weekly benefit shall be two hundred seventy-three dollars ($273) per week; 

(ii) For injuries occurring on or after July 1, 1991, and before August 1, 1992, the maximum weekly benefit shall be two hundred ninety-four dollars ($294) per week; 

(iii) For injuries occurring on or after August 1, 1992, through June 30, 1993, the maximum weekly benefit shall be sixty-six and two-thirds percent (662/3%) of the employee's average weekly wage up to seventy-eight percent (78%) of the state's average weekly wage, as determined by the division; 

(iv) For injuries occurring on or after July 1, 1993, through June 30, 1994, the maximum weekly benefit shall be sixty-six and two-thirds percent (662/3%) of the employee's average weekly wage up to eighty-two and four-tenths percent (82.4%) of the state's average weekly wage, as determined by the department; 

(v) For injuries occurring on or after July 1, 1994, through June 30, 1995, the maximum weekly benefit shall be sixty-six and two-thirds percent (662/3%) of the employee's average weekly wage up to eighty-six and eight-tenths percent (86.8%) of the state's average weekly wage, as determined by the department; 

(vi) For injuries occurring on or after July 1, 1995, through June 30, 1996, the maximum weekly benefit shall be sixty-six and two-thirds percent (662/3%) of the employee's average weekly wage up to ninety-one and two-tenths percent (91.2%) of the state's average weekly wage, as determined by the department; 

(vii) For injuries occurring on or after July 1, 1996, through June 30, 1997, the maximum weekly benefit shall be sixty-six and two-thirds percent (662/3%) of the employee's average weekly wage up to ninety-five and six-tenths percent (95.6%) of the state's average weekly wage as determined by the department; 

(viii) For injuries occurring on or after July 1, 1997, through June 30, 2004, the maximum weekly benefit shall be sixty-six and two-thirds percent (662/3%) of the employee's average weekly wage up to one hundred percent (100%) of the state's average weekly wage as determined by the division; 

(ix) For injuries occurring on or after July 1, 2004, the maximum weekly benefit for permanent disability benefits shall be sixty-six and two-thirds percent (66 2/3%) of the employee's average weekly wage up to one hundred percent (100%) of the state's average weekly wage, as determined by the department; and 

(x) (a) For injuries occurring on or after July 1, 2004, through June 30, 2005, the maximum weekly benefit for temporary disability benefits shall be sixty-six and two-thirds percent (66 2/3%) of the employee's average weekly wage up to one hundred five percent (105%) of the state's average weekly wage, as determined by the department; and 

(b) For injuries occurring on or after July 1, 2005, the maximum weekly benefit for temporary disability benefits shall be sixty-six and two-thirds percent (66 2/3%) of the employee's average weekly wage up to one hundred ten percent (110%) of the state's average weekly wage, as determined by the department. 

(B) As used in this subdivision (15), the state average weekly wage shall be determined as of the preceding January 1, and shall be adjusted annually using the data from the division and shall be effective on July 1 of each year; 

(16) "Mental injury" means a loss of mental faculties or a mental or behavioral disorder where the proximate cause is a compensable physical injury resulting in a permanent disability, or an identifiable work-related event resulting in a sudden or unusual mental stimulus. A mental injury shall not include a psychological or psychiatric response due to the loss of employment or employment opportunities; 

(17) "Minimum weekly benefit" means the minimum compensation per week payable to the worker; 

(A) For injuries occurring between July 1, 1985, and June 30, 1986, the minimum weekly benefit shall be twenty dollars ($20.00) per week; 

(B) For injuries occurring between July 1, 1986, and June 30, 1987, the minimum weekly benefit shall be twenty-five dollars ($25.00) per week; 

(C) For injuries occurring between July 1, 1987, and June 30, 1988, the minimum weekly benefit shall be thirty dollars ($30.00) per week; 

(D) For injuries occurring on or after July 1, 1988, and before July 1, 1993, the minimum weekly benefit shall be thirty-five dollars ($35.00) per week; and 

(E) For injuries occurring on or after July 1, 1993, the minimum weekly benefit shall be fifteen percent (15%) of the state's average weekly wage, as determined by the division; 

(18) "Utilization review" means evaluation of the necessity, appropriateness, efficiency and quality of medical care services provided to an injured or disabled employee based on medically accepted standards and an objective evaluation of the medical care services provided; provided, that "utilization review" does not include the establishment of approved payment levels or a review of medical charges or fees; and 

(19) "Workers' compensation specialist" or "specialist" means a department employee who provides information and communication services regarding workers' compensation for employees and employers, and who conducts benefit review conferences and performs other duties as provided in this chapter. 

[Acts 1919, ch. 123, § 2; 1923, ch. 84, § 2; Shan. Supp., § 3608a138; Code 1932, § 6852; Acts 1941, ch. 90, § 1; 1947, ch. 139, § 1; C. Supp. 1950, § 6852; Acts 1961, ch. 184, § 1; 1963, ch. 362, § 2; 1971, ch. 300, § 1; 1977, ch. 339, § 1; 1978, ch. 499, § 1; 1978, ch. 687, § 1; impl. am. Acts 1980, ch. 534, §§ 1, 3; Acts 1981, ch. 239, § 1; T.C.A. (orig. ed.), § 50-902; Acts 1985, ch. 393, § 1; 1988, ch. 923, § 1; 1990, ch. 990, § 1; 1991, ch. 225, § 1; 1992, ch. 900, §§ 2, 19, 20, 28; 1997, ch. 330, § 1; 1999, ch. 520, § 41; 2002, ch. 833, §§ 4, 5; 2004, ch. 962, §§ 22, 23, 32.]

50-6-103. Scope of chapter.

(a)  Every employer and employee subject to the Workers' Compensation Law, compiled in this chapter, shall, respectively, pay and accept compensation for personal injury or death by accident arising out of and in the course of employment without regard to fault as a cause of the injury or death; provided, that any employee who is a corporate officer of the employer shall not be bound if such employee has given, prior to any accident resulting in injury or death, notice to be exempted from the provisions of such law as provided in this part. 

(b)  The election by any employee who is a corporate officer of the employer to be exempted from the provisions of the Workers' Compensation Law, compiled in this chapter, shall not reduce the number of employees of such employer for the purposes of determining the requirements of coverage of the employer under such law. 

[Acts 1919, ch. 123, § 3; Shan. Supp., § 3608a139; Code 1932, § 6853; Acts 1973, ch. 379, § 1; 1975, ch. 198, § 1; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-903.]

50-6-104. Election of corporate officer to be exempt from chapter.

(a)  Any officer of a corporation may elect to be exempt from the operation of the Workers' Compensation Law, compiled in this chapter. Any officer who elects such exemption and who, after electing such exemption then revokes that exemption, shall give notice to such effect in accordance with a form to be prescribed by the division. 

(b)  Notice given pursuant to subsection (a) shall be given thirty (30) days prior to any accident resulting in injury or death; provided, that if any injury or death occurs less than thirty (30) days after the date of employment, notice of such exemption or acceptance given at the time of employment shall be sufficient notice thereof. 

(c)  The notice of election not to accept the provisions of the Workers' Compensation Law, compiled in this chapter, shall be as follows: 

The employee shall give written or printed notice to the employer of the employee's election not to be bound by the provisions of the Workers' Compensation Law and file with the division, a duplicate, with proof of service on the employer attached thereto, together with an affidavit of the employee that the action of the employee in rejecting the provisions of such law was not advised, counseled or encouraged by the employer or by anyone acting for the employer. 

[Acts 1975, ch. 198, § 2; impl. am. Acts 1980, ch. 534, § 1; T.C.A., § 50-904.]

50-6-105. Relief associations or funds for benefit of employees, spouses and dependents unaffected.

Nothing in the Workers' Compensation Law, compiled in this chapter, shall be construed as amending or repealing any statute or municipal ordinance relating to associations or funds for the relief, pensioning, retirement or other benefit of any employees of such municipal employer, or of the surviving spouses, children or dependents of such employees, or as in any manner interfering with the same as now or hereafter established. 

[Acts 1919, ch. 123, § 5; Shan. Supp., § 3608a141; Code 1932, § 6855; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-905.]

50-6-106. Employments not covered.

The Workers' Compensation Law, compiled in this chapter, shall not apply to: 

(1) (A) Any common carrier doing an interstate business while engaged in interstate commerce, which common carrier and such interstate business are already regulated as to employer's liability or workers' compensation by act of congress, it being the purpose of this law to regulate all such business that the congress has not regulated in the exercise of its jurisdiction to regulate interstate commerce; provided, that this chapter shall apply to those employees of such common carriers with respect to whom a rule of liability is not provided by act of  congress; provided, further, that no common carrier by motor vehicle operating pursuant to a certificate of public convenience and necessity shall be deemed the "employer" of a leased-operator or owner-operator of a motor vehicle or vehicles under a contract to such a common carrier; 

(B) Notwithstanding the provisions of subdivision (1)(A), a leased operator or a leased owner/operator of a motor vehicle under contract to a common carrier may elect to be covered under any policy of workers' compensation insurance insuring the common carrier upon written agreement of the common carrier, by filing written notice of the contract, on a form prescribed by the commissioner of labor and workforce development, with the division; provided, that such election shall in no way terminate or affect the independent contractor status of the leased operator or leased owner/operator for any other purpose than to permit workers' compensation coverage. Such election of coverage may be terminated by the leased operator, leased owner/operator, or common carrier by providing written notice of such termination to the division and to all other parties consenting to the prior election. The termination shall be effective thirty (30) days from the date of such notice to all other parties consenting to the prior election and to the division; 

(2) Any person whose employment at the time of injury is casual, that is, one who is not employed in the usual course of trade, business, profession or occupation of the employer; 

(3) Domestic servants and employers of domestic servants;   

(4) Farm or agricultural laborers and employers of those laborers; 

(5) In cases where fewer than five (5) persons are regularly employed, except as provided in § 50-6-113; provided, that in such cases the employer may accept the provisions of this chapter by filing written notice of the acceptance with the division at least thirty (30) days before the happening of any accident or death, and may at any time withdraw the acceptance by giving like notice of withdrawal; 

(6) The state of Tennessee, counties thereof and municipal corporations; provided, that the state, any county or municipal corporation may accept the provisions of this chapter by filing written notice of the acceptance with the division under the administrator, at least thirty (30) days before the happening of any accident or death, and may at any time withdraw the acceptance by giving like notice of the withdrawal. The state, any county or municipal corporation may accept the provisions of this chapter as to any department or division of the state, county or municipal corporation by filing written notice thereof with the division under the administrator, at least thirty (30) days before the happening of any accident or death and may, at any time, withdraw acceptance for the division or department by giving like notice of the withdrawal, and such acceptance by the state, county or municipal corporation for any department or division thereof shall have effect only of making the department or division designated subject to the terms of this chapter; or 

(7) Any person performing voluntary service as a ski patrolperson who receives no compensation for such services other than meals or lodging or the use of ski tow or ski lift facilities or any combination thereof. 

