The Administrative Review Program provides an independent review of a Benefit Review Order. If the injured employee, employer or insurance adjuster disagrees with an Order issued by a Benefit Review Attorney Specialist, he/she may request an Administrative Review of the Order. Once requested, an Administrator’s Designee will review all of the information and documentation in a case file and conduct an informal conference before making a decision and issuing a new order. The Program’s goals are to assure that Orders, whether awarding or denying benefits, are in accordance with the applicable Workers’ Compensation Law, rules and regulations, policies and procedures, as well as case law to provide a more informal and cost-effective appeal process than through the state’s Court system. The administrative review is conducted by a Workers’ Compensation Attorney Specialist, known as an Administrator’s Designee, in an expedited and efficient Informal Conference over the telephone in which each party is able to explain the facts and issues involved in their workers’ compensation matter. Either party may request the review by submitting a Request for Administrative Review Form C-44 within seven (7) calendar days of his/her receipt of the Benefit Review Order.
IMPORTANT NOTES:
•An Informal Conference is conducted within ten (10) calendar days from the date the Division receives the Request for Administrative Review Form C-44 unless otherwise agreed by both parties. The conference is a telephone conference call for the parties to explain the facts and issues of their workers’ compensation matter to a senior member of the Division.
•General information that was available and could have reasonably been obtained and provided by a Party to the Benefit Review Specialists before the Benefit Review Order was issued will not be considered by Administrative Review except in very limited circumstances.
•The Division must produce a new Order within seven (7) calendar days of the Informal Conference.
•The parties must comply with the new Order within ten (10) calendar days of the receipt of the decision.
Please note the previous information came from http://www.tn.gov/labor-wfd/wcomp/employers_info.shtml#ADMIN_REV