0800-02-05-.07
Benefit Review Conferences
Cite as Tenn. Comp. R. & Regs. 0800-02-05-.07
(1)
A Request for Benefit Review Conference must be filed within the statute of limitations
provided by Tenn. Code Ann. § 50-6-203.
(2)
The Request for Benefit Review Conference shall be assigned to the Benefit Review office
designated for the county where the employee lives unless otherwise designated by the
Administrator for good cause shown.
(3)
Scheduling of Benefit Review Conference:
(a)
A Benefit Review Conference shall not be scheduled until Maximum Medical
Improvement is reached, except upon request by a party and determination by a
Workers’ Compensation Specialist that extraordinary circumstances require
otherwise.
(b)
Scheduling of a Benefit Review Conference shall be within the time limitations
provided by statute.
(c)
All parties are required to cooperate in the scheduling of a Benefit Review
Conference pursuant to Tenn. Code Ann. § 50-6-239.
(4)
Notice and Response of Benefit Review Conference:
(a)
Upon scheduling of a Benefit Review Conference, notice of date, time, and location
shall be sent to all parties.
BENEFIT REVIEW PROCESS RULES
CHAPTER 0800-02-05
(b)
Accompanying the notice of the Benefit Review Conference, the parties shall receive
a standard discovery form showing all required information and documentation which
shall be exchanged between the parties and the requirements for submitting such
documentation.
(c)
In cases involving a claim against the Second Injury Fund, the Fund shall receive
notice of any Benefit Review Conference, and shall participate.
(5)
Continuances
(a)
Prior to Benefit Review Conference: A request for a continuance prior to a Benefit
Review Conference may be granted upon a finding, in the sole discretion of the
Specialist, that extraordinary circumstances require such continuance.
(b)
After convening a Benefit Review Conference, a Workers’ Compensation Specialist
has the sole discretion to continue the conference.
(6)
Conduct of the Benefit Review Conference
(a)
The conduct of the Benefit Review Conference shall be in the control of the Workers’
Compensation Specialist.
(b)
Either party may be represented by an attorney, but legal representation is not
required at a Benefit Review Conference.
(c)
Only in a situation where a collective bargaining relationship or a memorandum of
understanding exists between an employer and a collective bargaining agent may a
representative of that collective bargaining agent appear with and assist an employee
at the Benefit Review Conference. No provision of this chapter shall authorize a
representative of a collective bargaining agent to engage in the “practice of law” or
“law business”, prohibited by Tenn. Code Ann. § 23-3-103, or Rules of the
Tennessee Supreme Court, Rule 7, § 1.01, as a part of the informal mediation
procedure set forth in this chapter unless the representative is an attorney licensed to
practice law in the State of Tennessee.
(7)
Preparation and submission of Documentation
(a)
If a mediated settlement occurs, the Workers’ Compensation Specialist shall prepare
a mediated settlement agreement to be signed by the parties and by the Specialist at
the time of the conference. The signed mediated settlement agreement shall be filed
by the Specialist with the Commissioner. The Workers’ Compensation Specialist is
not required to prepare a mediated settlement agreement in cases involving the
Second Injury Fund.
(b)
If there is no settlement, the Specialist may declare an impasse. Upon declaring
impasse, the Specialist shall prepare a written report pursuant to Tenn. Code Ann. §
50-6-240 to be provided to the parties and filed with he Commissioner.