[Acts 1919, ch. 123, § 6; 1923, ch. 84, §§ 2, 5; Shan. Supp., § 3608a142; Code 1932, § 6856; Acts 1941, ch. 20, § 1; 1941, ch. 90, § 2; 1943, ch. 120, § 1; C. Supp. 1950, § 6856; Acts 1976, ch. 495, § 1; 1976, ch. 602, § 1; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-906; Acts 1988, ch. 525, § 1; 1997, ch. 330, § 2; 1999, ch. 520, § 41.]

50-6-107. Application to coal mine operators and employees.

All the provisions of the Workers' Compensation Law, compiled in this chapter, shall apply to coal mine operators and to their employees. 

[Code 1932, § 6857; Acts 1972, ch. 699, § 1; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-907.]

50-6-108. Right to compensation exclusive.

(a)  The rights and remedies granted to an employee subject to the Workers' Compensation Law, compiled in this chapter, on account of personal injury or death by accident, including a minor whether lawfully or unlawfully employed, shall exclude all other rights and remedies of such employee, such employee's personal representative, dependents or next of kin, at common law or otherwise, on account of such injury or death. 

(b)  This section shall not be construed to preclude third party indemnity actions against an employer who has expressly contracted to indemnify such third party. 

[Acts 1919, ch. 123, § 8; Shan. Supp., § 3608a157; Code 1932, § 6859; Acts 1961, ch. 184, § 2; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-908; Acts 1985, ch. 326, § 1.]

50-6-109. Nonperformance of statutory duty not relieved.

Nothing in the Workers' Compensation Law, compiled in this chapter, shall be construed to relieve any employer or employee from penalty for failure or neglect to perform any statutory duty. 

[Acts 1919, ch. 123, § 9; Shan. Supp., § 3608a158; Code 1932, § 6860; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-909.]

50-6-110. Injuries not covered - Drug and alcohol testing.

(a)  No compensation shall be allowed for an injury or death due to the employee's willful misconduct or intentional self-inflicted injury, due to intoxication or illegal drug useage, or willful failure or refusal to use a safety appliance or perform a duty required by law. 

(b)  If the employer defends on the ground that the injury arose in any or all of the ways stated in subsection (a), the burden of proof shall be on the employer to establish such defense. 

(c) (1)  In cases where the employer has implemented a drug-free workplace pursuant to chapter 9 of this title, if the injured employee has, at the time of the injury, a blood alcohol concentration level equal to or greater than eight hundredths of one percent (.08%) for non-safety sensitive positions, or four hundredths of one percent (.04%) for safety-sensitive positions, as determined by blood or breath testing, or if the injured employee has a positive confirmation of a drug as defined in § 50-9-103, then it is presumed that such drug or alcohol was the proximate cause of the injury. This presumption may be rebutted by a preponderance of the evidence that such drug or alcohol was not the proximate cause of injury. Percent by weight of alcohol in the blood must be based upon grams of alcohol per one hundred (100) milliliters of blood. If the results are positive, the testing facility must maintain the specimen for a minimum of three hundred sixty-five (365) days at minus twenty degrees celcius (-20ø C.). Blood serum may be used for testing purposes under this chapter; provided, however, that if this test is used, the presumptions under this section do not arise unless the blood alcohol level is proved to be medically and scientifically equivalent to or greater than the comparable blood alcohol level that would have been obtained if the test were based on percent by weight of alcohol in the blood. However, if, before the accident, the employer had actual knowledge of and acquiesced in the employee's presence at the workplace while under the influence of such alcohol or drug, the employer retains the burden of proof in asserting any defense under subsections (a) and (b), and this subsection (c) does not apply. 

(2) If the injured worker refuses to submit to a drug test, it shall be presumed, in the absence of a preponderance of the evidence to the contrary, that the proximate cause of the injury was the influence of drugs, as defined in § 50-9-103. 

(3) The commissioner of labor and workforce development shall provide, by rule, for the authorization and regulation of drug testing policies, procedures and methods. Testing of injured employees pursuant to a drug-free workplace program under chapter 9 of this title shall not commence until such rules are adopted. 

[Acts 1919, ch. 123, § 10; Shan. Supp., § 3608a159; Code 1932, § 6861; T.C.A. (orig. ed.), § 50-910; Acts 1994, ch. 765, § 1; 1996, ch. 944, § 49; 1999, ch. 520, § 41; 2005, ch. 390, § 1.]

50-6-111. Defenses not available to employer failing to secure payment of compensation.

No employer who fails to secure payment of compensation as required by the Workers' Compensation Law, compiled in this chapter, shall, in any suit brought against such employer by an employee covered by such law or by the dependent or dependents of such an employee, to recover damages for personal injury or death arising from an accident, be permitted to defend such suit upon any of the following grounds: 

(1) The employee was negligent; 

(2) The injury was caused by the negligence of a fellow servant or fellow employee; or 

(3) The employee had assumed the risk of the injury. 

[Acts 1919, ch. 123, § 11; Shan. Supp., § 3608a160; Code 1932, § 6862; Acts 1973, ch. 379, § 2; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-911.]

50-6-112. Actions against third persons.

(a)  When the injury or death for which compensation is payable under the Workers' Compensation Law, compiled in this chapter, was caused under circumstances creating a legal liability against some person other than the employer to pay damages, the injured worker, or such injured worker's dependents, shall have the right to take compensation under such law, and such injured worker, or those to whom such injured worker's right of action survives at law, may pursue such injured worker's or their remedy by proper action in a court of competent jurisdiction against such other person. 

(b)  In the event of a recovery from such other person by the worker, or those to whom such worker's right of action survives, by judgment, settlement or otherwise, the attorney representing such injured worker, or those to whom such injured worker's right of action survives, and effecting the recovery, shall be entitled to a reasonable fee for the attorney's services, and the attorney shall have a first lien therefor against the recovery; provided, that if the employer has engaged other counsel to represent the employer in effecting recovery against such other person, then a court of competent jurisdiction shall, upon application, apportion the reasonable fee between the attorney for the worker and the attorney for the employer, in proportion to the services rendered. 

(c) (1)  In the event of such recovery against such third person by the worker, or by those to whom such worker's right of action survives, by judgment, settlement or otherwise, and the employer's maximum liability for workers' compensation under this chapter has been fully or partially paid and discharged, the employer shall have a subrogation lien therefor against such recovery, and the employer may intervene in any action to protect and enforce such lien. 

(2) In the event the net recovery by the worker, or by those to whom such worker's right of action survives, exceeds the amount paid by the employer, and the employer has not, at the time, paid and discharged the employer's full maximum liability for workers' compensation under this chapter, the employer shall be entitled to a credit on the employer's future liability, as it accrues, to the extent the net recovery collected exceeds the amount paid by the employer. 

(3) In the event the worker, or those to whom such worker's right of action survives, effects a recovery, and collection of that recovery, from such other person, by judgment, settlement or otherwise, without intervention by the employer, the employer shall nevertheless be entitled to a credit on the employer's future liability for workers' compensation, as it accrues under this chapter, to the extent of the net recovery. 

(d) (1)  Such action against such other person by the injured worker, or those to whom such injured worker's right of action survives, must be instituted in all cases within one (1) year from the date of injury. 

(2) Failure on the part of the injured worker, or those to whom such injured worker's right of action survives, to bring such action within the one (1) year period shall operate as an assignment to the employer of any cause of action in tort that the worker, or those to whom such worker's right of action survives, may have against any other person for such injury or death, and such employer may enforce the cause of action in such employer's own name or in the name of the worker, or those to whom such worker's right of action survives, for such employer's benefit, as such employer's interest may appear, and the employer shall have six (6) months after such assignment within which to commence such suit. 

(3) If the cause of action described in subsection (a) arises in a jurisdiction other than Tennessee and such other jurisdiction has a statute of limitations for personal injury and wrongful death greater than the one (1) year statute of limitations provided in Tennessee, the court hearing the cause of action shall apply the statute of limitations that provides the injured worker, or those to whom such injured worker's right of action survives, the greatest amount of time in which to institute an action. 

(4) Under no circumstances shall the negligent party described in subsection (a) benefit from this subsection (d). 

[Acts 1919, ch. 123, § 14; Shan. Supp., § 3608a163; Code 1932, § 6865; Acts 1949, ch. 277, § 1; C. Supp. 1950, § 6865; Acts 1963, ch. 333, § 1; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-914; Acts 1985, ch. 393, § 2.]

50-6-113. Liability of principal intermediate contractor or subcontractor.

(a)  A principal or intermediate contractor, or subcontractor shall be liable for compensation to any employee injured while in the employ of any of the subcontractors of the principal, intermediate contractor, or subcontractor and engaged upon the subject matter of the contract to the same extent as the immediate employer. 

(b)  Any principal or intermediate contractor, or subcontractor who pays compensation under the foregoing provisions may recover the amount paid, from any person who, independently of this section, would have been liable to pay compensation to the injured employee, or from any intermediate contractor. 

(c)  Every claim for compensation under this section shall be in the first instance presented to and instituted against the immediate employer, but such proceedings shall not constitute a waiver of the employee's rights to recover compensation under this chapter from the principal or intermediate contractor; provided, that the collection of full compensation from one (1) employer shall bar recovery by the employee against any others, nor shall the employee collect from all a total compensation in excess of the amount for which any of the contractors is liable. 

(d)  This section applies only in cases where the injury occurred on, in, or about the premises on which the principal contractor has undertaken to execute work or that are otherwise under the principal contractor's control or management. 

