Key Provisions of Tennessee Senate Bill 200
Effective July 1, 2014, through July 1, 2016
2014
Construction of Statute
Revises Section 50-6-116, Construction of Chapter, to indicate that for dates of injury on
or after July 1, 2014, the chapter should no longer be remedially or liberally construed,
but shall be construed fairly, impartially, and in accordance with the basic principle of
statutory construction and this chapter shall not be construed in a manner favoring
either the employee or the employer.
Definition of Injury (Causation)
Amends Section 50-6-102(12) to expands the definition of injury and personal injury by:
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Adding “occupational diseases of the heart, lung and hypertension.”
Indicating an injury now must “primarily” arise out of and in the course and scope of
employment.
Providing that “an injury arises primarily out of and in the course and scope of
employment” only if it is “shown by a preponderance of the evidence that the
employment contributed more than fifty-percent (50%) in causing the injury,
considering all causes.”
Specifying that aggravation of a preexisting disease, condition or ailment is not an
injury unless it can be shown to a reasonable degree of medical certainty that the
aggravation arose primarily out of and in the course and scope of employment.
Indicating that “an injury causes death, disablement or the need for medical
treatment” only if it has been shown to a reasonable degree of medical certainty
that it contributed more than fifty percent (50%) in causing the death, disablement
or need for medical treatment, considering all causes.
Indicating that “shown to a reasonable degree of medical certainty” means that in
the opinion of the physician, it is more likely than not considering all causes, as
opposed to speculation or possibility.
Adding that the opinion of the treating physician, selected by the employee from the
employer’s designated panel of physicians is presumed to be correct on the issue of
causation, but the presumption is rebuttable by a preponderance of the evidence.
Employer Communication with
Treating Physician(s)
Amends Section 50-6-204(a)(2) to allows employers or case managers to communicate
with the employee’s authorized treating physician, orally or in writing, and each medical
provider is required to release the records of any employee treated for a work-related
injury to both the employee and the employer within 30 days after admission or
treatment. The requirement that the employee sign a waiver before the employer,
insurance carrier, third party administrator, employer attorney or division of workers’
compensation is allowed to review the medical records related to treatment for the
workers’ compensation injury is removed.
Physician Selection Process
Amends Section 50-6-204(a)(3) to require the provision of only one panel of three
reputable physicians, surgeons, chiropractors or specialty groups no matter the type of
injury the employee suffered.
If the treating physician refers the employee to a specialist, the referral is deemed to
have accepted the referral, unless the employer provides a panel of three specialists to
the employee within three business days.
Temporary Total Disability
Amends Section 50-6-207(1)(E), to indicate that when the date of injury is on or after July
1, 2014, for other than a mental injury, the injured employee is conclusively presumed to
be at maximum medical improvement (MMI) when the treating physician ends all active
medical treatment and the only care provided is for the treatment of pain.
Provides that the employer will be given credit against an award of permanent disability
for any amount of temporary total disability (TTD) benefits paid to the employee after
the date that the employee attains MMI as determined by a workers’ compensation
judge.
Temporary Partial Disability
Amends Section 50-6-207(2) to increase the maximum total benefit to 450 weeks times
one hundred percent (100%) of the state’s average weekly wage, instead of 400 weeks
for injuries occurring on or after July 1, 2014.
New subdivision (B) is added and indicates that in all cases of temporary partial disability
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Key Provisions of Tennessee Senate Bill 200
Effective July 1, 2014, through July 1, 2016
(TPD) for claims with a date of injury on or after July 1, 2014, the compensation shall be
sixty-six and two-thirds percent (66 2/3%) of the difference between the average weekly
wage of the worker at the time of the injury and the wage the worker is able to earn in
the worker's partially disabled condition. This compensation is to be paid during the
period of the disability, but not beyond four hundred fifty (450) weeks. Payments are to
be made as nearly as possible at the intervals when the wage was payable, subject to the
same maximum and in no event less than the minimum weekly benefit.
Permanent Partial Disability
New subdivision (C) is added to provide that in any case of a dispute over the date of the
employee’s attainment of MMI, the employer will be given credit against an award of
permanent disability for any amount of TPD paid to the employee after the date on
which the workers’ compensation judge determines MMI.
