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TN WORKERS’ COMP CHRONICLE May 2012

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TN WORKERS’ COMP CHRONICLE May 2012

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TN WORKERS’ COMP CHRONICLE May 2012

  1. 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. 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. 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.

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