(e)  A subcontractor under contract to a general contractor may elect to be covered under any policy of workers' compensation insurance insuring the contractor upon written agreement of the contractor, by filing written notice of the election, on a form prescribed by the commissioner of labor and workforce development, with the division of workers' compensation. It is the responsibility of the general contractor to file such written notice with the division. Failure of the general contractor to file such written notice shall not operate to relieve or alter the obligation of an insurance company to provide coverage to a subcontractor when such subcontractor can produce evidence of payment of premiums to the insurance company for such coverage.  Such election shall in no way terminate or affect the independent contractor status of the subcontractor for any other purpose than to permit workers' compensation coverage. Such election of coverage may be terminated by the subcontractor or general contractor by providing written notice of such termination to the division and to all other parties consenting to the prior election. Such termination shall be effective thirty (30) days from the date of such notice to all other parties consenting to the prior election and to the division. 

(f) (1)  Except as provided in subdivision (f)(4), any person engaged in the construction industry, including principal contractors, intermediate contractors, or subcontractors, shall be required to carry workers' compensation insurance. This requirement shall apply whether or not the person employs fewer than five (5) employees. Sole proprietors and partners shall not be required to carry workers' compensation insurance on themselves. In addition, the provisions of this subsection (f) shall not apply to any person building a dwelling or other structure, or performing maintenance, repairs, or making additions to structures, on the person's own property for the person's own use and for which the person receives no compensation. 

(2) Nothing within this subsection (f) shall be construed to impact any person whose employment at the time of injury is casual as provided in § 50-6-106. 

(3) For purposes of this subsection (f), "a person engaged in the construction industry" means any person or entity who undertakes to, attempts to, or submits a price or bid or offers to construct, supervise, superintend, oversee, schedule, direct, or in any manner assume charge of the construction, alteration, repair, improvement, movement, demolition, putting up, tearing down, or furnishing labor to install material or equipment for any building, highway, road, railroad, sewer, grading, excavation, pipeline, public utility structure, project development, housing, housing development, improvement, or any other construction undertaking. 

(4) The provisions of this subsection (f) do not apply in counties having a population, according to the 1990 federal census or any subsequent federal census of not less than six thousand seven hundred (6,700) nor more than six thousand nine hundred fifty (6,950) and not less than forty-four thousand five hundred (44,500) nor more than forty-five thousand (45,000). 

[Acts 1919, ch. 123, § 15; Shan. Supp., § 3608a164; Code 1932, § 6866; T.C.A. (orig. ed.), § 50-915; Acts 1988, ch. 525, § 2; 1992, ch. 793, § 1; 1997, ch. 330, §§ 3, 4; 1998, ch. 1024, § 23; 1999, ch. 404, §§ 2, 3; 1999, ch. 520, § 41.]

50-6-114. Supremacy of chapter - Setoffs for payments by disability plan.

(a)  No contract or agreement, written or implied, or rule, regulation or other device, shall in any manner operate to relieve any employer, in whole or in part, of any obligation created by this chapter, except as provided in subsection (b). 

(b)  Any employer may set off from temporary total, temporary partial, and permanent partial and permanent total disability benefits any payment made to an employee under an employer funded disability plan for the same injury; provided, that the disability plan permits such an offset. Such an offset from a disability plan may not result in an employee's receiving less than the employee would otherwise receive under the Workers' Compensation Law, compiled in this chapter. In the event that a collective bargaining agreement is in effect, this provision shall be subject to the agreement of both parties. 

[Acts 1919, ch. 123, § 16; Shan. Supp., § 3608a165; Code 1932, § 6867; T.C.A. (orig. ed.), § 50-916; Acts 1996, ch. 919, § 1.]

50-6-115. Extraterritorial application of chapter.

If an employee, while working outside the territorial limits of this state, suffers an injury on account of which the employee, or, in the event of the employee's death, the employee's dependents, would have been entitled to the benefits provided by this chapter had such injury occurred within this state, the employee, or in the event of the employee's death resulting from such injury, the employee's dependents, shall be entitled to the benefits provided by this chapter; provided, that at the time of such injury: 

(1) The employment was principally localized within this state; 

(2) The contract of hire was made in this state; or 

(3) If at the time of the injury the injured worker was a Tennessee resident and there existed a substantial connection between this state and the particular employer and employee relationship. 

[Acts 1919, ch. 123, § 19; Shan. Supp., § 3608a168; Code 1932, § 6870; Acts 1975, ch. 85, § 1; 1976, ch. 389, § 1; T.C.A. (orig. ed.), § 50-917; Acts 2004, ch. 648, § 1.]

50-6-116. Construction of chapter.

The rule of common law requiring strict construction of statutes in derogation of common law shall not be applicable to the provisions of the Workers' Compensation Law, compiled in this chapter but the same is declared to be a remedial statute, which shall be given an equitable construction by the courts, to the end that the objects and purposes of this chapter may be realized and attained. 

[Acts 1919, ch. 123, § 47; Shan. Supp., § 3608a197; Code 1932, § 6901; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.) § 50-918.]

50-6-117. Suits by corporation officer against employer.

Every employee who is a corporate officer and who elects not to operate under the provisions of the Workers' Compensation Law, compiled in this chapter, in any action to recover damages for personal injury or death by accident brought against an employer who has elected to operate under such law, shall proceed as at common law, and the employer in such suit may make use of all common law defenses. 

[Acts 1975, ch. 198, § 3; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-919.]

50-6-118. Penalties.

(a)  The division of workers' compensation shall, by rule promulgated pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, establish and collect penalties for the following: 

(1) Failure of a covered employer to provide workers' compensation coverage or qualify as a self-insurer; 

(2) Late filing of accident reports; 

(3) Bad faith denial of claims; 

(4) Late filing of notice of denial of claim; 

(5) Late filing of notice of change in benefit payments; 

(6) Late filing with the department of notice of filing of lawsuits by employees or employee representatives; and 

(7) Late filing of judgments by insurance companies or by employers, if self-insured. 

(b)  All penalties collected by the department from an employer for failure to provide workers' compensation coverage or failure to qualify as a self-insurer shall be paid into and become a part of the uninsured employers fund. All other penalties collected by the department shall be paid into and become a part of the second injury fund. 

(c)  The commissioner, commissioner's designee, or an agency member appointed by the commissioner, may assess the penalties authorized by this chapter, upon providing notice and an opportunity for a hearing to an employer, an employee, an insurer, or a self-insured pool or trust. If a hearing is requested, the commissioner, commissioner's designee, or an agency member appointed by the commissioner, shall have the authority to hear the matter as a contested case, and the authority to hear the administrative appeal of an agency decision, relating to the assessment of the penalties authorized by this chapter. When a hearing or review of an agency decision is requested, the requesting party shall have the burden of proving, by a preponderance of the evidence, that the penalized party was either not subject to the Workers' Compensation Law, compiled in this chapter, or that the penalties assessed pursuant to this chapter should not have been assessed. 

[Acts 1985, ch. 393, § 18; 1999, ch. 520, § 41; 2000, ch. 972, § 3; 2001, ch. 192, § 8; 2004, ch. 962, § 8; 2005, ch. 390, § 2.]

50-6-119. Information awareness programs.

(a)  In order to provide greater awareness among employers and employees of the rights and obligations of the workers' compensation laws, the division of workers' compensation shall institute an information awareness program. Such program shall: 

(1) Involve a statewide effort to consult with employers on the actions required; 

(2) Provide that employers with frequent incidents of injuries be targeted for referral to appropriate agencies on accident prevention; 

(3) Provide education and information aimed at preventing disputes and delays in the processing of claims, through the use of speakers' seminars and conferences; 

(4) Provide a system to communicate developments in the law to interested groups; 

(5) Provide injured employees with complete information on their rights to compensation and day-to-day assistance with problems on their claims; 

(6) Develop general informational literature and audio-visual aids for both employees and employers; and 

(7) Provide a toll-free number for employers and employees to receive information from and ask questions of the department. 

(b)  Any publications for distribution under this section must be published in accordance with the rules, regulations, policies and procedures of the state publications committee. 

[Acts 1985, ch. 393, § 19; 1990, ch. 1024, § 29; 1999, ch. 520, § 41.]

50-6-120. Liability of construction design professionals.

(a)  No construction design professional, or any employee of the construction design professional, who is retained to perform professional services on a construction project, shall be liable for the personal injury or death of any nonemployee of the construction design professional, working on the construction project, unless the construction design professional or any employee of the construction design professional is guilty of negligence that is a proximate cause of the injury or death of the nonemployee. 

(b)  Nothing in the provisions of this section shall be construed to affect the rights or responsibilities of any person under the Workers' Compensation Law, compiled in this chapter. 

(c)  The Tennessee Rules of Civil Procedure, Rule 11, shall apply in all actions against construction design professionals. 

[Acts 1988, ch. 923, §§ 2-4.]

50-6-121. Advisory council on workers' compensation.

(a) (1)  There is created an advisory council on workers' compensation. There shall be seven (7) voting members of the council, with three (3) representing employers, three (3) representing employees, and one (1) member, who shall serve as the chair and who shall be the state treasurer or the state treasurer's designee. There shall be seven (7) nonvoting members of the council. All members shall have a demonstrable working knowledge of the workers' compensation system. 

(A) The chair shall preside at meetings of the council and, under the general direction of the council, shall supervise the work of the staff of the council. The chair may vote only on matters related to the administration of the council or the council's research. The chair is not permitted to vote on any matter that constitutes the making of a policy recommendation to the governor or to the general assembly. 

(B) The speaker of the house of representatives, the speaker of the senate and the governor shall each appoint one (1) employer and one (1) employee representative to the council, who shall be voting members. Representatives, officers and employees from labor organizations or business trade organizations are eligible for appointment. In making the appointments of the employer representatives, the appointing authorities shall strive to ensure a balance of a commercially insured employer, self-insured employer or an employer who operates a small business. At least one (1) employee representative shall be from organized labor and shall be selected from a list of three (3) names provided by the state labor council of the AFL-CIO. Proxy voting is prohibited by voting members of the council; provided, however, that in instances where a voting member will be absent from a vote of the council, the member's appointing authority is authorized to appoint an alternate or designee for such vote or votes. 

(C) Voting members shall serve four-year terms and the terms shall be staggered so that the terms of only three (3) voting members shall terminate at the same time. The terms of the voting members who are serving as of June 30, 2003, shall be amended as follows: those members whose terms are scheduled to expire in 2004 shall expire on June 30, 2004, and the successors shall serve a four-year term to begin on July 1, 2004, and to end on June 30, 2008, and those members whose terms are scheduled to expire in 2006 shall expire on June 30, 2006, and the successors shall serve a four-year term to begin on July 1, 2006, and to expire on June 30, 2010. Thereafter, all four-year terms shall begin on July 1 and terminate on June 30, four (4) years thereafter. 

