TN WORKERS’ COMP CHRONICLE May 2012

Moore Ingram Johnson & Steele, LLP
Moore Ingram Johnson & Steele, LLPMoore Ingram Johnson & Steele, LLP

TN WORKERS’ COMP CHRONICLE May 2012

Tennessee Workers’ Comp Chronicle
May 2012
Inside This
Issue:
• RFA Process
Revamped
• TDOL
Educational
Conference
• About MIJS
Moore, Ingram, Johnson & Steele LLP (865) 692-9039 & (615) 425-7347
DOL Announces Substantial Changes to RFA Process
Deadlines Firmly Enforced
In the short time since these changes
have gone into effect, we have noticed
several important differences in the
RFA process. First, the DOL is now
taking its deadlines for submitting
information seriously. The parties will
have only 20 calendar days from the
official notice of the RFA to provide
the specialist with documentation
supporting their position. The DOL
has indicated that once the deadline
has passed, the RFA will be sent to a
DOL attorney for a decision and no
new information will be considered.
While this will likely create issues for
both sides, it is now critical for
employers and carriers to rapidly
respond once an RFA is submitted to
the DOL.
No Ex Parte Communications
The second drastic change to the RFA
process is the prohibition on ex parte
communications with the DOL
attorneys who will be issuing the
decision. In this respect, the initial
phase of an RFA now resembles the
existing Administrative Review
proceedings. Going forward, the
parties will be expected to orally set
forth their positions at informal
teleconferences and argue the merits of
the claim. These new teleconferences
are just now beginning to take place,
but it is already clear that the DOL is
becoming stricter with respect to
deadlines and burdens of proof.
After battling constitutional challenges
and lawsuits seeking judicial review of
specialists’ orders, the Tennessee
Department of Labor has implemented
sweeping changes to its Request for
Assistance procedures. The DOL’s
“restructuring” was announced by the new
Workers’ Compensation Administrator,
Abbie Hudgens, who stated that the new
process “should result in improved Orders,
more opportunities for parties to settle
their disagreements, improved timeliness,
and should reflect feedback received from
various stakeholders about opportunities
for improvements in the process.”
New RFA Process
According to her email announcement,
“Beginning May 1, 2012 the Request for
Assistance process will have two stages.
In the first stage a Workers’
Compensation Specialist II or III will
assist the parties in resolving areas of
disagreement. If the parties become
deadlocked, the claim will be forwarded to
a Workers’ Compensation Specialist IV (a
licensed attorney) for a teleconference
with all parties. After the informal
teleconference, the Specialist IV will issue
an order. These orders will be written in
accordance with set guidelines developed
by the division.”
TN Workers Comp Chronicle Page 2 of 3
The new RFA policies offer
opportunities and challenges.
In light of these changes, MIJS
recommends that adjusters swiftly
develop a plan for responding to an
RFA. Gathering documentation of
disputed issues takes time. In cases
involving pre-existing conditions, it can
be difficult to collect past medical
records within the short timeframe. If it
becomes necessary to obtain important
records, an employer or carrier should
file their own RFA demanding discovery
pursuant to Rule 0800-2-5-.06 of the
Benefit Review Process regulations.
Doing so will slow the process down
and allow more time to thoroughly
investigate a claim.
Revised Forms
As part of the changes the DOL has also
revised a number of its most essential
forms. New versions of forms requesting
BRC’s as well as RFA’s have been
issued. These include:
-C40R Certificate of Readiness;
-C40B BRC Request;
-C40A Request for Assistance;
In addition, the DOL has developed a
new healthcare provider form that will
be sent to claimants in order to identify
each provider that a claimant has treated
with in relation to a claim. These new
forms are not yet available on the DOL’s
website. If you need to complete one of
these new forms, please contact MIJS
and we will be happy to provide you
with the updated version.
DOL Announces Substantial Changes to RFA Process
First Report of Injury Penalties
Another change associated with the
new leadership at the DOL is an
increase in the assessment of penalties
for late filing of C20 first reports of
injuries. We have noticed that
employers and carriers are
experiencing stepped up enforcement
of Rule 0800-2-1.06 which calls for a
$25.00 civil penalty for every 15 day
period that a C20 should have been
filed. Please be sure to timely submit
all C20’s to avoid any potential for
penalties.
The new changes are a positive sign
that the DOL is listening to the
concerns of employers and carriers.
Although the ultimate implications of
this “restructuring” are uncertain, it
does appear that the DOL is taking the
employee’s burden of proof
requirement more seriously by
requiring employees to provide
sufficient documentation of their
claims.
At the same time, the new process
requires vigilance on the part of
employers and carriers. Waiting until
a week before the deadline will make
it very difficult to properly defend a
claim. We at MIJS welcome the
DOL’s efforts at improving its process
and encourage our clients to make the
most of these new procedures. Please
contact one of our 18 comp attorneys
to discuss how to make the new
policies work for you.
By: Gregory H. Fuller
TN Workers’ Comp ChroniclePage 3 of 3
It’s that time of year again. The DOL
will be rolling out its new policies at
its annual Workers’ Compensation
Educational Conference at the
Nashville Airport Marriott on June
21 and 22, 2012.
This conference is a great way to
catch up on all the latest
developments in Tennessee. It’s also
a wonderful opportunity to get to
know the attorneys, vendors and
specialists that administer
Tennessee’s workers’ compensation
system.
This year’s topics include:
-“Improvement” in the RFA Process;
-New Pain Management Law;
-Settlement Approval Strategies;
-“Finding the Easy Button” Training
for Adjusters
-Closing Future Medicals
-Discovery in the Administrative
Context
-Impact of the 6th
Edition AMA
Guides
15th
Annual DOL Conference June 21-22, 2012
MIJS is a value oriented law firm
focused on providing customized
solutions for our clients. Based in
Marietta, GA, MIJS offers a full
spectrum of legal services ranging from
general liability to transactional tax
planning.
Our Tennessee offices specialize in
workers’ compensation defense
allowing us to aggressively minimize the
overall expenses of claims. By
leveraging the experience of 18 comp
attorneys, we help employers and
insurers navigate Tennessee’s workers’
compensation system with an eye
towards cutting costs.
About Moore Ingram Johnson & Steele…
408 N. Cedar Bluff Rd
Suite 500
Knoxville, TN 37923
PHONE:
(865) 692-9039
FAX:
(856) 692-9071
3200 West End Ave.
Suite 500
Nashville, TN 37203
PHONE:
(615) 425-7347
FAX:
(615) 783-1665
E-MAIL:
WTH@MIJS.com
Online
www.mijs.com
If you are interested in attending the
Conference you can find more
information and register at:
http://www.tn.gov/labor-
wfd/forms/WComp_TN%20Brochure.p
df
Be sure to let MIJS know if you plan on
going so we can include you in our
activities. We’ll see you there!
We are now serving Tennessee,
Georgia, Florida and Kentucky. Please
contact Troy Hart to see how MIJS can
help you meet your workers’ comp
goals.
Disclaimer
This is a legal advertisement. The
articles are intended to provide
background and general guidance to the
TN workers’ comp system. They are not
intended as legal advice as each lawsuit
is unique and requires specific analysis.
Please contact MIJS to discuss the
discuss the details of your claim.

