IMPORTANT: Depending upon the severity of the injury, you should immediately report your claim either before you go to seek medical attention or after treatment on the same day. They can advise you of where to seek treatment if you can’t get to one of the providers listed below. A claim number will be assigned immediately upon reporting the incident. Your claim number will be used as you visit the hospital/doctor and/or the pharmacy. If you have an on-the-job accident which requires medical treatment, you must choose a provider who is authorized in the state's workers' compensation network.
Notify Sedgwick (open 24 hours a day) of injury ASAP by:
Phone: 866-245-8588 (Someone will ask you the questions.)
TTU code: 33278
To receive workers' compensation benefits, you must be injured while performing some activity which falls within the scope of employment. In other words, the accident which causes an injury to you must be related to your work. These are referred to as compensable injuries. Examples of compensable injuries include a clerk who strains a shoulder when lifting an archive box or a highway worker who is hit by a car while controlling traffic at a construction site. You should be aware that not all accidents which happen at work will be compensable under the workers' compensation law. What you are doing when the injury occurs may be more important than where you are. No clear-cut definition is available to describe when an injury is or is not compensable. The best advice for all state employees is to perform the duties of your job in a careful manner and to report any conditions in your workplace which are hazardous to the appropriate officials. It is every employee's responsibility to help prevent accidents and to assist in providing a safe workplace.
The benefits provided under Tennessee's workers' compensation law are set out in Tennessee Code Annotated, Title 50, chapter 6. Basically, the benefits are (1) payment of medical expenses directly related to the treatment of a compensable injury, (2) payment of temporary disability benefits until you are able to return to your job, (3) payment of permanent disability benefits if your compensable injury permanently lessens your ability to perform your job and (4) death benefits which are payable to your dependents in the event that your compensable injury leads to your death. Each of these benefits is described in greater detail in the Worker's Compensation Program Employee Handbook.
A common question asked by state employees is "What do I do if I have an accident and am injured while on the job?" This section will outline in basic terms what you should do if you or a coworker is injured while on the job.
Our workers’ compensation carrier, Sedgwick James of Tennessee, has updated the procedure for reporting an on-the-job injury. This is now so convenient that anyone needing medical care can immediately report the injury so that there is no delay in treatment.
If you have an on-the-job accident, you should immediately notify your supervisor. You should tell your supervisor exactly what happened, how it happened, who saw what happened and whether you were injured as a result of the accident. If you are a witness to a work-related accident where a fellow employee is injured severely enough that the involved employee cannot notify his supervisor, you should attempt to notify the supervisor for him/her. This may be as simple as calling the supervisor to report that an accident has occurred.
SEEKING MEDICAL TREATMENT. If you have an on-the-job accident which requires medical treatment, you must choose a provider who is authorized in the state's workers' compensation network. This will be the only physician authorized to treat you for your compensable injury. This means that the state will only accept and pay medical expenses submitted by this physician, unless your treating physician notifies Sedgwick James (800-526-2305) that you have been referred to another network physician for treatment. The state will not pay any medical expenses you incur from a physician other than your treating physician or a network physician you are referred to by your treating physician.
When seeking medical treatment, you should notify the doctor's office that you were injured while at work and that you will be filing a claim for workers' compensation benefits with the state.
LISTED BELOW ARE HEALTH PROVIDERS COVERED AT THIS TIME:
Sedgwick must approve referrals to specialists in advance of treatment. You may call 800-526-2305 to obtain names of specialist in the workers' comp network.
If you fail to follow the guidelines and see an unauthorized physician, these charges may not be covered by workers' compensation and you will be responsible for payment.
For those who have had an accident, but you do not feel you will need medical attention, this procedure will be the same.
If medical treatment is required, you must file a "State of TN Accident Report " form. You may do this via telephone by calling the toll free number below or you may download this form from our web site and submit it to your supervisor.
Information contained on this form enables the claims adjuster to determine whether your injury is compensable under the workers' compensation law. If all the information requested is not provided or the report is not signed by both you and your supervisor, no decision can be made. This will result in a delay in payment of your medical bills and temporary total disability benefits. Generally, you will be notified as to whether your injury is compensable within 90 days of the date your completed Accident Report is received by the TPA.
In summary, if you have an accident at work: