By Judge Robert Durham, Cookeville

The Bureau of Workers’ Compensation, like any organization, is a sum of its parts. You’re probably familiar with many of its programs: the Court, MOST, and Utilization Review. However, some are a bit more under the radar. One you may not know about, although they’re certainly working hard to change that, is the recently created Certified Physician Program.

The Bureau created the CCP in 2023, and its purpose is set out in the title—to certify physicians in the treatment of patients with work-related injuries. It does so through training “in all the tasks that the Tennessee Workers’ Compensation Law requires.” The program’s goals are “increasing injured employees’ access to trained physicians and reducing the days they are out of work.”

Candidates must meet certain criteria before they can enter the program. They must be medical doctors, osteopaths, or chiropractors and certified, or at least eligible for certification, with boards of specialty maintained by the American Medical Association. This ensures that doctors in the CCP are highly qualified to treat work injuries.

If they’re qualified and approved, they’re then ready to begin training, which consists of an online “Best Practices” course and certification in determining anatomic impairment under the AMA Guides.

The online course covers all aspects of workers’ compensation law and procedure that might touch on a doctor’s duties in a workers’ compensation claim. It includes training on the medical fee schedule, utilization review, causation standards, and return-to-work. In addition, the Bureau offers in-person AMA Guides training to physician groups of 10 or more or to one or more for in-demand specialists, such as neurologists, psychiatrists, pulmonologists, ophthalmologist, urologists, dermatologists, and otolaryngologists.

The course takes eight to nine hours to complete, but candidates can do so at their own pace. They must then pass a 60-question multiple-choice test. As a bonus, successful completion entitles the candidate to ten hours of continuing medical education credits.

As for impairment certification, the Bureau often offers training, but candidates can go through other approved programs. Certification not only qualifies a candidate for the CPP but also gives them the opportunity to join the Bureau’s Medical Impairment Rating Registry.

Once they’re received training, doctors are qualified for certification so long as they agree to be listed on the Bureau’s website and to treat workers’ compensation patients impartially. They must also serve a one-year probation and submit their first three impairment ratings to the Bureau for review.

In addition to becoming more equipped to treat workers’ compensation patients, certified doctors will immediately see tangible benefits. Certified physicians can often charge fees over that allowed uncertified doctors under the medical fee schedule. For example, they can charge $80 more for an initial assessment; $40 more for additional visits; and, $100 more for assigning permanent impairment and completing a medical report. Also, insurance companies, attorneys, and employees will be able to see a doctor’s certified status by simply visiting the Bureau website. This should lead to more patients.

Employers and employees also receive clear advantages if they use certified doctors. They are assured of doctors trained in workers’ compensation cases and committed to meeting their obligations under the law. Everyone involved in workers’ compensation has felt the frustration of going through multiple panels trying to find a doctor who takes workers’ compensation cases, or dealing with doctors who won’t address causation, restrictions, or impairment ratings. With the certification list, and the Bureau’s oversight of those on the list, those frustrations should lessen.

Of course, to be most effective, the CPP requires a large list of doctors in a variety of specialties throughout the state. While the CPP has made significant progress since its inception, the goal is to have enough doctors so that a panel can be formed from any specialty in each of Tennessee’s Grand Divisions. Currently, the list contains 117 doctors. Most are orthopedists, and they are predominantly located in West and Middle Tennessee. However, due to the CPP’s diligence, more are being added every month.

Once the Certified Physicians Program reaches its full potential, it will undoubtedly play a significant role in the future of Tennessee Workers’ Compensation. If you’d like to know more about the CPP, visit the Bureau’s website at Certified Physician Program or contact CPP program coordinator Jay Blaisdell at jay.blaisdell@tn.gov.

Photo by Kim Weaver, paralegal, Knoxville.