Section 0800-02-30-.07 - MEDIATION(1) Upon the filing of a petition for benefit determination (PBD, or Form LB 1095) for an Uninsured Employers Fund claim, the matter shall be mediated under T.C.A. § 50-6-236.(2) The mediator shall notify the Uninsured Employers Fund benefit coordinator of the PBD filing, who will consult with the Third-Party Administrator to open a file, make an initial investigation, and determine if the circumstances warrant a medical causation opinion.(3) Upon settlement, the mediator shall complete the settlement agreement and arrange for court approval of the agreement and the issuance of an order approving the settlement by the Court of Workers' Compensation Claims. This settlement shall not be considered approval of the claim against the UEF Benefit program.(4) In the event of an impasse, the dispute certification notice shall include information about the employee's eligibility for Uninsured Employers Fund benefits in addition to identifying all disputed issues. The cover letter to the first and second dispute certification notices shall include the following language: If you fail to provide workers' compensation insurance coverage for your employee, you might be responsible for workers' compensation benefits. If the Uninsured Employers Fund pays any portion of these benefits to or on behalf of your injured employee, the Uninsured Employers Fund may take action to collect the amount of payments made as set forth in T.C.A. § 50-6-803, or as otherwise allowed or permitted by law.
(5) The mediator shall send the dispute certification notice or settlement agreement to the Uninsured Employers Fund benefit coordinator.Tenn. Comp. R. & Regs. 0800-02-30-.07
Original rules filed January 2, 2019; effective April 2, 2019. Amendments filed February 2, 2022; effective 5/3/2022.Authority: T.C.A. §§ 50-6-216, 50-6-236, 50-6-801, 50-6-802, and 50-6-803.