(D) The governor shall also appoint seven (7) nonvoting members of the council as follows: one (1) to represent local governments, one (1) to represent insurance companies, two (2) to represent health care providers and three (3) attorneys. The nonvoting local government representative shall be appointed from a list of three (3) names submitted jointly by the Tennessee Municipal League and the Tennessee County Services Association. The Tennessee Municipal League and the Tennessee County Services Association may alternate recommendations between municipal and county representatives. The nonvoting insurance company representative shall be appointed from either a list of three (3) names submitted by the Alliance of American Insurers or a list of three (3) names submitted by the American Insurance Association. One nonvoting health care provider representative shall be appointed from a list of three (3) names submitted by the Tennessee Medical Association and one nonvoting healthcare provider representative shall be appointed from a list of three (3) names submitted by the Tennessee Hospital Association. The nonvoting attorney members shall be appointed as follows: one (1) from a list of three (3) names submitted by the Tennessee Trial Lawyers Association, who shall primarily represent injured workers' compensation claimants; one (1) from a list of three (3) names submitted by the Tennessee Defense Lawyers Association, who shall primarily represent employers or workers' compensation insurers; and one (1) from a list of three (3) names submitted by the Tennessee Bar Association. 

(E) Beginning with the appointments made in calendar year 2003, the nonvoting members appointed by the governor shall serve the following terms: the local government representative, the health care representative selected from a list submitted by the Tennessee Medical Association, and the attorney selected from the list submitted by the Tennessee Bar Association shall serve from the date of appointment until June 30, 2005; the insurance company representative, the health care representative selected from the list submitted by the Tennessee Hospital Association, the attorney selected from the list submitted by the Tennessee Trial Lawyers Association, and the attorney selected from the list submitted by the Tennessee Defense Lawyers Association shall serve from the date of appointment until June 30, 2007. Thereafter, the nonvoting members shall be appointed to four-year terms that shall begin on July 1 and terminate on June 30, four (4) years thereafter. 

(F) The chair and vice-chair of the special joint committee on workers' compensation, the commissioner of labor and workforce development and the commissioner of commerce and insurance, or their designees, shall be ex officio, nonvoting members of the council. 

(2) Each voting and nonvoting member of the advisory council on workers' compensation shall, upon the expiration of such member's term, be eligible for reappointment and shall serve until a successor is appointed. In the event a member resigns or becomes ineligible for service during such member's term, a successor shall be appointed by the appropriate appointing authority to serve the remainder of the term. 

(3) No employer shall discriminate in any manner against an employee who serves on the advisory council because of such service. Employees who serve on the advisory council shall not be denied any benefit from their employer because of such service. Travel expenses of the employee representatives on the council shall be reimbursed pursuant to subsection (b); however, employers may choose to pay the travel expenses of their employees' service on the advisory council according to their own policies. 

(b)  Members of the council shall not be paid but may be reimbursed for travel expenses. All reimbursement for travel expenses shall be in accordance with the provisions of the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter. 

(c)  The council shall meet at least twice each year. It shall annually review workers' compensation in Tennessee and shall issue a report of its findings and conclusions on or before July 1 of each year. The annual report shall be sent to the governor, the speakers of the house of representatives and senate, the chair and vice-chair of the special joint committee on workers' compensation, the commissioner of labor and workforce development, the commissioner of commerce and insurance and the clerks of the house of representatives and senate. Notice of the publication of the annual report and all other reports published by the council shall be provided to all members of the general assembly pursuant to § 3-1-114. The annual report shall include a summary of significant court decisions relating to workers' compensation including an explanation of their impact on existing policy and a summary of all permanency awards broken down by judicial district. 

(d)  In performing its responsibilities, the council's role shall be strictly advisory, but it may: 

(1) Make recommendations to the governor, the general assembly, the special joint committee on workers' compensation, the standing committees of each house that review the status of the workers' compensation system, the commissioner of labor and workforce development and the commissioner of commerce and insurance relating to the promulgation or adoption of legislation or rules; 

(2) Make recommendations to the commissioner of labor and workforce development and the commissioner of commerce and insurance regarding the method and form of statistical data collections; and 

(3) Monitor the performance of the workers' compensation system in the implementation of legislative directives. 

(e)  The council is authorized to retain staff and professional assistance, such as consultants and actuaries, subject to budgetary approval in the general appropriations act. For administrative purposes, the council shall be attached to the department of labor and workforce development for all administrative matters relating to receipts, disbursements, expense accounts, budget, audit and other related items. The autonomy of the council and its authority are not affected hereby and the commissioner of labor and workforce development shall have no administrative or supervisory control over the council or its employees. Employees of the council shall not have the status of career service employees pursuant to title 8. 

(f)  The council shall develop evaluations, statistical reports and other information from which the general assembly may evaluate the impact of the legislative changes to workers' compensation law, including, but not limited to, the Reform Acts of 1992 and 1996 and subsequent changes to, the workers' compensation system. 

(g)  Within its annual report to the general assembly, the council shall report on activities and outcomes related to the Workers' Compensation Fraud Act, compiled in title 56, chapter 47. The department of commerce and insurance, department of labor and workforce development, Tennessee bureau of investigation and the district attorneys general conference shall cooperate with the council in the development of information for inclusion in such report. 

(h)  The advisory council on workers' compensation shall, within ten (10) business days of each meeting it conducts, provide a summary of the meeting and a report of all actions taken and all actions recommended to be taken to each member of the consumer and employee affairs committee of the house of representatives and commerce, labor and agriculture committee of the senate. 

(i)  Whenever any bill is introduced in the general assembly proposing to amend this chapter or to make any change in workers' compensation law, or to make any change in the law that may have a financial or other substantive impact on the administration of workers' compensation law, the standing committee to which the bill is referred may refer the bill to the council. The council's review of bills relating to workers' compensation should include, but not be limited to, bills that propose to amend chapters 3, 6, 7, and 9 of this title, and title 56, chapters 5 and 47. All bills referred to the council shall be reported back to the standing committee to which they were assigned as quickly as reasonably possible. Notwithstanding the absence of a report from the council, the standing committee is free to consider the bill at any time. The chair making such referral shall immediately notify the prime sponsors of such referral and the council shall not review and comment on the proposed legislation until the prime sponsors have been notified. The comments of the council shall not include recommendations for or against passage of the proposed legislation but shall describe the potential effects of the proposed legislation on the workers' compensation system and its operation and any other information or suggestions that the council may think helpful to the sponsors, the standing committees or the general assembly. 

(j)  The council shall study and report on the occupational health and safety of employment in Tennessee and make recommendations for safe employment education and training and promote the development of employer-sponsored health and safety programs. 

[Acts 1992, ch. 900, § 4; 1996, ch. 944, §§ 4-7; 1997, ch. 235, §§ 1, 2; 1997, ch. 533, § 49; 1998, ch. 1024, §§ 13, 20; 1999, ch. 520, § 41; 2000, ch. 852, § 3; 2001, ch. 192, §§ 11, 12; 2002, ch. 695, §§ 1, 2, 6; 2003, ch. 359, § 1; 2004, ch. 962, §§ 26, 27, 30, 43, 45; 2005, ch. 390, § 3.]

50-6-122. Case management and utilization review - Use of HMOs and PPOs - Legislative intent - Claims by health care providers - Collection agencies - Reports to credit bureau.

(a) (1)  It is the intent of the general assembly that quality medical care services shall be available to injured and disabled employees.  It is also the legislative intent to control increasing medical costs in workers' compensation matters by establishing cost control mechanisms to ensure cost-effective delivery of medical care services by employing a program of medical case management and a program to review the utilization and quality of medical care services. 

(2) In order to assure that in workers' compensation cases quality medical care is rendered and to control medical care costs, an employer is authorized to use, but is not required to use, health maintenance organizations (HMO) and preferred provider organizations (PPO). An HMO or PPO may contract with medical care providers as permitted by law. Such contracts are authorized to use, but are not limited to the use of, the following managed care methodologies: 

(A) Medical bill review; 

(B) Establishment of medical practice guidelines; 

(C) Case management, subject to the provisions of § 50-6-123; 

(D) Utilization review, subject to the provisions of § 50-6-124; and 

(E) Peer review programs. 

(3) The provisions of § 50-6-204(a)(4), relative to medical care, shall apply to any managed care methodology employed pursuant to this section. For the purposes of § 50-6-204(a)(4), physicians and surgeons in the same health maintenance organization or preferred provider organization are considered to be associated in practice together if they share a common employer for purposes of their clinical practice, or are associated together in a group practice. 

(b)  A health care provider shall not pursue a private claim against a workers' compensation claimant for all or part of the costs of health care services provided to the claimant by the provider unless: 

(1) The injury is finally adjudicated not to be compensable under this chapter; 

(2) The physician or surgeon, as provided in § 50-6-204, who was not authorized by the employer at the time the services were rendered, knew that such physician or surgeon was not an authorized physician or surgeon; or 

(3) The employee knew that the physician or surgeon was not an authorized physician or surgeon; provided, that subdivisions (b)(2) and (b)(3) do not apply to emergency care. 

(c)  A health care provider shall not employ a collection agency or make a report to a credit bureau concerning a private claim against an employer for all or part of the costs of medical care provided to an employee that are not paid by the employer's workers' compensation insurer without having first exhausted all administrative remedies as provided by § 50-6-226(a)(4). The medical director may include the insurer in such administrative process. 

[Acts 1992, ch. 900, § 6; 1996, ch. 944, §§ 8, 10.]

50-6-123. Case management system for coordinating medical care services.

(a)  The commissioner shall establish, pursuant to the commissioner's rule and regulation-making authority, a system of case management for coordinating the medical care services provided to employees claiming benefits under this chapter. 

(b)  Employers may, at their own expense, utilize case management, and, if utilized, the employee shall cooperate with the case management, and such case management shall include, but not be limited to: 

(1) Developing a treatment plan to provide appropriate medical care services to an injured or disabled employee; 

(2) Systematically monitoring the treatment rendered and the medical progress of the injured or disabled employee; 

(3) Assessing whether alternate medical care services are appropriate and delivered in a cost-effective manner based on acceptable medical standards; 

(4) Ensuring that the injured or disabled employee is following the prescribed medical care plan; and 

(5) Formulating a plan for return to work with due regard for the employee's recovery and restrictions and limitations, if any. 

