303 North Church Street • Murfreesboro, TN 37130 • Phone: (615) 898-7715 • Fax: (615) 867-4602

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Post Injury Follow-Up

• Notify your supervisor of the status of your injury and when the physician recommends you return to work.

• To avoid out of pocket expenses, fill your prescription at one of the following authorized pharmacies.

• If the physician recommends light or restricted duty and your supervisor can provide a job within your restrictions, you MUST report to work. Failure to report will terminate disability benefits.

• If a job cannot be provided within your restrictions and you will miss work, have your supervisor fill out the Return to Work Agreement Form and fax it to the Safety Coordinator at (615) 867-4602.

• Under TN Workers’ Compensation Law, the date of injury and the first seven (7) days following the injury are the waiting period. Compensation begins on the eighth (8th) day of disability “from work”. Consult your supervisor about the use of sick time for the seven-day waiting period.

• Benefits are due for each day over the seven (7) day waiting period until the lost time reaches fourteen (14) days. If you will be out of work beyond fourteen (14) days, you “may” qualify for temporary total disability benefits (TTD). Temporary total disability benefits will be calculated beginning with the day following the injury and will be paid biweekly.

• TTD benefits are based on 66 2/3% of your gross average weekly wage for the last 52 weeks worked prior to the injury. This is called your weekly compensation rate and is subject to the minimum and maximum rates in effect on the day you were injured.

• If you refuse to comply with any reasonable request for medical examination or to accept medical treatment, compensation may be stopped for as long as you continue your refusal.

• Depending on the extent of your injury, you will be contacted by CCMSI to verify details of your claim. This may include a recorded statement.

If you have any questions, please contact the Safety Coordinator at (615) 898-7715.

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