This question has caused much consternation in workers’ compensation systems throughout the country, and Tennessee has adopted something of a compromise position.
The main issue is possible or probable bias. Many company doctors have a well-earned reputation for downplaying a job injury, or even denying that one occurred. Legally, there is a question of where loyalties lie in these situations. Does the doctor owe a duty to the patient who is being examined or the company that pays for the visit according to the contract? This question is financial as well. On the other side, there is sometimes a question as to whether or not an unaffiliated physician is competent to render a diagnosis in these cases.
In the Volunteer State, an injured worker has a choice among three workers’ compensation doctors, plus a chiropractor in the event of a back injury claim.
Past Benefits Available in a Workers’ Compensation Case
The primary handicap in this system is that to many workers, the three doctors are just three names on a list. An attorney can offer solid advice as to which doctor to select, or at least which one(s) to avoid.
There is a larger point. Essentially, this division of the Tennessee Department of Labor & Workforce Development (TDLWD) is essentially a state-subsidized insurance company that needs to be financially self-sufficient for political reasons. And, like any other insurance company, the TDLWD makes money by collecting premiums and not by paying claims.
Adjusters look for every possible opportunity to reduce the amount of compensation in areas like:
- Lost Wages: Some familiar arguments include “the worker missed half day for a half-hour visit” and “the employee could have gone during lunch or after hours and missed no time.” There must be evidence in the record that the doctor was only available at certain times or that it was impossible or impractical to return to work immediately following the visit.
- Doctor Bills: “Medically unnecessary” are two of an adjuster’s favorite words. This argument can also be refuted by competent evidence.
- Prescription Drugs: The 2013 reforms reduced benefits in this area, underscoring the need for an experienced lawyer.
Most workers receive benefits that are retroactive to the date of injury.
If the injury is long-lasting, a worker is generally entitled to 66.67 percent of the average weekly wage. This percentage varies based on the length and amount of disability. For example, a doctor might conclude that a leg injury created a 50 percent disability that is expected to last six months.
Future benefits are challenged in much the same way as prior benefits, again underscoring the need for an experienced attorney.
There is significant compensation available for injured workers, but there are significant obstacles to overcome. For a free consultation with an experienced Memphis workers’ compensation attorney, contact a lawyer today. An attorney will fight for the benefits you deserve.