(c)  The commissioner may contract with an independent organization, not owned by or affiliated with any carrier authorized to write workers' compensation insurance in the state of Tennessee, to assist with the administration of the provisions of this section. 

(d)  Nothing in this section shall prevent an employer from establishing its own program of case management that meets the guidelines promulgated by the commissioner in rules and regulations. 

(e)  Medical care, treatment, therapy or services provided at the employee's residence pursuant to chapter 6 of this title, shall not be considered home health services as defined in § 68-11-201(21) when provided pursuant to direction of the employee's attending physician in the following specific circumstances only: 

(1) By a licensed health care provider who routinely provides services to employees at the place of employment, if the services rendered by such provider at the employee's residence are of the same type rendered by the provider at the place of employment; or 

(2) By a licensed physical therapist, occupational therapist or speech therapist practicing independently of a home health agency, when the employee's attending physician determines that it is in the best interest of the employee to be treated by such independent therapist because of the therapist's expertise in workplace injuries. 

[Acts 1992, ch. 900, § 7; 1996, ch. 944, § 9; 2001, ch. 148, § 1; 2004, ch. 962, §§ 28, 29.]

50-6-124. Utilization review system - Pre-admission review - Penalties for rendering excessive or inappropriate services - Chiropractic and physical therapy services.

(a)  The commissioner of labor and workforce development shall establish a system of utilization review of selected outpatient and inpatient health care providers to employees claiming benefits under the Workers' Compensation Law, compiled in this chapter, by providers qualified pursuant to law or the utilization review accreditation commission. 

(b)  The commissioner shall also establish a system of pre-admission review of all hospital admissions, except for emergency services. However, utilization review pursuant to subsections (a) and (b) shall begin within one (1) working day of all emergency hospital admissions. 

(c)  Pursuant to the commissioner's established system of utilization review, the commissioner may contract with an independent utilization review organization, not owned by or affiliated with any carrier authorized to write workers' compensation insurance in the state of Tennessee, to provide utilization review, including peer review. 

(d)  Nothing in this section shall prevent an employer from electing to provide utilization review; however, if the employee, provider or any other party not contractually bound to the employer's utilization review program disagrees with that employer's utilization review, then that employee, provider or other party shall have recourse to the commissioner's utilization review program, as provided for in this section. 

(e)  Pursuant to the utilization review conducted by the commissioner, including providing an opportunity for a hearing, any health care provider who is found by the commissioner to have rendered excessive or inappropriate services may be subject to: 

(1) A forfeiture of the right to payment for those services that are found to be excessive or inappropriate; 

(2) A civil penalty of not less than one hundred dollars ($100) nor more than one thousand dollars ($1,000); or 

(3) A temporary or permanent suspension of the right to provide medical care services for workers' compensation claims if the health care provider has established a pattern of violations. 

(f)  The commissioner is directed to review the role of chiropractic and physical therapy services in workers' compensation costs and to determine whether such services should be included in the utilization review system established pursuant to this section. In such review, the commissioner shall consult with the medical care and cost containment committee. The commissioner shall conclude such review by January 1, 1997, and report to the advisory council on workers' compensation and the special joint committee on workers' compensation. If the review determines that chiropractic or physical therapy services merit inclusion in the utilization review system, the commissioner shall include such services by rule in the system. 

[Acts 1992, ch. 900, § 8; 1996, ch. 944, § 11; 1999, ch. 520, § 41.]

50-6-125. Medical care and cost containment committee - Penalties for imposing excessive charges.

(a)  The commissioner shall appoint a medical care and cost containment committee. The committee shall approve regulations pursuant to § 50-6-233(c)(7) before they become effective, assist the commissioner in their implementation, and advise the commissioner at the commissioner's request on issues relating to medical care and cost containment in the workers' compensation system. 

(b) (1)  The committee shall be composed of fifteen (15) voting members appointed by the commissioner as follows: 

(A) Three (3) members shall be physicians licensed to practice medicine and surgery under title 63, chapter 6, and shall be appointed from a list of nominees submitted by the Tennessee Medical Association; 

(B) Two (2) members shall represent employers and shall be appointed from a list of nominees submitted by the Tennessee Chamber of Commerce and Industry; 

(C) One (1) member shall represent employers and shall be appointed from a list of nominees submitted by the Associated Builders and Contractors, Inc.; 

(D) Three (3) members shall represent employees and shall be appointed from a list of nominees submitted by the Tennessee AFL-CIO State Labor Council; 

(E) Three (3) members shall represent hospitals and shall be appointed from a list of nominees submitted by the Tennessee Hospital Association; 

(F) One (1) member shall be a pharmacist and shall be appointed from a list submitted by the Tennessee Pharmacists Association; 

(G) One (1) member shall represent the health insurance industry; and 

(H) One (1) member shall be a chiropractor and shall be appointed from a list of nominees submitted by the Tennessee Chiropractic Association. 

(2) The medical director shall serve as a nonvoting ex officio member of the committee. 

(3) An organization that submits a list of nominees shall list at least three (3) nominees for each of the committee positions for which it is requested to submit nominations.  If the commissioner finds a list of nominees unsatisfactory, the commissioner shall return the list to the submitting organization.  The organization shall submit another list within thirty (30) days.  This process shall continue until the commissioner appoints a member. If an organization that is required to submit a list of nominees fails to do so within thirty (30) days of a request for such list by the commissioner, then the commissioner may appoint a member of such commissioner's own choosing. 

(4) In making such appointments, the commissioner shall strive to achieve a geographic balance and, in the case of the physician members of the committee, shall assure to the extent possible that the membership of the committee reflects the diversity of specialties involved in the medical treatment and management of workers' compensation claimants. 

(c)  The members of the committee shall be appointed for terms of four (4) years. In order to provide staggered terms, in making the initial appointments to the committee: the representative of the health insurance industry, one (1) of the physicians, the pharmacist, one (1) representative of employees, and one (1) of the representatives of hospitals shall be appointed to an initial term of four (4) years; one (1) of the physicians, one (1) of the representatives of employers, and one (1) of the representatives of hospitals shall be appointed to an initial term of three (3) years; one (1) of the physicians, one (1) of the representatives of employers, and one (1) of the representatives of employees shall be appointed to an initial term of two (2) years; and one (1) of the representatives of employers, one (1) of the representatives of employees, and one (1) of the representatives of hospitals shall be appointed to an initial term of one (1) year. Each member of the committee shall, upon the expiration of such member's term, be eligible for reappointment and shall serve until a successor is appointed and qualified.  

(d)  Members of the committee shall serve without compensation but, when engaged in the conduct of their official duties as members of the committee, shall be entitled to reimbursement for travel expenses in accordance with uniform regulations promulgated by the department of finance and administration and approved by the attorney general and reporter. 

[Acts 1992, ch. 900, § 9; 1999, ch. 520, § 41; 2004, ch. 962, § 33; 2005, ch. 105, §§ 1, 2.]

50-6-126. Medical director.

The commissioner shall appoint a medical director who shall be the executive secretary and a nonvoting ex officio member of the medical committee. The medical director shall be appointed from a list of three (3) nominees submitted by the Tennessee Medical Association.  If the commissioner finds the list of three (3) nominees to be unsatisfactory, then the commissioner shall return the list to the Tennessee Medical Association and the association shall submit another list of nominees. This process shall be repeated, if necessary, until the commissioner selects a nominee to be medical director.  The medical director may be a part-time employee, a full-time employee or a contract employee, and shall perform the following functions for which the medical director shall be responsible to the commissioner or medical care and cost containment committee, as appropriate: 

(1) Institute administrative procedures that will enable the medical director to evaluate medical care to effect optimal treatment in workers' compensation cases; 

(2) Inquire into instances where the medical treatment or the physical rehabilitation provided appears to be deficient or incomplete and recommend corrective action when indicated; 

(3) Advise on the disposition of complaints of a physician's failure to furnish adequate medical care as required by this law or by rules and regulations adopted by the administrator, the disposition of complaints concerning other aspects of the medical management of a workers' compensation case or the failure to render required reports, and the disposition of complaints of any affected party as to unreasonable interference with the medical management of a workers' compensation case; 

(4) Gather data and maintain records necessary to fulfill the medical director's responsibilities; 

(5) Conduct studies and prepare and issue reports on the medical aspect of workers' compensation cases; 

(6) Expedite the submission and processing of medical reports necessary to the processing of claims; 

(7) Advise health care providers of their rights and responsibilities under this chapter and under any rules or regulations promulgated thereto; 

(8) Advise the medical care and cost containment committee as to the reasonableness of fees for medical services in particular cases; and 

(9) Undertake such other functions as may be delegated to the medical director by the administrator. 

[Acts 1992, ch. 900, § 10; 1999, ch. 520, § 41.]

50-6-127. Public awareness program concerning workers' compensation fraud - Investigations and referrals.

(a)  The commissioner, in consultation with the commissioner of commerce and insurance and appropriate law enforcement officials, shall implement a public awareness program concerning workers' compensation fraud. 

(b)  The division of workers' compensation shall investigate to determine whether any fraudulent conduct relating to workers' compensation is being practiced, and shall refer to an appropriate law enforcement agency any finding of fraud. 

(c)   

[Acts 1992, ch. 900, § 21; 1996, ch. 944, § 12; 1999, ch. 520, § 41; 2000, ch. 852, § 14; 2003, ch. 355, § 16.]

50-6-128. Penalty for employer causing compensable claim to be paid by insurance or failing to provide necessary medical treatment.

If any employer knowingly, willfully, and intentionally causes a medical or wage loss claim to be paid under health or sickness and accident insurance, or fails to provide reasonable and necessary medical treatment, including a failure to reimburse when the employer knew that the claim arose out of a compensable work-related injury and should have been submitted under its workers' compensation insurance coverage, then a civil penalty of five hundred dollars ($500) shall be assessed against such employer, and the employer may not offset any sickness and accident income benefit paid to the employee against its temporary total disability benefit payment liability due to the employee pursuant to the provisions of this chapter. The commissioner of labor and workforce development has the authority to assess and collect such civil penalty. 

[Acts 1992, ch. 900, § 24; 2000, ch. 734, § 1.]

50-6-129. [Repealed.]

