Workers’ Comp Claims Process: A Guide for TN Construction Business'

For construction business owners in Tennessee, understanding the workers’ compensation claims process is crucial. The construction industry is high-risk, with roughly 125,000 workers statewide, making it one of the most hazardous sectors. Even well-managed job sites can experience accidents, so having a clear injury-response plan is vital. Workers’ compensation insurance provides injured employees with necessary care and shields your business from expensive lawsuits, offering an exclusive remedy for work-related injuries. This guide explains the basics of workers’ comp, why it matters, outlines the claims process steps, details Tennessee-specific regulations, and provides practical compliance and claim-handling tips.

What Is Workers’ Compensation and Why Is It Important?

Workers’ compensation insurance provides benefits to employees injured or made ill through job-related activities. It covers medical expenses and partial lost wages, regardless of fault, preventing employees from suing employers for injuries. Construction sites contain inherent risks like heavy machinery and heights, making workers’ comp essential. It ensures injured employees receive immediate medical attention and income support while protecting your business from civil lawsuits. In Tennessee, having workers’ compensation is legally required for construction companies with at least one employee, emphasizing its importance for compliance and financial protection.

Common Construction Injuries and Real-Life Examples: Construction injuries are varied but often severe. Common injuries include:

• Falls from Heights: The leading cause of injuries, including falls from roofs or scaffolding.
• Struck-by Incidents: Workers injured by falling tools or equipment.
• Electrocutions: Injuries from exposed wiring or overhead power lines.
• Caught-in/Between Accidents: Workers trapped or crushed by equipment or collapsing structures.
• Overexertion/Repetitive Strain: Chronic injuries from heavy lifting or repetitive tasks.

In 2018 alone, Tennessee construction sites reported 870 severe injuries and 25 fatalities. Having proper safety measures and workers’ comp coverage is critical.

Workers’ Comp Claims Process: Step-by-Step:

1. Report Injury Immediately: Employees must report within 15 days. Employers must document and notify the insurer within one business day.
2. Provide Initial Medical Care: Employers must cover reasonable immediate medical care without out-of-pocket costs for employees.
3. File the Injury Claim: Employers complete and submit the First Report of Injury form (Form C-20) within one working day.
4. Provide a Panel of Physicians: Offer employees a state-required list of at least three authorized medical providers.
5. Insurance Evaluation: Insurers must investigate and accept or deny claims within 15 days.
6. Benefit Payments: Accepted claims provide medical coverage, wage replacement (two-thirds of average weekly wage), and possible permanent disability compensation.
7. Recovery and Return to Work: Facilitate return-to-work plans, offering modified duties as necessary.

Tennessee Workers’ Comp Laws: Key Requirements:

• Mandatory Coverage: Required for construction businesses with even one employee. Owners can file for exemption but must cover employees.
• Reporting Deadlines: Employees have 15 days to report; employers must notify insurers within one business day.
• Panel of Physicians: Employers must provide a choice of three physicians.
• No Retaliation: Firing or penalizing employees for filing claims is illegal.
• Workplace Posting: Mandatory posting of workers’ comp information in a visible location.
• Cooperation with the Bureau: Employers must cooperate with Tennessee’s Bureau of Workers’ Compensation as required.

Best Practices for Compliance and Claims Management:

• Prioritize Safety: Regular safety training and inspections.
• Clear Reporting Procedures: Ensure employees and supervisors know the injury-reporting process.
• Urgent Medical Response: Immediate medical care and empathy for injured workers.
• Always Report Injuries: Do not handle injuries informally or pay costs directly.
• Keep Detailed Records: Maintain comprehensive injury and payroll documentation.
• Collaborate with Adjusters: Provide timely and thorough information to insurance adjusters.
• Maintain Employee Communication: Keep injured workers informed and supported.
• Offer Modified Duties: Provide suitable tasks to accommodate medical restrictions.
• Verify Subcontractor Coverage: Ensure subcontractors have their own workers’ comp or valid exemptions.
• Stay Updated: Regularly review policy coverage and keep informed about changes in laws and regulations.

Get Expert Guidance from Hutsenpiller Insurance: Managing workers’ compensation can be complex, especially for Tennessee construction businesses. Hutsenpiller Insurance specializes in guiding local construction business owners through compliance and obtaining suitable coverage. As a local independent agency, we provide tailored, cost-effective solutions, expert advice on Tennessee-specific laws, and personalized support. Protect your employees and your business by ensuring you have comprehensive workers’ comp coverage.