Tennessee § 50-6-216 - Ombudsman program.

§ 50-6-216. Ombudsman program.

The administrator shall establish a workers' compensation ombudsman program to assist injured or disabled employees, persons claiming death benefits, employers, and other persons in protecting their rights, resolving disputes, and obtaining information available under workers' compensation laws. The ombudsman program shall be available only to those individuals or organizations that are not represented by an attorney in the claim for workers' compensation benefits. No statement, discussion, evidence, allegation or other matter of legal significance that occurs in the presence of an ombudsman shall be admissible as evidence in any other proceeding. The administrator may adopt rules and regulations consistent with this chapter in order to fulfill the purposes of this section in an orderly and efficient manner. The bureau shall have authority to assess a civil penalty against any person or organization, with the exception of the state or a representative of the state, that refuses to cooperate with the services provided by an ombudsman as provided in § 50-6-118. Any party that is not represented by legal counsel may request the services of a workers' compensation ombudsman by contacting the office of mediation services. The ombudsman's authority shall include, but not be limited to, the following: Meet with and provide information to unrepresented parties about the unrepresented party's rights and responsibilities under the law; Explain the administrative process for resolving workers' compensation claims; Investigate claims and attempt to resolve disputes without resort to alternative dispute resolution and court proceedings; Communicate with all parties and providers in the claim; Assist the parties in the completion of forms; and Facilitate the exchange of medical records. An ombudsman who is not a licensed attorney shall not provide legal advice; however, an ombudsman who is a licensed attorney may provide limited legal advice but shall not represent any party as the party's attorney. No ombudsman shall make attorney referrals. An ombudsman shall not be called to testify in any proceeding and no statement or representation made to an ombudsman shall be considered by a workers' compensation judge for any purpose. An unrepresented party has a right to consult with an ombudsman and receive services under this subsection. If the party receiving the services of an ombudsman obtains legal counsel pertaining to the case or dispute for which the services of an ombudsman were engaged, the party, or the party's counsel, shall immediately notify the bureau and the office of mediation services. Upon receipt of notice that the party has retained counsel, the ombudsman shall terminate all services. Acts 2013, ch. 289, § 77; 2014, ch. 837, § 1; 2015, ch. 341, § 15; 2016, ch. 1056, § 5. Compiler's Notes. Acts 2013, ch. 289, § 103 provided that the act, which enacted this section, shall be known and may be cited as the “Workers' Compensation Reform Act of 2013.” Pursuant to Article III, Section 18 of the Constitution of Tennessee, Acts 2014, ch. 837 took effect on April 28, 2014 for purposes of promulgating rules. Acts 2016, ch. 1056, § 6 provided section 5 of the act, which amended this section, shall apply to injuries that occur on or after July 1, 2016. Amendments. The 2014 amendment added (e). The 2015 amendment substituted “bureau” for “division” in (d) and (e)(5). The 2016 amendment, in (e)(3), inserted “who is not a licensed attorney” in the first sentence, added the proviso at the end of the first sentence, and added the second sentence. Effective Dates. Acts 2013, ch. 289, § 106. July 1, 2014; provided, that, for purposes of promulgating rules and regulations, making appointments and making necessary provisions for the implementation of the act, the act shall take effect April 29, 2013. Acts 2014, ch. 837, § 3. July 1, 2014; provided that for purposes of promulgating rules, the act took effect April 28, 2014. [See the Compiler's Notes.] Acts 2015, ch. 341, § 19. May 4, 2015. Acts 2016, ch. 1056, § 6. July 1, 2016.