50-6-130. Special joint committee [Effective until June 30, 2007.  See the Compiler's Notes].

(a)  There is hereby created a special joint committee of the general assembly on workers' compensation issues composed of eight (8) members of the senate appointed by the speaker of the senate and eight (8) members of the house of representatives appointed by the speaker of the house of representatives. 

(b)  This committee shall monitor the implementation of the Workers' Compensation Reform Act of 1992 and subsequent reforms, and shall study such other programs, initiatives or topics related to the workers' compensation system as the members deem appropriate. 

(c)  The committee shall report to the governor and general assembly at least annually. 

(d) (1)  The departments of labor and workforce development and commerce and insurance shall provide the committee with such information as it may require. 

(2) The comptroller of the treasury and the state treasurer shall provide staff support to the committee. 

(e)  The special committee shall terminate on June 30, 2007. 

(f) (1)  Members of the committee shall be entitled to reimbursement for their expenses in attending meetings of the committee or any subcommittee thereof at the same rates and in the same manner as when attending the general assembly. 

(2) The committee shall elect from its membership a chair, a vice chair and such other officers as it deems necessary. 

(g)  The committee shall promptly review and comment on any bill referred to the committee by a standing committee of the general assembly. The absence of comment by the committee shall not prohibit any standing committee from acting on a bill. The committee shall review legislation referred to it for comment with respect to its impact on the following: 

(1) Accidents and workplace safety; 

(2) Adequacy of benefits; 

(3) Stability and adequacy of relevant insurance markets; 

(4) The system of claim and dispute resolution; and 

(5) Such other matters as the committee may deem relevant. 

[Acts 1996, ch. 944, § 2; 1997, ch. 533, § 1; 1999, ch. 520, § 4; 2001, ch. 192, § 1.]

50-6-131. Confidentiality of medical records.

Medical records provided to the division of workers' compensation in the course of its activities relative to benefit review conferences and the review of settlements pursuant to this chapter shall remain confidential and shall not be considered to be public records. 

[Acts 1996, ch. 944, § 25; 1999, ch. 520, § 41.]

50-6-132. Report of employers failing to provide coverage.

No later than December 31 of each year, the division of workers' compensation shall produce a report that includes a listing of the name of each covered employer that failed, during the preceding state fiscal year, to provide workers' compensation coverage or qualify as a self-insured employer as required by law. Only those employers whose failure resulted in periods of non-coverage shall be included within the report. Such report shall also include the penalty assessed by the division and the payment status of such penalty. The report shall be provided to the advisory council on workers' compensation, the oversight committee on workers' compensation, and the chair of the senate commerce, labor and agriculture committee and the consumer and employee affairs committee of the house of representatives. 

[Acts 1999, ch. 217, § 1.]

50-6-133. Continuing education programs on workers' compensation.

It shall be the duty of the administrative office of the courts, in consultation with the advisory council on workers' compensation, to develop and provide appropriate continuing education programs on topics related to workers' compensation at each annual meeting. Such continuing education shall include both generalized applications of the provisions of this chapter and the use of the AMA Guides. The program shall also address any specific variances in the application of the provisions of this chapter throughout the state. 

[Acts 2004, ch. 962, § 31.]

50-6-134. Annual review.

The commissioner of commerce and insurance shall, on or before July 1, 2007, and annually thereafter through 2010, review the impact of the provisions of Acts 2004, ch. 962 on premiums charged by insurers who provide workers' compensation coverage in this state. The commissioner of commerce and insurance is authorized to require the production of any information, documents, books or records from any person who is subject to regulation by the department that the commissioner deems necessary to implement the provisions of this section. 

[Acts 2004, ch. 962, § 41.]

50-6-201. Notice of injury.

(a)  Every injured employee or such injured employee's representative shall, immediately upon the occurrence of an injury, or as soon thereafter as is reasonable and practicable, give or cause to be given to the employer who has no actual notice, written notice of the injury, and the employee shall not be entitled to physician's fees or to any compensation that may have accrued under the provisions of the Workers' Compensation Law, compiled in this chapter, from the date of the accident to the giving of such notice, unless it can be shown that the employer had actual knowledge of the accident. No compensation shall be payable under the provisions of this chapter, unless such written notice is given the employer within thirty (30) days after the occurrence of the accident, unless reasonable excuse for failure to give such notice is made to the satisfaction of the tribunal to which the claim for compensation may be presented. 

(b)  In those cases where the injuries occur as the result of gradual or cumulative events or trauma, then the injured employee or such injured employee's representative shall provide notice to the employer of the injury within thirty (30) days after the employee: 

(1) Knows or reasonably should know that such employee has suffered a work-related injury that has resulted in permanent physical impairment; or 

(2) Is rendered unable to continue to perform such employee's normal work activities as the result of the work-related injury and the employee knows or reasonably should know that the injury was caused by work-related activities. 

[Acts 1919, ch. 123, § 22; Shan. Supp., § 3608a171; Code 1932, § 6872; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-1001; Acts 2001, ch. 219, § 1.]

50-6-202. Contents and service of notice.

(a) (1)  The notice required to be given of the occurrence of an accident to the employer shall state in plain and simple language the name and address of the employee, the time, place, and nature and cause of the accident resulting in injury or death, and shall be signed by the claimant or by some person in the claimant's behalf, or by any one (1) or more of the claimant's dependents if the accident resulted in death to the employee. 

(2) No defect or inaccuracy in the notice shall be a bar to compensation, unless the employer can show to the satisfaction of the tribunal in which the matter is pending that the employer was prejudiced by the failure to give the proper notice, and then only to the extent of such prejudice. 

(b)  The notice shall be given personally to the employer or to the employer's agent or agents having charge of the business in working at which the injury was sustained by the employee. 

[Acts 1919, ch. 123, § 23; Shan. Supp., § 3608a172; Code 1932, § 6873; T.C.A. (orig. ed.), § 50-1002.]

50-6-203. Limitation of time, claims and actions.

(a)  No claim for compensation under Workers' Compensation Law, compiled in this chapter, shall be filed with a court having jurisdiction to hear workers' compensation matters, as provided in § 50-6-225, until the parties have exhausted the benefit review conference process provided by the division of workers' compensation. Notwithstanding the provisions of this section, if the parties have mutually agreed to a compromise and settlement of a claim for workers' compensation, the parties shall not be required to exhaust the benefit review conference process before filing a claim and submitting the compromise and settlement to the appropriate court for approval pursuant to § 50-6-206(a) or to the commissioner of labor and workforce development or the commissioner's designee pursuant to § 50-6-206(c). If the settlement is not approved, the parties shall then exhaust the benefit review conference process. 

(b) (1)  In those instances where the employer has not paid workers' compensation benefits to or on behalf of the employee, the right to compensation under Workers' Compensation Law, compiled in this chapter, shall be forever barred, unless the notice required by § 50-6-202 is given to the employer and a benefit review conference is requested on a form prescribed by the commissioner and filed with the division within one (1) year after the accident resulting in injury. 

(2) In those instances where the employer has paid workers' compensation benefits, either voluntarily or as a result of an order to do so, within one (1) year following the accident resulting in injury, the right to compensation is forever barred unless a form prescribed by the commissioner requesting a benefit review conference is filed with the division within one (1) year from the latter of the date of the last authorized treatment or the time the employer ceased to make payments of compensation to or on behalf of the employee. 

(c)  For purposes of this section, the issuing date of the last payment of compensation by the employer, not the date of its receipt, shall constitute the time the employer ceased making payments and an employer or its insurer shall provide such date on request. 

(d)  In case of physical or mental incapacity, other than minority, of the injured person or such injured person's dependents to perform or cause to be performed any action required within the time specified in this section then the period of limitation in such case shall be extended for one (1) year from the date when such incapacity ceases. 

(e) (1)  Unless a claim for death benefits is settled or voluntarily paid, the dependent or dependents of a deceased employee shall request a benefit review conference within one (1) year of the date of death of the employee. 

(2) In the event the deceased employee was a native of a foreign country and leaves no known dependent or dependents within the United States, it shall be the duty of the commissioner to give written notice forthwith of the death to the duly accredited consular officer of the country of which the beneficiaries are citizens. 

(f)  In the event the employee fails to appear and participate in the benefit review conference as scheduled by the division, the commissioner shall have the authority to dismiss the employee's claim by sending a copy of the order of dismissal by certified mail with return receipt requested, signed by the employee, to the employee's last known address. The order of dismissal shall become final and the claim shall be forever barred unless the employee contacts the department to schedule a benefit review conference and attends a benefit review conference within sixty (60) days of the date the order of dismissal is signed by the commissioner or the commissioner's designee. 

(g) (1)  If the parties are not able to reach a compromise and settlement of all issues at the benefit review conference held pursuant to this section, the parties shall have ninety (90) days, after the date a written agreement or a written report regarding the conference is filed with the commissioner pursuant to § 50-6-240, to file a complaint with a court of competent jurisdiction as provided in § 50-6-225. The division of workers' compensation shall maintain an official record of the date on which a written agreement or written report is filed with the commissioner and supply the information to the parties or the appropriate court upon request of either the parties or the court. 

(2) Notwithstanding the provisions of this subsection (g), in no event shall an employee have less than the latter of: 

(A) One (1) year from the date of the accident resulting in injury; or 

(B) One (1) year from the latter of the date of the last authorized treatment or the time the employer ceased to make payments of compensation to or on behalf of the employee in which to file a complaint with a court of competent jurisdiction, as provided in § 50-6-225. 

(h)  In the event a workers' compensation's complaint is filed with a court of competent jurisdiction pursuant to this section by the employer or the employer's agent and the employer or agent files notice of non-suit of the action, either party shall have ninety (90) days from the date of the order of dismissal to institute an action for recovery of benefits under this chapter. 

(i)  Proceedings to obtain a judgment in the case of the failure of the employer for thirty (30) days to pay any compensation due under any settlement or determination shall be filed within one (1) year after such default. 

[Acts 1919, ch. 123, § 24; Shan. Supp., § 3608a173; Code 1932, § 6874; Acts 1947, ch. 139, § 4; C. Supp. 1950, § 6874; impl. am. Acts 1980, ch. 534, § 1; T.C.A. (orig. ed.), § 50-1003; Acts 1996, ch. 944, § 13; 1998, ch. 1024, §§ 1, 2; 1999, ch. 520, § 41; 2004, ch. 962, § 14; 2005, ch. 390, §§ 5, 6.]