Amends Section 50-6-207(3) to replace the formula for determining permanent partial
disability. In the case of partial disability adjudged to be permanent, at the time the
injured employee reaches MMI the injured employee is to be paid sixty-six and twothirds percent (66 2/3%) of the employee’s average weekly wages for the period of
compensation, which is determined by multiplying the employee’s body as a whole
impairment rating by four hundred fifty (450) weeks. The injured employee shall receive
these benefits, in addition to medical benefits whether the employee has returned to
work or not.
If at the time the injured employee’s weekly PPD benefits are exhausted, the employee
has not returned to work with any employer or has returned to work and is receiving
wages or a salary that is less than one hundred percent (100%) of the wages or salary the
employee received from his pre-injury employer on the date of injury, the injured
employee may file a claim for increased benefits. If appropriate, the injured employee’s
award will be increased by multiplying the award by a factor of 1.35. In addition, the
injured employee’s award will be further increased by multiplying the award by the
product of the following factors, if applicable:
1) 1.45 if the employee lacks a high school diploma or general equivalency diploma;
2) 1.2 if the employee was more than forty (40) years of age at the time the period of
compensation ends; and
3) 1.3 if the unemployment rate, in the Tennessee county where the employee was
employed by the employer on the date of the workers’ compensation injury, was at
least two percentage (2%) points greater than the yearly average unemployment
rate in Tennessee according to the yearly average unemployment rate compiled by
the department for the year immediately prior to the expiration of the period of
compensation.
In determining the employee’s increased, the employer will be given credit for payment
of the original award of PPD benefits.
Any employee may file a claim for increased benefits by filing a new petition for benefit
determination with the division no more than one (1) year after the original PPD benefit
award ends. Any claim for increased benefits under subsection shall be forever barred,
unless the employee files a new petition for benefit determination with the division
within one (1) year after the period of compensation for the subject injury ends.
Under no circumstances shall an employee be entitled to additional benefits when:
1) The employee’s loss of employment is due to the employee's
2) voluntary resignation or retirement; provided, however, that the resignation or
retirement does not result from the work-related disability;
3) The employee’s loss of employment is due to the employee's misconduct connected
with the employee's employment; or
4) The employee remains employed but received a reduction in salary, wages, or hours
that is concurrent with a reduction in salary, wages or reduction in hours that
affected at least fifty percent (50%) of all hourly employees operating at or out of
the same location.
The employer and employee are allowed to settle the issue of additional benefits at any
time after the employee reaches MMI.
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Key Provisions of Tennessee Senate Bill 200
Effective July 1, 2014, through July 1, 2016
Increased benefits are not available for injuries sustained by an employee who is not
eligible or authorized to work in the United States under federal immigration laws.
If an employee has previously sustained an injury compensable under this section and
has been awarded benefits for that injury, the injured employee shall be paid
compensation for the period of temporary total disability or temporary partial disability
and only for the degree of permanent disability that results from the subsequent injury.
Assigning Permanent Impairment
Access to Medical Records
Amends Section 50-6-204 to provide the following regarding the assignment of
impairment ratings:
 All permanent impairment ratings are to be assigned by the treating physician.
 The treating physician is to utilize the applicable edition of the AMA guides
established by this chapter.
 Within six (6) months of the release of a new edition of the AMA guides, the medical
advisory committee must conduct an evaluation of the new edition, report the
committee’s findings to the administrator and recommend to the administrator
whether the new edition should be designated. The administrator must report the
committee’s finding and recommendation to the general assembly.
 Deletes the scheduled members list and requires that the treating physician assign
impairment ratings as a percentage of the body as a whole without consideration of
pain complaints in calculating the degree of impairment.
 Subjects an employee who fails to attend a scheduled evaluation for purposes of
assigning an impairment rating without justifiable cause to sanctions up to and
including dismissal of the employee’s workers’ compensation claim.
 The administrator is to establish by rule time limits for the scheduling of the
evaluation and the completion and submission of the impairment rating report.
 The treating physician’s written opinion of the injured employee’s permanent
impairment rating shall be presumed to be the accurate impairment rating. This
presumption shall be rebuttable by the presentation of contrary evidence that
satisfies a preponderance of the evidence standard.
Amends Section 50-6-204(a)(2) to allow employers, the employer’s attorney, the
employer’s insurance carrier or third party administrator, case managers or utilization
review agent to communicate with the employee’s authorized treating physician, orally
or in writing, and each medical provider is required to release the records of any
employee treated for a work-related injury to both the employee and the employer
within 30 days after admission or treatment.
