Tennessee § 50-6-802 - Request for benefits from fund.

§ 50-6-802. Request for benefits from fund.

An eligible employee may request that the bureau provide the employee temporary disability or medical benefits, pursuant to § 50-6-801(d), by submitting a request for benefits from the uninsured employers fund to the bureau no more than sixty (60) days after conclusion of the claim, including all appeals. The request shall be made on a form prescribed by the bureau, and shall be submitted to the bureau via certified mail. The eligible employee shall include a copy of the judgment with the request. Any request for benefits that does not meet the requirements of this subsection (a) shall not be considered. For claims with a date of injury that is on or after July 1, 2015, the bureau may, upon receipt of a request for benefits pursuant to subsection (a) from an eligible employee, provide the employee workers' compensation benefits for temporary disability and medical benefits only. The bureau shall promulgate rules, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, setting forth the circumstances under which benefits may be paid pursuant to this part. If the bureau pays workers' compensation benefits to the injured employee, the workers' compensation benefits shall be paid to the employee from the uninsured employers fund and the amount paid to, or on behalf of, any injured employee, pursuant to this part, shall not exceed forty thousand dollars ($40,000). Of the forty thousand dollars ($40,000), no more than twenty thousand dollars ($20,000) shall be payable for medical benefits and no more than twenty thousand dollars ($20,000) shall be payable for temporary disability benefits. However, if less than twenty thousand dollars ($20,000) has been paid to the employee for temporary disability or medical benefits and the employee has secured a judgment for temporary disability or medical benefits in an amount greater than twenty thousand dollars ($20,000), the administrator may pay the remaining funds to the employee for temporary disability or medical benefits. The administrator shall not pay benefits pursuant to this part to, or on behalf of, any employee for more than one workplace injury. In order to establish medical causation, the administrator shall have authority to provide medical benefits to an employee who meets the requirements of § 50-6-801(d)(1)-(4) for the payment of the cost associated with the employee's visit with a physician to perform an evaluation and provide an opinion on medical causation. The employer shall be required to reimburse the bureau for the payment of benefits pursuant to this section even when the employee's injury is determined not to be compensable under this chapter. When medical benefits have been provided pursuant to subdivision (d)(1), the amount of payment shall be deducted from the total amount of benefits that may be provided under subsection (c) in the event that those benefits are provided. However, the provision of medical benefits pursuant to this subsection (d) shall not automatically entitle the employee to the benefits provided by subsection (c) even when the claim is determined to be compensable under this chapter. If medical causation is established and a workers' compensation judge determines that an employee, who meets the requirements of § 50-6-801(d)(1)-(4), is entitled to temporary disability or medical benefits, following an expedited hearing as provided in § 50-6-239(d), the administrator has the discretion to begin paying temporary disability or medical benefits. If the administrator makes any payments of temporary disability or medical benefits pursuant to this subsection (e) and the employee fails to prosecute the claim, the bureau has authority to seek recovery of the payments from the employee. The provision of medical benefits pursuant to this subsection (e) shall not automatically entitle the employee to the benefits provided by subsection (c) even when the claim is determined to be compensable under this chapter. [Deleted by 2020 amendment.] Acts 2014, ch. 765, § 3; 2015, ch. 341, § 15; 2020, ch. 731, § 4. Compiler's Notes. Acts 2020, ch. 731, § 5 provided that the act, which amended this section, applies to injuries occurring on or after June 22, 2020. Amendments. The 2015 amendment substituted “bureau” for “division” throughout. The 2020 amendment deleted former (f) which read: “(f) When an employee who has provided notice pursuant to § 50-6-801(d)(4) files a claim for workers' compensation benefits against the employer identified in the notice, the court of workers' compensation claims shall convene a full and final hearing no more than sixty (60) days after the notice of hearing has been filed pursuant to § 50-6-239(a) .” Effective Dates. Acts 2014, ch. 765, § 4. April 24, 2014. Acts 2015, ch. 341, § 19. May 4, 2015. Acts 2020, ch. 731, § 5. June 22, 2020.