50-6-204. Medical treatment, attendance and hospitalization - Release of medical records - Reports - Disputes - Reimbursement or payment of expenses - Burial expenses - Physical examinations.

(a) (1)  The employer or the employer's agent shall furnish free of charge to the employee such medical and surgical treatment, medicine, medical and surgical supplies, crutches, artificial members, and other apparatus, including prescription eyeglasses and eye wear, such nursing services or psychological services as ordered by the attending physician and hospitalization, including such dental work made reasonably necessary by accident as defined in this chapter, as may be reasonably required; provided, that within thirty (30) days after examination or treatment of an employee, a physician shall, upon request, furnish to the employer or to the employer's insurer and to the employee or the employee's attorney a complete medical report at a charge not to exceed ten dollars ($10.00) for reports twenty (20) pages or less in length and twenty-five cents (25›) per page for each page copied after the first twenty (20) pages, as to the claimed injury, its effect upon the employee, the medical treatment prescribed, an estimate of the duration of required hospitalization, if any, and an itemized statement of charges for medical services to date. If an employer or an insurer has not previously requested copies of such records from a physician or hospital, then an attorney for an employer may request such records under this subdivision (a)(1). 

(2) (A) Any hospital in which the employee may have been hospitalized shall, within thirty (30) days of admission, also release its medical records to both the employee and the employer upon the request of either.  The set of records for the employee may be released to either the employee or to the employee's attorney and the set of records for the employer may be released to either the employer, the insurer, a claims representative, or an attorney representing the employer or the insurer.  Only the records pertaining to the current admission shall be released under this subdivision (a)(2)(A). 

(B) If requested in writing by the employer or insurer, or by the employee or the employee's attorney, the physician and hospital shall also furnish subsequent prognosis reports, medical records and statements of charges at intervals of not less than sixty (60) days. No such relevant information developed in connection with treatment or examination for which compensation is sought by the employee shall be considered a privileged communication. The employee's consent shall not be required for the furnishing of such reports or records, and no physician or hospital furnishing such report or record shall incur any liability as a result thereof. 

(3) Whenever it appears that the amount of medical benefits to which the employee may be entitled under this section will exceed the amount of five thousand dollars ($5,000), the insurer shall file written notice with the division of workers' compensation, which shall, upon receipt of such notice, notify the employer that the claim for medical benefits for the employee will exceed five thousand dollars ($5,000). 

(4) (A) The injured employee shall accept the medical benefits afforded hereunder; provided, that, except as provided in subdivision (a)(4)(B) or (a)(4)(C), the employer shall designate a group of three (3) or more reputable physicians or surgeons not associated together in practice, if available in that community, from which the injured employee shall have the privilege of selecting the operating surgeon or the attending physician; and provided, further, that the liability of the employer for such services rendered the employee shall be limited to such charges as are established in the applicable medical fee schedule adopted pursuant to this section. 

(B) If the injury is a back injury, then the group of three (3) or more physicians or surgeons required to be designated pursuant to subdivision (a)(4)(A) shall be expanded to four (4), one of whom must be a doctor of chiropractic; provided, that no more than twelve (12) visits to such doctor of chiropractic shall be approved per back injury, except upon the approval of the employer. The provisions of this subdivision (a)(4)(B) shall not apply to state or local government employees and shall not apply to workers' compensation self-insurer pools established pursuant to § 50-6-405(c)(1). 

(C) If the injury or illness requires the treatment of a physician or surgeon who practices orthopedic or neuroscience medicine, then the employer may appoint a panel of physicians or surgeons practicing orthopedic or neuroscience medicine required to be designated pursuant to subdivision (a)(4)(A) consisting of five (5) physicians, with no more than four (4) physicians affiliated in practice. 

(D) In circumstances where an employee is offered a treating panel as described in subdivision (a)(4)(C), the injured employee shall be entitled to have a second opinion on the issue of surgery, impairment, and a diagnosis from that same panel of physicians selected by the employer. 

(E) The employer shall provide the applicable panel of physicians to the employee in writing on a form prescribed by the division, and the employee shall document in writing the physician the employee has selected and the employee shall sign and date the prescribed form. The employer shall provide a copy of the completed form to the employee and shall maintain a copy of the completed form in the records of the employer and shall produce a copy of the completed form upon request by the division. 

(5) All cases of dispute as to the value of such services shall be determined by the tribunal having jurisdiction of the claim of the injured employee for compensation. Such tribunal may also deny payment of physicians' fees and hospital charges for failure to submit the reports as required herein. 

(6) (A) When an injured worker is required by the worker's employer to travel to an authorized medical provider or facility located outside a radius of fifteen (15) miles from such insured worker's residence or workplace, then, upon request, such employee shall be reimbursed for reasonable travel expenses. The injured employee's travel reimbursement shall be calculated based on a per mile reimbursement rate, as defined in subdivision (a)(6)(B), times the total round trip mileage as measured from the employee's residence or workplace to the location of the medical provider's facility. The definition of "community" as contemplated by this subdivision shall apply only for the purposes of this section. 

(B) The per mile reimbursement rate for the injured employee shall be not less than the mileage allowance authorized for state employees who have been authorized to use personally owned vehicles in the performance of their duties. This minimum per mile reimbursement rate shall be based on the last published comprehensive travel regulations promulgated by the department of finance and administration. 

(b) (1)  Where the nature of the injury or occupational disease, as defined in § 50-6-102, is such that it does not disable the employee but reasonably requires medical, surgical, psychological or dental treatment or care, medicine, surgery, dental and psychological treatment, medicine, medical and surgical supplies, crutches, artificial members, and other apparatus shall be furnished by the employer. 

(2) In addition to any attorney fees provided for pursuant to the provisions of § 50-6-226, a court may award attorney fees and reasonable costs to include reasonable and necessary court reporter expenses and expert witness fees for depositions and trials incurred when the employer fails to furnish appropriate medical, surgical and dental treatment or care, medicine, medical and surgical supplies, crutches, artificial members and other apparatus to an employee provided for pursuant to a settlement or judgment under this chapter. 

(c)  In case death results from the injury or occupational disease, as defined in § 50-6-102, the employer shall, in addition to the medical services, etc., referred to above, and the second injury fund assessment referred to in § 50-6-208, pay the burial expenses of the deceased employee, not exceeding seven thousand five hundred dollars ($7,500). If the deceased employee leaves no dependents entitled to compensation under the provisions of the Workers' Compensation Law, the employer shall pay to such employee's estate the additional benefit provided in § 50-6-209(b)(1) and (2), and shall also be liable for the medical and hospital services, second injury fund assessment and burial expenses provided for herein. 

(d) (1)  The injured employee must submit to examination by the employer's physician at all reasonable times if requested to do so by the employer, but the employee shall have the right to have the employee's own physician present at such examination, in which case the employee shall be liable to such physician for such physician's services. 

(2) Any medical report submitted to the employer based upon such examination, or a true copy of such report, shall be furnished by the employer to the employee upon request; provided, that the employer may, in the employer's discretion, furnish such report to the attorney for the employee or to a member of the employee's family. 

(3) (A) To provide uniformity and fairness for all parties in determining the degree of anatomical impairment sustained by the employee, a physician, chiropractor or medical practitioner who is permitted to give expert testimony in a Tennessee court of law and who has provided medical treatment to an employee or who has examined or evaluated an employee seeking workers' compensation benefits shall utilize the applicable edition of the AMA Guides as established in § 50-6-102 or in cases not covered by the AMA Guides an impairment rating by any appropriate method used and accepted by the medical community. 

(B) No anatomical impairment or impairment rating, whether contained in a medical record, medical report, including a medical report pursuant to § 50-6-235(c), deposition or oral expert opinion testimony shall be accepted during a benefit review conference or be admissible into evidence at the trial of a workers' compensation matter unless the impairment is based on the applicable edition of the AMA Guides or in cases not covered by the AMA Guides an impairment rating by any appropriate method used and accepted by the medical community. 

(C) The administrator of the division of workers' compensation shall determine the date on which the most recent edition of the AMA Guides became effective for purposes of this subdivision and the administrator shall maintain the full title of the most recent edition and the date it became effective on the division's website. 

(4) The employer shall pay for the services of the physician making the examination at the instance of the employer. 

(5) When a dispute as to the degree of medical impairment exists, either party may request an independent medical examiner from the commissioner's registry. If the parties are unable to mutually agree on the selection of an independent medical examiner from the commissioner's registry, it shall be the responsibility of the employer to provide a written request to the commissioner for assignment of an independent medical examiner with a copy of the notice provided to the other party. Upon receipt of such written request, the commissioner shall provide the names of three (3) independent medical examiners chosen at random from the registry. No physician may serve as an independent medical examiner in a case and serve on any panel of providers selected under this section for the employer involved in such case. The commissioner shall immediately notify the parties by facsimile or email when the list of independent medical examiners has been assigned to a matter, but in any event the notification shall be made within five (5) business days of the date of the request. The employer may strike one (1) name from the list, with such rejection made and communicated to the other party by facsimile or email not later than the third business day after the date on which notification of the list is provided. The employee shall select a physician to perform the independent medical examination from the remaining physicians on the list. All costs and fees for an independent medical examination and report made pursuant to this subdivision (d)(5) shall be paid by the employer. The written opinion as to the permanent impairment rating given by the independent medical examiner pursuant to this subdivision (d)(5) shall be presumed to be the accurate impairment rating; provided, however, that this presumption may be rebutted by clear and convincing evidence to the contrary. 

(6) The commissioner of labor and workforce development shall establish by rule, in accordance with the provisions of the Uniform Administrative Procedures Act, compiled title 4, chapter 5, an independent medical examiners registry. The commissioner shall establish qualifications for the independent medical examiners, including continuing education and peer review requirements, with the advice of the Tennessee Medical Association and the Workers' Compensation Advisory Council. The rules established shall include, but not be limited to, qualifications and procedures for submission of an application for inclusion on the registry, procedures for the review and maintenance of the registry, and procedures for assignment that ensures that the composition of such panels is random. The rules required by this subdivision (d)(6) shall take effect on July 1, 2005. The commissioner is authorized to use public necessity rules under § 4-5-209(a)(4) or emergency rules under § 4-5-208, as appropriate, in order to have such rules in effect no later than July 1, 2005. 

