Employment Law Alert – August 2016 Issue

September 2nd, 2016   •   Comments Off on Employment Law Alert – August 2016 Issue   
NEW TENNESSEE CASE MANAGEMENT REGULATIONS TAKE EFFECT IN AUGUST

 

The Tennessee Department of Labor and Workers’ Comp Bureau has recently adopted new rules on case management procedures in workers’ comp claims.  These rules go into effect on August 29, 2016.  The new rules now put a responsibility on the claimant to cooperate with all reasonable requests for information from the case manager, timelines on reporting, and limits on case managers’ conduct.  Parties may face penalties up to $1,000.00 for each rules violation, at the Administrator’s discretion.

The rules include new guidelines for assignment of and initial handling by case managers. For all catastrophic injury claims (e.g., spinal cord injuries with severe paralysis, amputations, brain/closed head injuries, significant burns, or blindness), employers now should provide case management claims and assign a case manager within 7 calendar days of notice of the injury.  Case managers must have a face-to-face meeting with the claimant within 14 calendar days of assignment and should have additional face-to-face meetings upon hearing the claimant’s condition worsens.  Case managers must file documentation of the first meeting to the Workers’ Comp Bureau’s Medical Director within 30 calendar days after that meeting.  For non-catastrophic injuries, case managers should have one face-to-face meeting, at least within 14 days of assignment, if and when a case manager is assigned. The case manager can communicate with the employee as the case warrants.  The new rules press for prompt case management in catastrophic injuries but still give employers discretion on non-catastrophic claims.

The new rules also prohibit certain conduct by case managers. For example, case managers cannot prepare the physicians panel or influence the employee’s selection, discuss what the impairment rating should be with either the employee or physician, or assist in any way in recording the employee’s activity for the purpose of disproving the employee’s claim. Case managers face penalties up to $500 for these or other actions prohibited in the rules. Case managers may also face penalties up to $100 for failing to timely submit the required forms within 30 days of referral and 30 days of case closure.  As well, case managers must now register with the Workers’ Comp Bureau, pay registration and renewal fees, and complete 4 hours of continuing education each year.