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All Tennessee employers and employees may download and use any of our TN workers' compensation forms, applications, and guides for free. We are always updating our Tennessee Forms Library so check back often for the latest form versions.
If you need help completing or locating a form needed for your coverage, please contact one of our Specialist for assistance. We are happy to answer your questions about current coverage or provide information about our current work comp programs and insurance rates for Tennessee coverage.
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Tennessee Workers Compensation Employer Notice
This posting is required to be displayed in every insured's workplace by The TN Department of Insurance to be
Tennessee Acord 130 Workers Compensation Application
The standard Acord 130 application form for workers comp coverage in Tennessee.
Tennessee First Report of Injury Form
First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
Exempt Employers Notice of Acceptance: Form I-8
Complete this form if you are an employer who is exempt under the Tennessee workers compensation Act, but would like to obtain workers comp coverage..
Exempt Employers Notice of Withdrawal: Form I-9
Complete this form if you are an exempt employee who elected coverage at one pint in time and now would like to become exempt from voluntary workers compensation coverage..
Tennessee Application for Exclusion of Officers: Form I-6
Owners and Officers of corporations should complete this form to exclude themselves from a work comp policy.
Tennessee Application for Exemption from Workers' Comp: Form I-4
Complete this form if you are a sole-proprietor, partnership with no employees or a sole officer of a corporation and would like to be exempt from coverage.
Tennessee Owner Election Withdrawal from Workers' Comp: Form I-5
Complete this form if you are a sole-proprietor or partnership and would like to withdrawal your election to be covered under workers compensation insurance.
Workers’ Compensation Contact Information
This document contains contact information for various workers' compensation assistance programs.
Choice of Physician Agreement Form
This document contains information regarding the Agreement Between Employer/Employee Choice of Physician Policy.
Drug Free Workplace Poster
Poster promoting a Drug Free Workplace.
Drug Free Workplace Information Guide
A guide on how to build a drug-free workplace program for you business.
Tennessee Workers' Compensation Information Guide
Complete the form and post it so that employees will know who to contact in case of a work related injury.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
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State Resources for Tennessee
Tennessee Department of Labor and Workforce Development
Workers' Compensation Division710 James Robertson Pkwy 2nd FloorNashville, TN 37243-4812615-532-4812 TN Department of Labor
Tennessee Workers' Compensation Insurance Plan
PO Box 681089Franklin, TN 37068800-471-6767 TWCIP
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