Medical Panel

Employers should offer injured workers a panel of physicians when a work-related injury is reported via the "Employee's Choice of Physician" Form.

Required by Law

Most Tennessee employers are required by law to provide a panel of physicians within three business days of receiving notice of a work-related injury. This ensures that employees receive the medical treatment needed to help them recover while allowing the employer to have some control over the claim.

This panel, or list of physicians, should name at least three physicians located in the employee’s community who are willing to treat the injured worker and is typically developed with the assistance of the employer’s insurance adjuster.

Employee Chooses

Once the form has been given to the injured worker, he or she chooses which of the doctors listed becomes the treating physician. The injured worker then sends the completed form back to the employer.

 That physician becomes the “authorized treating physician” or ATP.

What is an Authorized Treating Physician?

When an authorized treating physician is selected from the panel by the employee, that physician will be in charge of the injured employee’s medical care for as long as it is necessary or appropriate.

Appropriate Physicians for the Panel

The employer can select any appropriate, independent, reputable physician in the employee’s community to be on the panel. The panel should include:

  • At least three independent physicians
    • No more than two of them can be within the same practice or practicing at the same location.
    • Walk-in clinics, urgent care facilities and other similar providers may be an option on a medical panel if the provider is staffed by at least one physician and the name of the staff physician or medical director is also indicated on the panel.
    • (Optional) Employers can additionally offer injured workers the choice to seek medical treatment in a quicker, more convenient manner. Telehealth allows injured workers to connect with their caregivers from anywhere — including their homes.
  • Located within the community of the injured employee
    • If three physicians cannot be located within the community of the injured employee, the employer may extend the search to a 125-mile radius of the community of the injured employee.

Travel Reimbursement

If the injured worker has to travel more than 15 miles one way for treatment with an authorized provider, he or she is entitled to mileage reimbursement.

Emergency Care

If emergency treatment is required, the panel should be provided to the worker as soon as practicable, usually after emergent care has been provided.

Referrals to Specialists

If needed, the authorized treating physician can make a referral to a specialist (such as an orthopedist) for further treatment or surgery. If that happens, the employer can either provide a panel of specialty physicians or allow the authorized treating physician’s referral of a recommended specialist to become the new ATP.

Employee's Choice of Physician

Employers must use this official form. Alternative versions of the form are not allowed.

Keep the completed form on file and send a copy to the employee for their records.

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Frequently Asked Questions

Typically, the employer is only obligated to pay for treatment provided by the authorized treating physician. If you want treatment to be paid by workers’ compensation insurance, you should seek treatment from the agreed upon ATP that you select from the C-42 form.

Any treatment you seek on your own from your own primary-care doctor will likely have to be paid by you out of your pocket.

Panels should be provided within three business days of the employee’s report of the injury.

Yes, you can offer as many physicians as you would like, so long as it is at least three.

Yes. Panels should be appropriate for the type of injury. 

Example: A panel provided for a reported muscle strain would not contain the same type of physicians as a panel for someone who reported bleach being splashed in their eyes.

Best Practices & Tips

Pre-Examinations
Employers may direct injured employees to onsite, in-house or other similar employer-sponsored medical providers prior to providing an initial panel of physicians to determine the medical specialty needed to treat the injury. Having such a provider examine the injured employee does not satisfy nor alleviate the requirement for providing an appropriate panel.

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