Tenn. Comp. R. & Regs. 0800-02-14-.09 - CLAIMS RESOLUTION FILING REQUIREMENTS
(1) The
appropriate resolution form must be submitted to the Bureau in all claims when
they are resolved.
(a) In matters concluded by
settlement or resolved by trial, the employer or the employer's agent must file
a fully completed appropriate version of the Statistical Data Form
contemporaneously with the filing of the final order or settlement.
1. To be considered fully complete, the form
must contain all required data, as determined by the Bureau, and reflect
information that is current as of the date the information is submitted to the
court for approval, whether or not an appeal of the matter is anticipated or
filed.
2. The employee and any
agent of the employee must cooperate with the adjusting entities in completing
the statistical data form.
(b) In matters not concluded by settlement or
resolved by trial, adjusting entities must submit the required information via
EDI within thirty (30) days following the final payment of compensation. The
filing must include all compensation benefits paid on a claim, including all
disability benefits, medical expenses (including in-patient, outpatient,
pharmacy, case management, therapy, etc.), death benefits and funeral expenses,
and legal costs.
(2) A
fully completed appropriate version of the Statistical Data Form is also
required for every workers' compensation matter even if the only issue resolved
is the closing of future medical benefits that had remained open pursuant to a
prior order. This requirement applies even if a statistical data form was filed
at the time of submission of the prior order.
(3) Pursuant to T.C.A. §
50-6-244,
an order of the court is not final until the Statistical Data Form has been
completed and filed with the appropriate clerk of the court or Bureau
office.
(4) If the Administrator or
the Administrator's designee determines that an employer or the employer's
agent fails to fully complete or timely file the statistical data form, the
bureau may assess a civil penalty against the offending party not to exceed one
hundred dollars ($100) per violation. A party assessed a penalty by the
Administrator pursuant to this subsection may appeal the penalty by requesting
a contested case hearing pursuant to Rule 0800-0213.
Notes
Authority: T.C.A. §§ 50-6-206 [Applicable to injuries occurring prior to July 1, 2014], 50-6-233, 50-6-244, and 50-6-419.
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