Deletes requirement that an employee claiming workers' compensation benefits provide
the employer or the division of workers' compensation a signed, written medical
authorization form addressed to a specific medical provider authorized.
Alternative Dispute Resolution
Amends Section 9-8-402 by replacing all references to section 50-6-239 with references
to section 50-6-236, and replacing every mention of the phrase “benefit review
conference” in the section and replacing it, instead, with the phrase “alternative dispute
resolution.
Section 50-6-236 is amended to require the administrator to establish a workers’
compensation mediators program to assist injured or disabled employees, persons
claiming death benefits, employers and other persons in protecting their rights, resolving
disputes, and obtaining information pertinent to workers’ compensation laws and
practices. A workers' compensation mediator will not be an advocate for either party
and must mediate all issues without favor or presumption for or against either party. A
mediator has no authority to order the provision of workers’ compensation benefits.
The mediators will conduct alternative dispute resolution.
When mediation is held, a person representing the employee and the employer, or the
employer's insurer, with the authority to settle, must attend.
Parties entering into mediation must be prepared to mediate all disputed issues at the
beginning of mediation and are required to mediate all issues in good faith.
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Key Provisions of Tennessee Senate Bill 200
Effective July 1, 2014, through July 1, 2016
When a mediator determines that a party is not prepared to mediate as required or
believes a party is not mediating in good faith, the mediator shall include comments to
that effect in the dispute certification notice. A civil penalty of not less than fifty dollars
($50) or more than five thousand dollars ($5,000) may be assessed the party or their
representatives that violate rules established to enforce this subsection.
If the parties are unable to reach settlement of any disputed issues, the mediator must
issue a written dispute certification notice setting forth all unresolved issues for hearing
before a workers’ compensation judge.
No party is entitled to a hearing before a workers’ compensation judge to determine
temporary or permanent benefits or to resolve a dispute over the terms of an agreed
settlement of a workers’ compensation claim, unless a workers’ compensation mediator
has issued a dispute certification notice setting forth the issues for adjudication by a
workers’ compensation judge.
Medical Bill Disputes
Section 50-6-203(f), is amended to provided that if the employee fails to appear and
participate in alternative dispute resolution as scheduled by the division, a workers’
compensation judge has the authority to dismiss the employee's claim by sending a copy
of the order of dismissal by certified mail with return receipt requested to the
employee's last known address. The order of dismissal for failure to participate in
alternative dispute resolution shall become final and the claim is forever barred, unless
the employee contacts the division to schedule mediation and attends mediation within
sixty (60) days after the date on which the workers’ compensation judge enters the order
of dismissal. If the employee complies with the requirements of this subsection within
the timeframe provided, the workers’ compensation judge will rescind the order
dismissing the employee’s claim for failure to participate in alternative dispute
resolution.
Amends Section 50-6-125 to create a medical payment committee to hear disputes on
medical bill payments between providers and insurers and advise the administrator on
issues related to the medical fee schedule and medical care cost containment in the
workers’ compensation system. Members will be representative of the medical
provider industry and the workers’ compensation industry and serve without
compensation, except for reimbursement for travel expenses when engaged in the
conduct of their official duties.
The medical payment committee will have the authority to render decisions on medical
bill disputes between providers and insurers. If the medical payment committee
determines that a provider or insurer has acted in bad faith in refusing to provide
payment for a medical bill or refusing to provide reimbursement for overpayment, upon
a majority vote the medical payment committee shall refer the provider or insurer to the
division for consideration of assessment of a civil penalty of no more than $1,000 per
occurrence.
Ombudsman Program
The aggrieved provider or insurer has the right to seek review of the penalty assessment.
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Adds a new section to the Tennessee Code to establish a workers’ compensation
ombudsman program to assist injured or disabled employees, persons claiming death
benefits, employers, and other persons in protecting their rights, resolving disputes, and
obtaining information available under workers’ compensation laws.
The ombudsman program is available only to those individuals or organizations that are
not represented by an attorney in the claim for workers’ compensation benefits.
No statement, discussion, evidence, allegation or other matter of legal significance that
occurs in the presence of an ombudsman is admissible as evidence in any other
proceeding.
The division has authority to assess a civil penalty against any person or organization,
with the exception of the state or a representative of the state that refuses to cooperate
with the services provided by an ombudsman.