(7) Whenever the nature of the injury is such that specialized medical attention is required or indicated and such specialized medical attention is not available in the community in which the injured employee resides, the injured employee can be required to go, at the request of and at the expense of the employer, to the nearest location at which such specialized medical attention is available. 

(8) If the injured employee refuses to comply with any reasonable request for examination or to accept the medical or specialized medical services which the employer is required to furnish under the provisions of this law, such injured employee's right to compensation shall be suspended and no compensation shall be due and payable while such injured employee continues such refusal. 

(9) For accidents or injuries occurring on or after July 1, 2005, in case of a dispute as to the injury, other than disputes as to the degree of medical impairment, the court may, at the instance of either party or on its own motion, appoint a neutral physician of good standing and ability to make an examination of the injured person and report such physician's findings to the court, the expense of which examination shall be borne equally by the parties. 

(e)  In all death claims where the cause of death is obscure or is disputed, any interested party may require an autopsy, the cost of which is to be borne by the party demanding the same. 

(f)  Any physician whose services are furnished or paid for by the employer and who treats or makes or is present at any examination of an injured employee may be required to testify as to any knowledge acquired by such physician in the course of such treatment or examination as same relates to the injury or disability arising therefrom. 

(g) (1)  If an emergency, or on account of the employer's failure or refusal to provide the medical care and services required by this law, the injured employee or the injured employee's dependents may provide the same, and the cost thereof not exceeding three hundred dollars ($300), shall be borne by the employer; provided, that the pecuniary liability of such employer shall be limited to the charges for such service as prevail in the community where the services are rendered. 

(2) All cases of dispute as to the value of such services shall be determined by the tribunal having jurisdiction of the matter of compensation to the employee. 

(h)  All psychological or psychiatric services available under subdivisions (a)(1) and (b)(1) shall be rendered only by psychologists or psychiatrists and shall be limited to those ordered upon the referral of physicians authorized under subdivision (a)(4). 

(i) (1)  The commissioner of labor and workforce development, in consultation with the medical care and cost containment committee and the advisory council on workers' compensation, is authorized to establish by rule, in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, a comprehensive medical fee schedule and a related system which includes, but is not limited to, procedures for review of charges, enforcement procedures and appeal hearings to implement the fee schedule. In developing the rules, the commissioner shall strive to assure the delivery of quality medical care in workers' compensation cases and access by injured workers to primary and specialist care while controlling prices and system costs. The medical care fee schedule shall be comprehensive in scope and shall address fees of physicians and surgeons, hospitals, prescription drugs, and ancillary services provided by other health care facilities and providers. The commissioner may consider any and all reimbursement systems and methodologies in developing the fee schedule. 

(2) The commissioner is authorized to retain experts to assist in the development of the fee schedule and related system in accordance with the contracting rules of the department of finance and administration. 

(3) The commissioner shall file a copy of such proposed rules with the medical care and cost containment committee, established by § 50-6-125, and the workers' compensation advisory council, established by § 50-6-121, by December 1, 2004. The cost containment committee and the advisory council shall comment on the proposed rules within thirty (30) days of receiving the rules and shall promptly provide such comments to the commissioner and the special joint committee of the general assembly on workers' compensation. The special joint committee may recommend appropriate legislative action to the general assembly. 

(4) The commissioner shall file the rules proposed to implement the provisions of this section with the clerk of the senate, the clerk of the house of representatives, the consumer and employee affairs committee of the house of representatives, and the commerce, labor and agriculture committee of the senate, by April 1, 2005. 

(5) The rules required by this subsection shall take effect on July 1, 2005.  The penalty provisions established by these rules shall not become effective until January 1, 2006. The commissioner is authorized to use public necessity rules under § 4-5-209(a)(4) or emergency rules under § 4-5-208, as appropriate, in order to have such rules in effect on July 1, 2005. 

(6) The commissioner, in consultation with the medical care and cost containment committee and the advisory council on workers' compensation, shall review the fee schedules adopted pursuant to this section on an annual basis and when appropriate the commissioner shall revise the fee schedules as necessary. It is the intent of the general assembly that this annual review consider, among other factors, the medical consumer price index. 

(7) The comprehensive medical fee schedule adopted pursuant to this subsection (i) is not intended to prohibit an employer, trust or pool, or insurer from negotiating lower fees in its own medical fee agreements. 

[Acts 1919, ch. 123, § 25; Shan. Supp., § 3608a174; Code 1932, § 6875; Acts 1941, ch. 90, § 3; 1943, ch. 117, § 1; 1949, ch. 227, § 2; C. Supp. 1950, § 6875; Acts 1953, ch. 111, § 1; 1957, ch. 234, § 1; 1959, ch. 62, § 1; 1959, ch. 172, § 1; 1963, ch. 362, § 3; 1967, ch. 313, § 3; 1971, ch. 134, § 3; 1973, ch. 379, § 4; 1977, ch. 417, § 1; 1978, ch. 521, § 1; impl. am. Acts 1980, ch. 534, § 1; Acts 1980, ch. 650, § 1; T.C.A. (orig. ed.), § 50-1004; Acts 1983, ch. 194, § 1; 1983, ch. 215, § 1; 1983, ch. 276, § 1; 1984, ch. 782, § 1; 1985, ch. 393, § 3; 1986, ch. 792, § 1; 1986, ch. 809, § 1; 1988, ch. 525, § 3; 1989, ch. 210, § 1; 1989, ch. 446, § 1; 1991, ch. 255, § 1; 1996, ch. 790, § 1; 1997, ch. 198, § 1; 1997, ch. 259, § 1; 1997, ch. 533, § 2; 1998, ch. 1024, §§ 21, 22; 1999, ch. 225, § 1; 1999, ch. 294, §§ 2-5; 1999, ch. 520, § 41; 2000, ch. 990, §§ 1, 3; 2001, ch. 192, §§ 9, 10; 2001, ch. 246, § 1; 2003, ch. 359, § 2; 2004, ch. 433, § 1; 2004, ch. 962, §§ 1, 2, 5, 13, 24, 46; 2005, ch. 7, § 1; 2005, ch. 107, §§ 1, 2; 2005, ch. 188, § 1.]

50-6-205. Period of compensation - Maximum amount - Notice of payment, change or nonpayment - Records - Notice of controversy.

(a)  No compensation shall be allowed for the first seven (7) days of disability resulting from the injury, excluding the day of injury, except the benefits provided for in § 50-6-204, but if disability extends beyond that period, compensation shall commence with the eighth day after the injury. In the event, however, that the disability from the injury exists for a period as much as fourteen (14) days, then compensation shall be allowed beginning with the first day after the injury. 

(b) (1)  The total amount of compensation payable under this part shall not exceed the maximum total benefit provided in §  50-6-102(13) in any case, exclusive of travel reimbursement, medical, hospital and funeral benefits. 

(2) Compensation shall be paid promptly. The first payment shall be due and payable within fifteen (15) days after the employer has knowledge of any disability or death, and thereafter compensation shall be paid to the employee or the employee's dependents semimonthly. Evidence of the initiation or denial of such compensation is inadmissible in a subsequent proceeding concerning the issue of the compensability of injury. 

(3) (A) In addition to any other penalty provided by law, if an employer, trust or pool, or an employer's insurer fails to pay, or untimely pays, temporary disability benefits within twenty (20) days after the employer has knowledge of any disability that would qualify for benefits under this chapter, a workers' compensation specialist shall have the authority to assess against the employer, trust or pool, or the employer's insurer a civil penalty in addition to the temporary disability benefits that are due to the employee. The penalty, if assessed, shall be in an amount equal to twenty-five percent (25%) of such temporary disability benefits that were not paid in accordance with the provisions of this subsection (b). Furthermore, the penalty may be assessed as to all temporary disability benefits that are determined to not be paid in compliance with this subsection (b). 

(B) Prior to the assessment of any civil penalty, the specialist shall issue a written request to the employer or insurance carrier to provide documentation as to why the civil penalty should not be assessed. 

(C) If the specialist determines the employer or insurer was not in compliance with this subsection (b), the specialist shall issue a written order that assesses the penalty in a specific dollar amount to be paid directly to the employee. If the employer or insurer fails to comply with the order within fifteen (15) calendar days of that order's becoming final, the employer or insurer shall be subject to penalties as set forth in § 50-6-238(d). 

(D) In any civil action filed pursuant to this chapter, the court shall have the authority to assess penalties as provided in this subdivision (b)(3). 

(c) (1)  Upon making the first payment of benefits, and upon stopping or changing such benefits for any cause other than final settlement, or upon denying a claim after proper investigation, the employer's insurance carrier or the employer, if self-insured, shall immediately notify the administrator, on a form prescribed by the administrator, that the payment of income benefits has begun or has been stopped or changed. 

(2) Failure to file such notice shall be a misdemeanor and shall, upon conviction, be punishable by a fine of not more than fifty dollars ($50.00). 

(d) (1)  If payments have been made without an award, and the employer subsequently elects to controvert such employer's liability, notice of controversy shall be filed with the administrator within fifteen (15) days of the due date of the first omitted payment. 

(2) In such cases, the prior payment of compensation shall not be considered a binding determination of the obligations of the employer as to future compensation payments. 

(3) Likewise, the acceptance of compensation by the employee shall not be considered a binding determination of the obligations of the employer as to future compensation payments; nor shall the acceptance of compensation by the employee be considered a binding determination of such employee's rights. 

[Acts 1919, ch. 123, § 26; 1923, ch. 84, § 3; Shan. Supp., § 3608a175; Code 1932, § 6876; Acts 1941, ch. 90, § 4; C. Supp. 1950, § 6876; Acts 1955, ch. 182, § 1; 1963, ch. 362, § 1; 1967, ch. 313, § 2; 1969, ch. 196, § 2; 1971, ch. 134, § 2; 1972, ch. 699, § 2; 1973, ch. 379, § 5; 1974, ch. 617, § 1; 1975, ch. 86, § 1; 1977, ch. 354, § 1; 1978, ch. 532, § 1; 1979, ch. 365, § 1; 1980, ch. 607, § 1; 1981, ch. 333, § 1; 1982, ch. 880, § 1; T.C.A. (orig. ed.), § 50-1005; Acts 1983, ch. 215, § 2; 1985, ch. 393, §§ 4, 20; 1996, ch. 790, § 2; 1997, ch. 533, § 3; 1999, ch. 520, § 41; 2004, ch. 962, § 6.]

50-6-206. Settlements.