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TN WORKERS’ COMP CHRONICLE May 2012

  • 1. Tennessee Workers’ Comp Chronicle May 2012 Inside This Issue: • RFA Process Revamped • TDOL Educational Conference • About MIJS Moore, Ingram, Johnson & Steele LLP (865) 692-9039 & (615) 425-7347 DOL Announces Substantial Changes to RFA Process Deadlines Firmly Enforced In the short time since these changes have gone into effect, we have noticed several important differences in the RFA process. First, the DOL is now taking its deadlines for submitting information seriously. The parties will have only 20 calendar days from the official notice of the RFA to provide the specialist with documentation supporting their position. The DOL has indicated that once the deadline has passed, the RFA will be sent to a DOL attorney for a decision and no new information will be considered. While this will likely create issues for both sides, it is now critical for employers and carriers to rapidly respond once an RFA is submitted to the DOL. No Ex Parte Communications The second drastic change to the RFA process is the prohibition on ex parte communications with the DOL attorneys who will be issuing the decision. In this respect, the initial phase of an RFA now resembles the existing Administrative Review proceedings. Going forward, the parties will be expected to orally set forth their positions at informal teleconferences and argue the merits of the claim. These new teleconferences are just now beginning to take place, but it is already clear that the DOL is becoming stricter with respect to deadlines and burdens of proof. After battling constitutional challenges and lawsuits seeking judicial review of specialists’ orders, the Tennessee Department of Labor has implemented sweeping changes to its Request for Assistance procedures. The DOL’s “restructuring” was announced by the new Workers’ Compensation Administrator, Abbie Hudgens, who stated that the new process “should result in improved Orders, more opportunities for parties to settle their disagreements, improved timeliness, and should reflect feedback received from various stakeholders about opportunities for improvements in the process.” New RFA Process According to her email announcement, “Beginning May 1, 2012 the Request for Assistance process will have two stages. In the first stage a Workers’ Compensation Specialist II or III will assist the parties in resolving areas of disagreement. If the parties become deadlocked, the claim will be forwarded to a Workers’ Compensation Specialist IV (a licensed attorney) for a teleconference with all parties. After the informal teleconference, the Specialist IV will issue an order. These orders will be written in accordance with set guidelines developed by the division.”
  • 2. TN Workers Comp Chronicle Page 2 of 3 The new RFA policies offer opportunities and challenges. In light of these changes, MIJS recommends that adjusters swiftly develop a plan for responding to an RFA. Gathering documentation of disputed issues takes time. In cases involving pre-existing conditions, it can be difficult to collect past medical records within the short timeframe. If it becomes necessary to obtain important records, an employer or carrier should file their own RFA demanding discovery pursuant to Rule 0800-2-5-.06 of the Benefit Review Process regulations. Doing so will slow the process down and allow more time to thoroughly investigate a claim. Revised Forms As part of the changes the DOL has also revised a number of its most essential forms. New versions of forms requesting BRC’s as well as RFA’s have been issued. These include: -C40R Certificate of Readiness; -C40B BRC Request; -C40A Request for Assistance; In addition, the DOL has developed a new healthcare provider form that will be sent to claimants in order to identify each provider that a claimant has treated with in relation to a claim. These new forms are not yet available on the DOL’s website. If you need to complete one of these new forms, please contact MIJS and we will be happy to provide you with the updated version. DOL Announces Substantial Changes to RFA Process First Report of Injury Penalties Another change associated with the new leadership at the DOL is an increase in the assessment of penalties for late filing of C20 first reports of injuries. We have noticed that employers and carriers are experiencing stepped up enforcement of Rule 0800-2-1.06 which calls for a $25.00 civil penalty for every 15 day period that a C20 should have been filed. Please be sure to timely submit all C20’s to avoid any potential for penalties. The new changes are a positive sign that the DOL is listening to the concerns of employers and carriers. Although the ultimate implications of this “restructuring” are uncertain, it does appear that the DOL is taking the employee’s burden of proof requirement more seriously by requiring employees to provide sufficient documentation of their claims. At the same time, the new process requires vigilance on the part of employers and carriers. Waiting until a week before the deadline will make it very difficult to properly defend a claim. We at MIJS welcome the DOL’s efforts at improving its process and encourage our clients to make the most of these new procedures. Please contact one of our 18 comp attorneys to discuss how to make the new policies work for you. By: Gregory H. Fuller
  • 3. TN Workers’ Comp ChroniclePage 3 of 3 It’s that time of year again. The DOL will be rolling out its new policies at its annual Workers’ Compensation Educational Conference at the Nashville Airport Marriott on June 21 and 22, 2012. This conference is a great way to catch up on all the latest developments in Tennessee. It’s also a wonderful opportunity to get to know the attorneys, vendors and specialists that administer Tennessee’s workers’ compensation system. This year’s topics include: -“Improvement” in the RFA Process; -New Pain Management Law; -Settlement Approval Strategies; -“Finding the Easy Button” Training for Adjusters -Closing Future Medicals -Discovery in the Administrative Context -Impact of the 6th Edition AMA Guides 15th Annual DOL Conference June 21-22, 2012 MIJS is a value oriented law firm focused on providing customized solutions for our clients. Based in Marietta, GA, MIJS offers a full spectrum of legal services ranging from general liability to transactional tax planning. Our Tennessee offices specialize in workers’ compensation defense allowing us to aggressively minimize the overall expenses of claims. By leveraging the experience of 18 comp attorneys, we help employers and insurers navigate Tennessee’s workers’ compensation system with an eye towards cutting costs. About Moore Ingram Johnson & Steele… 408 N. Cedar Bluff Rd Suite 500 Knoxville, TN 37923 PHONE: (865) 692-9039 FAX: (856) 692-9071 3200 West End Ave. Suite 500 Nashville, TN 37203 PHONE: (615) 425-7347 FAX: (615) 783-1665 E-MAIL: WTH@MIJS.com Online www.mijs.com If you are interested in attending the Conference you can find more information and register at: http://www.tn.gov/labor- wfd/forms/WComp_TN%20Brochure.p df Be sure to let MIJS know if you plan on going so we can include you in our activities. We’ll see you there! We are now serving Tennessee, Georgia, Florida and Kentucky. Please contact Troy Hart to see how MIJS can help you meet your workers’ comp goals. Disclaimer This is a legal advertisement. The articles are intended to provide background and general guidance to the TN workers’ comp system. They are not intended as legal advice as each lawsuit is unique and requires specific analysis. Please contact MIJS to discuss the discuss the details of your claim.