A person who sustains an injury or becomes ill at work may be entitled to workers' compensation benefits to get remuneration for related expenses, including medical bills and lost earning capacity if they cannot work as usual.
In Nashville, Tennessee, every company with five or more employees must provide workers' insurance. The employer's family members, corporate officers, and part-time workers may also be entitled to these benefits if they meet the definition of "employee" set by the state.
However, since many workers' comp claims go on for a long time, insurance adjusters often hire an investigator to double-check whether claimants' injury or illness is genuine. Therefore, those who want to retain their benefits should avoid certain things.
This article contains more information about what injured employees shouldn't do while on workers' comp.
What Is Workers' Compensation?
Workers' compensation is a type of insurance that provides medical care and wage protection to people who have been injured or become ill at work or as a direct result of their jobs.
This program has been designed to protect both employees and employers from the consequences that a work-related injury can bring. Additionally, it helps injured parties return to their health and jobs as soon as possible.
Most employers purchase workers' compensation insurance through state-certified compensation insurance funds or private insurers. Depending on their size, many can also self-insure.
However, each state may have its own workers' compensation system and set different laws. As a result, these claims are often complex.
Workers' Comp in Nashville, Tennessee
The Tennessee Bureau of Workers' Compensation (BWC) administers the laws regarding employees' right to recover compensation for their work-related injuries in this state.
Through the Bureau's services, both parties can obtain information about their rights and responsibilities to understand the requirements set by the Tennessee Workers' Compensation Law.
This law provides financial protection to employees in the event of a work injury or illness, as it guarantees partial wage replacement and medical treatment. Additionally, this program defines the benefits that employers are legally required to provide.
Workers' Comp Benefits That Injured Employees May Receive
If an Authorized Treating Physician (ATP) has determined that the injury or illness is work-related, employees may receive compensation. These are the benefits that are often available in these cases:
Medical treatment at no cost to the employee as long as it's provided by the authorized physician
Reimbursement for travel expenses for and from medical treatment only if the distance exceeds 15 miles one-way
Temporary disability benefits, which provide wage replacement to injured workers if the authorized physician takes them off work
What an Injured Worker Shouldn't Do
Whether they're just thinking about filing a claim or are already receiving workers' comp benefits, employees should avoid doing certain things. Otherwise, they could lose this remuneration. These are:
Fail to Properly Report the Accident to the Employer
Any employee who has an accident and is injured or becomes ill at work should report it to their supervisor immediately. Otherwise, they could lose their benefits.
According to the Tennessee Workers' Compensation Law, employees often have 15 calendar days from the date when they found out or should have found out about their work-related injury or illness to report it to employers. Workers who report their condition immediately or within 48 hours of the injury often have a better chance of success.
However, this doesn't mean that injured workers only have to talk to their HR department or boss about the accident that harmed them. They must file an official report. Ignoring this step can affect their cases. Also, if there are significant delays, employers and insurance companies will likely believe it's suspicious.
Downplay the Extent of the Work-related Injury or Illness
Many refuse to demonstrate that they're suffering or show pain, even when speaking to a medical provider. This is common because most people don't want to be sick or hurt.
However, it's essential to properly document the injuries and their severity. Employees must provide clear and strong evidence to prove how this has affected their personal and professional lives.
Injured workers who fail to demonstrate the impact of the accident or illness on their lives may receive less compensation than they deserve or even lose these benefits. In some cases, they may even be forced back to work before they have truly recovered.
Ideally, a person who has been injured or becomes ill at work should explain all the symptoms they're experiencing to medical care providers, document their pain or discomfort, and be clear about how this affects their quality of life.
Miss Medical Appointments and Fail to Follow Doctors' Recommendations
An injured worker will be sent to a workers' compensation doctor who will examine them to diagnose the injury or illness and recommend treatment.
As mentioned, the employer pays for this treatment through a program purchased from a state-certified provider or private insurance company to ensure employees can eventually return to work. This also means that they'll pick the doctor.
In Tennessee, employers must provide information on three doctors, and employees can select an Authorized Treating Physician (ATP) from that panel.
This doctor will prescribe treatment, defining the path to recovery or to maximum medical improvement, if the employee sustains a disabling injury. Adhering to this plan and following the physician's recommendations will benefit the workers' compensation claim.
To avoid losing workers' comp benefits, injured employees must follow the treatment plan, avoid performing activities that go against restrictions set by doctors, and attend all medical appointments after the injury. Otherwise, their claims may be denied, or their compensation may be reduced. Schuerger Shunnarah Trial Attorneys can also give insight to questions such as Can I get disability after workers comp settlement?
Assume They Must Stick with the Doctor Suggested by the Employer
Tennessee law says that employees must start getting treatment from an ATP who is on the panel provided by the employer. However, doctors chosen by the employer may have a conflict of interest because companies and insurers want to reduce compensation as much as possible.
In this state, injured workers may have another option. An employer or insurance company isn't legally required to offer an alternative. However, when employees disagree with the ATP's findings or treatment, they can seek a second opinion.
Tennessee workers can also get additional medical treatment from another doctor, but they must pay for this service.
Refuse Light-Duty Work
If the workers' comp doctor has determined that the injured employee can return to work in a restricted capacity, it's important to listen to them and follow their recommendations.
Employees who disagree with this decision can seek a second opinion and appeal it if they truly believe they cannot return to work. Failure to get back on the job as determined by the ATP may jeopardize workers' right to receive compensation for their injuries.
Tennessee laws specifically state that those who fail to report for light-duty work offered by their employers can get their temporary disability benefits terminated if the ATP clears them to go back to work in a restricted capacity.
Engage in Activities That Should Be Avoided
If workers' compensation insurers or employers suspect that employees are exaggerating their injuries or illness or committing fraud, they can hire an investigator and put them under surveillance to confirm their claims.
Unfortunately, many investigators paint an inaccurate picture to try to reduce compensation. If a worker who has reportedly sustained a back injury is seen on a ladder making repairs on their properties, this could affect their workers' comp claim.
Those who post on social media about their vacations, feeling good, or attending parties can also jeopardize their cases because employers and insurers will likely put their injuries into question.
To avoid jeopardizing their claims, injured workers shouldn't engage in activities that may suggest that their injuries aren't as severe as they claimed or post about their outings on social media, asking family and friends not to tag them in pictures that can be used against them.
Accept a Settlement Without Talking to a Workers' Comp Lawyer
Many insurance companies and employers offer settlements to injured employees to avoid workers' compensation claims. Although these sums often seem huge, claimants shouldn't accept this offer without speaking to a seasoned lawyer.
It can be a huge mistake to accept a settlement for a work-related injury without knowing its implications. This decision could jeopardize people's ability to get the full compensation they're entitled to.
Before signing any document requested by the employer or the insurance company, employees should speak with a workers' compensation lawyer and get the advice they need. They can also help answer questions like Do I get full pay if injured at work?
Contact Schuerger Shunnarah Trial Attorneys Today!
An experienced workers' comp attorney can help injured employees file a comprehensive claim to recover the compensation they deserve if they have been harmed or become ill while on duty. Additionally, Nashville work injury lawyers can provide advice to those who need to appeal the denial of their claims or have seen their benefits jeopardized.
Fortunately, workers who are going through this complex situation can count on us to defend their rights. At Schuerger Shunnarah Trial Attorneys, we understand Tennessee Workers' Compensation Laws and are ready to help Nashville employees get the compensation they're entitled to for their work-related injuries or illnesses. Contact us today!