Section 0800-02-30-.05 - REQUIREMENTS FOR PAYMENT OF BENEFITS(1) An Expedited Request for Investigation form may be admissible in the Court of Workers' Compensation Claims under the Court's rules as evidence of potential eligibility for benefits from the Uninsured Employers Fund.(2) Notice to the Uninsured Employer must be included in the cover letters to the dispute certification notices or within a settlement agreement. The notice language informs the employer that benefits may be paid by the Bureau and that the Bureau will seek to collect the amount expended by the state from the employer under T.C.A. § 50-6-803.(3) A Third-Party Administrator will be contracted to provide adjusting services, access to medical networks, and to monitor billing compliance with Tennessee's medical fee schedule.(4) The referral of the injured worker to obtain a medical causation opinion will take place in consultation with the mediator, Third-Party Administrator, and Uninsured Employers Fund Benefits claims coordinator.(5) The payment of benefits is at the Administrator's discretion and is subject to the availability of sufficient funds in the Uninsured Employers Fund, including the amount available from the Employee Misclassification Education and Enforcement Fund (EMEEF) allowed by statute (up to 25% of the balance of funds remaining after the costs and expenditures provided by T.C.A. § 50-6-913(b) have been satisfied).Tenn. Comp. R. & Regs. 0800-02-30-.05
Original rules filed January 2, 2019; effective April 2, 2019. Amendments filed February 2, 2022; effective 5/3/2022.Authority: T.C.A. §§ 50-6-801, 50-6-802, and 50-6-803.