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Key Provisions of Tennessee Senate Bill 200
Effective July 1, 2014, through July 1, 2016
Penalties
Amends Section 50-6-118 that addresses the establishment and collection of penalties to
delete penalties for:
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Late filing of notice of change in benefit payments;
Late filing with department of notice of filing lawsuits by employees or employee
representatives;
Late filing of judgments by insurance companies or by employers, if self-insured.
Penalties are added for:
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Attorney Fees
Failure of any party to appear or to mediate in good faith at any alternative dispute
resolution proceeding;
Failure of any party to comply, within the designated timeframe, with any order or
judgment issued by a workers’ compensation judge;
Performance of any listed action in Section 29-9-102 in relation to any proceedings
in the court of workers’ compensation claims;
Failure of any employer to timely provide medical treatment made reasonably
necessary by the accident and recommended by the authorized treating physician or
operating physician;
Failure of an employer to timely provide a panel of physician that meets the
statutory requirements of this chapter;
Wrongful failure of an employer to pay an employee’s claim for temporary total
disability payments;
Wrongful failure to satisfy the terms of an approved settlement; and
Refusal to cooperate with the services provided by an ombudsman.
Amends Section 50-6-207(4)(A)(iii) to provide that for injuries occurring on or after July
1, 2014, attorneys’ fees in contested cases of permanent disability shall be calculated
upon the first four hundred fifty (450) weeks of disability only.
Amends Section 50-6-226 by a subsection that indicates “In addition to any attorneys’
fees provided for in this section, the court of workers’ compensation claims may award
attorneys’ fees and reasonable costs, including 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 in a settlement or judgment under this chapter.
Workers’ Compensation Appeals
Board
Adds a new section that establishes a Workers’ Compensation Appeals Board to hear
appeals from the Workers’ Compensation Claims Court. The Workers’ Compensation
Appeals Board will consist of three judges appointed by the governor.
Final appeal of decisions by the Workers’ Compensation Appeal Board will be to the
Tennessee Supreme Court.
Statute of Limitations
Amends Section 50-6-203 by requiring the filing of a petition for benefit determination
within one (1) year of either:
1) The date of injury, in cases where the employer was provided notice, but has not
paid workers’ compensation benefits or behalf or to the employee; or
2) In instances when the employer has voluntarily paid workers' compensation
benefits, 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.
Medical E-Billing
Amends Section 50-6-202 to indicate that on after July 1, 2014, the administrator, in
cooperation with the commissioner of commerce and insurance, will adopt rules
regarding the electronic submission and processing of medical bills by health care
providers to insurance carriers. Insurance carriers are required to accept medical bills
submitted electronically by health care providers in accordance with the administrator’s
rules. The administrator will establish by rule the criteria for granting exceptions to
insurance carriers and health care providers who are unable to submit or accept medical
bills electronically.
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Key Provisions of Tennessee Senate Bill 200
Effective July 1, 2014, through July 1, 2016
Notice Requirements
2015
Bill Impact Review
2016
Treatment Guidelines
Deletes subsection (c ) of Section 50-6-201, which requires the insurer, employer or selfinsured or trust to file a wage statement with the department detailing the employee's
wages for the previous 52 weeks, unless the employer stipulates that the maximum
weekly workers' compensation rate applies.
Deletes requirement that the insurer provide written notice to the division whenever it
appears that the amount of medical benefits to which the employee may be entitled will
exceed $5,000 and the division will notify the employer.
Amends Section 50-6-134 to requires that the Division of Workers’ Compensation review
the impact of the Workers' Compensation Reform Act of 2013 on the workers’
compensation system in this state on or before July 1, 2015, and annually thereafter
through 2018.
Amends Section 50-6-124 to provide that in consultation with the administrator’s
medical advisory committee, the administrator, by rules to become effective on January
1, 2016, is required to adopt guidelines for the diagnosis and treatment of commonly
occurring workers’ compensation injuries.
Any treatment that explicitly or reasonably follows the treatment guidelines adopted by
the administrator has a presumption of medical necessity for utilization review purposes.
This presumption shall be rebuttable only by clear and convincing evidence that the
treatment erroneously applies the guidelines or that the treatment presents an
unwarranted risk to the injured worker.
The administrator may assess a reasonable fee, not to exceed two hundred fifty dollars
($250), for an appeal of any utilization review decision.
Click here to view a summary of the bill prepared by the Tennessee legislature.
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