§ 50-6-118. Penalties.

TN Code § 50-6-118 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(a) The bureau of workers' compensation shall, by rule promulgated pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, establish and collect penalties for the following:

(1) Failure of a covered employer to provide workers' compensation coverage or qualify as a self-insurer;

(2) Late filing of accident reports;

(3) Bad faith denial of claims;

(4) Late filing of notice of denial of claim;

(5) [Deleted by 2013 amendment, effective July 1, 2014.]

(6) [Deleted by 2013 amendment, effective July 1, 2014.]

(7) [Deleted by 2013 amendment, effective July 1, 2014.]

(8) Failure of any party to appear or to mediate in good faith at any alternative dispute resolution proceeding;

(9) Failure of any party to comply, within the designated timeframe, with any order or judgment issued by a workers' compensation judge;

(10) Performance of any enumerated action provided in § 29-9-102 in relation to any proceedings in the court of workers' compensation claims;

(11) Failure of any employer to timely provide medical treatment made reasonably necessary by the accident and recommended by the authorized treating physician or operating physician;

(12) Failure of an employer to timely provide a panel of physicians that meets the statutory requirements of this chapter;

(13) Wrongful failure of an employer to pay an employee's claim for temporary total disability payments;

(14) Wrongful failure to satisfy the terms of an approved settlement;

(15) Refusal to cooperate with the services provided by an ombudsman; and

(16) Any violation of § 50-6-215 by an individual or entity not licensed by the department of commerce and insurance.

(b) All penalties collected by the bureau from an employer for failure to provide workers' compensation coverage or failure to qualify as a self-insurer shall be paid into and become a part of the uninsured employers fund. All other penalties collected pursuant to an assessment made under this section shall be paid to the bureau for use by the bureau, at the discretion of the administrator, to offset the cost of administering this chapter.

(c) The bureau of workers' compensation may assess the penalties authorized by this chapter, upon providing notice and an opportunity for a hearing to an employer, an employee, an insurer, or a self-insured pool or trust. If a hearing is requested, the commissioner, commissioner's designee, or an agency member appointed by the commissioner shall have the authority to hear the matter as a contested case, and the authority to hear the administrative appeal of an agency decision, relating to the assessment of the penalties authorized by this chapter. When a hearing or review of an agency decision is requested, the requesting party shall have the burden of proving, by a preponderance of the evidence, that the penalized party was either not subject to this chapter, or that the penalties assessed pursuant to this chapter should not have been assessed. Any party assessed a penalty pursuant to this section shall have the right to appeal the penalty assessed by the bureau and affirmed by the commissioner, the commissioner's designee or an agency member in the manner provided in this subsection (c), pursuant to the Uniform Administrative Procedures Act.

(d) If an employee receives a settlement, judgment or decree under this chapter that includes the payment of medical expenses and the employer or workers' compensation carrier wrongfully fails to reimburse an employee for any medical expenses actually paid by the employee within sixty (60) days of the settlement, judgment or decree, or fails to provide reasonable and necessary medical expenses and treatment, including failure to reimburse for reasonable and necessary medical expenses, in bad faith after receiving reasonable notice of their obligation to provide the medical treatment, the employer or· workers' compensation carrier shall be liable, in the discretion of the court, to pay the employee, in addition to the amount due for medical expenses paid, a sum not exceeding twenty-five percent (25%) of the expenses; provided, that it is made to appear to the court that the refusal to pay the claim was not in good faith and that the failure to pay inflicted additional expense, loss or injury upon the employee.