Tenn. Comp. R. & Regs. 0800-02-07-.01

Current through October 22, 2024

Section 0800-02-07-.01 - DEFINITIONS - GENERAL

As used in this chapter, the following terms are used as follows:

(1) "Administrator" means the administrator of the Tennessee Bureau of Workers' Compensation.

(2) "Bureau" means the Tennessee Bureau of Workers' Compensation.

(3) "Case management" means medical case management or the ongoing coordination of medical care services provided to an injured or disabled employee and for the purpose of this chapter shall only be provided by a registered case manager or case manager assistant under the direct supervision of a registered case manager.

(4) "Case manager" means an individual who provides or supervises the provision of case management services under this chapter and who is either:

(a) A licensed registered nurse, licensed under T.C.A., Title 63, Chapter 7, who possesses one or more of the following:

1. A Master's Degree in Vocational Rehabilitation Counseling; or

2. Certification as a Certified Disability Management Specialist (CDMS); or

3. Certification as a Certified Rehabilitation Registered Nurse (CRRN); or

4. Certification as a Certified Occupational Health Nurse (COHN); or

(b) Certified as a Certified Case Manager (CCM).

(5) "Case manager assistant" means an individual who provides case management services under the direct supervision of a case manager and who meets one of the following:

(a) The individual is a registered nurse, licensed under T.C.A., Title 63, Chapter 7; or

(b) The individual possesses one of the following:

1. A Master's Degree in Vocational Rehabilitation Counseling; or

2. Certification as a Certified Insurance Rehabilitation Specialist (CIRS). (Note: This certification is now called "Certified Disability Management Specialist" (CDMS); or

3. Certification as a Certified Rehabilitation Counselor (CRC).

(c) Registered Case Manager Assistants may continue their present duties under direct supervision of a Registered Case Manager for 24 months from the date of the effect of these rules. A Case Manager Assistant, at the end of a 24-month period must be certified by one of the categories under the definition of a Case Manager or their registration with the Bureau will terminate. Persons who are not current Case Manager Assistants shall have a 24-month period from the date they become Case Manager Assistants under the supervision of a Registered Case Manager to obtain certification.

(6) "Catastrophic injury" means any injury which is one of the following:

(a) Spinal cord injury involving severe paralysis of an arm, a leg, or the trunk;

(b) Amputation of an arm, a hand, a foot, or a leg involving the effective loss of use of that appendage;

(c) Severe brain or closed head injury as evidenced by:

1. Severe sensory or motor disturbances;

2. Severe communication disturbances;

3. Severe complex integrated disturbances of cerebral function;

4. Severe disturbances of consciousness;

5. Severe episodic neurological disorders; or

6. Other conditions at least as severe in nature as any condition provided in subparagraphs 1 through 5 of this paragraph;

(d) Second or third degree burns over 25 percent of the body as a whole or third degree burns to 5 percent or more of the face or hands; or

(e) Total or industrial blindness.

(7) "Commissioner" means the Commissioner of the Department of Labor and Workforce Development.

(8) "Contractor" means that organization or organizations referred to in T.C.A. § 50-6-124 [Section 8 of Public Chapter 900 of the Acts of 1992].

(9) "Department" means the Tennessee Department of Labor and Workforce Development.

(10) "Medical Director" means the Medical Director appointed by the Administrator of the Bureau of Workers' Compensation pursuant to T.C.A. § 50-6-126.

Tenn. Comp. R. & Regs. 0800-02-07-.01

Original rule filed January 28, 1993; effective May 13, 1993. Amended by Public Chapter 467; effective May 31, 1993. Amendment filed March 20, 2007; effective July 27, 2007. Amendment filed December 26, 2013; effective March 26, 2014. Repeal and new rule filed May 31, 2016; effective 8/29/2016.

Authority: T.C.A. §§ 4-5-202, 50-6-102, 50-6-122, 50-6-123, 50-6-124, 50-6-126, 50-6-233, Public Acts 1992, Chapter 900, § 2, and Public Acts 2013, Chapters 282 and 289.