(a)

medical exam

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Terms Used In Tennessee Code 50-6-226

  • Administrator: means the chief administrative officer of the bureau of workers' compensation of the department of labor and workforce development. See Tennessee Code 50-6-102
  • Credit bureau: An agency that collects individual credit information and sells it for a fee to creditors so they can make a decision on granting loans. Typical clients include banks, mortgage lenders, credit card companies, and other financing companies. (Also commonly referred to as consumer-reporting agency or credit-reporting agency.) Source: OCC
  • Department: means the department of labor and workforce development. See Tennessee Code 50-6-102
  • Dependent: A person dependent for support upon another.
  • Deposition: An oral statement made before an officer authorized by law to administer oaths. Such statements are often taken to examine potential witnesses, to obtain discovery, or to be used later in trial.
  • Employee: includes every person, including a minor, whether lawfully or unlawfully employed, the president, any vice president, secretary, treasurer or other executive officer of a corporate employer without regard to the nature of the duties of the corporate officials, in the service of an employer, as employer is defined in subdivision (11), under any contract of hire or apprenticeship, written or implied. See Tennessee Code 50-6-102
  • Employer: includes any individual, firm, association or corporation, the receiver or trustee of the individual, firm, association or corporation, or the legal representative of a deceased employer, using the services of not less than five (5) persons for pay, except as provided in §. See Tennessee Code 50-6-102
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
(1) The reasonableness of attorney fees for services to employees under this chapter is subject to the approval of the workers’ compensation judge before whom the matter is pending; provided, that attorney fees must not exceed twenty percent (20%) of the amount of the recovery or award to the injured worker, or in cases governed by § 50-6-207(4), twenty percent (20%) of the first four hundred fifty (450) weeks of the award; provided, further, that such fees must be paid by the party employing the attorney. All attorney fees for attorneys representing employers are subject to review for reasonableness of the fee and are subject to approval by a workers’ compensation judge when the fee exceeds ten thousand dollars ($10,000).
(2)

(A) Medical costs that have been voluntarily paid by the employer or its insurer shall not be included in determining the award for purposes of calculating the attorney’s fee.
(B) In cases that proceed to trial, an employee‘s attorney shall file an application for approval of a proposed attorney’s fee. Where the award of an attorney’s fee exceeds ten thousand dollars ($10,000), the court shall make specific findings as to the factors that justify the fee as provided in Tennessee Supreme Court Rule 8, RPC 1.5.
(C) The final order or settlement in all workers’ compensation cases shall set out the attorney portion of the award in both dollar and percentage terms and the required findings.
(3) In accident cases that result in death of an employee, the plaintiff‘s attorney’s fees shall not exceed reasonable payment for actual time and expenses incurred when the employer makes a voluntary settlement offer in writing to dependents or survivors eligible under § 50-6-210 within thirty (30) days of the employee’s death if the employer offers to provide the dependents or survivors with all the benefits provided under this chapter. The approving authority shall review and approve the settlements on an expedited basis.
(4) The fees of physicians and charges of hospitals for services to employees under this chapter, shall be subject to the approval of the administrator or the court before which the matter is pending, as appropriate, as provided in this subdivision (a)(4). Unless a medical fee or charge is contested, the department shall deem it to be reasonable. If a fee or charge is contested, the department shall permit a party to seek review only of the contested fee or charge in any court with jurisdiction to hear a matter pursuant to § 50-6-237. A court may review the case solely for the purpose of approving the fees and charges that are reasonable.
(b) The charging or receiving of any fee by an attorney in violation of subsection (a) shall be deemed unlawful practice and render the attorney liable to disbarment; and, further, the attorney shall forfeit double the entire amount retained by the attorney, to be recovered as in case of debt by the injured person or the injured person’s creditor.
(c)

(1) The fees charged to the claimant by the treating physician or a specialist to whom the employee was referred for giving testimony by oral deposition relative to the claim shall, unless the interests of justice require otherwise, be considered a part of the costs of the case, to be charged against the employer when the employee is the prevailing party.
(2) The workers’ compensation judge shall have the discretion to determine the reasonableness of the fee charged by any physician pursuant to this subsection (c).
(3) This subsection (c) applies only to workers’ compensation actions arising on or after July 1, 1988.
(d)

(1) In addition to attorneys’ fees provided for in this section, the court of workers’ compensation claims may award reasonable attorneys’ fees and reasonable costs, including, but not limited to, reasonable and necessary court reporter expenses and expert witness fees for depositions and trials, incurred when the employer:

(A) Fails to furnish appropriate medical, surgical, and dental treatment or care, medicine, medical and surgical supplies, crutches, artificial members, and other apparatus to an employee provided for in a settlement, expedited hearing order, compensation hearing order, or judgment under this chapter; or
(B) Unreasonably denies a claim or unreasonably fails to timely initiate any of the benefits to which the employee or dependent is entitled under this chapter, including medical benefits under § 50-6-204, temporary or permanent disability benefits under § 50-6-207, or death benefits under § 50-6-210 if the workers’ compensation judge makes a finding that the benefits were owed at an expedited hearing or compensation hearing.
(2) Subdivision (d)(1)(B) applies to injuries that occur:

(A) Between July 1, 2016, and June 30, 2020; and
(B) Between July 1, 2021, and June 30, 2025.
(e) A health care provider shall not employ a collection agency or make a report to a credit bureau concerning a private claim against an employer for all or part of the costs of medical care provided to an employee that are not paid by the employer’s workers’ compensation insurer without having first given notice of the dispute to the medical payment committee. The medical director may include the insurer in the administrative process.
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