Tennessee Permanent Total Disability Final Order Form

• Category: Tennessee Workers Compensation - Official
• State: Tennessee
• Control #: TN-SKU-1601
• Format: PDF

Description

Permanent Total Disability Final Order Form The Tennessee Permanent Total Disability Final Order Form is a document issued by the Tennessee Department of Labor and Workforce Development (TOLD) to certify that an employee has been permanently and totally disabled due to an injury or illness suffered while on the job. The form is used to document the employee’s disability and to request payment of benefits from the TOLD. There are three types of Tennessee Permanent Total Disability Final Order Forms: 1) Employee-Initiated Permanent Total Disability Final Order Form; 2) Employer-Initiated Permanent Total Disability Final Order Form; and 3) Dependent-Initiated Permanent Total Disability Final Order Form. The Employee-Initiated form is used when the employee is the one who has applied for and received the disability certification; the Employer-Initiated form is used when the employer has applied for and received the disability certification; and the Dependent-Initiated form is used when a dependent of the employee has applied for and received the disability certification. All forms must be completed in full and submitted to the TOLD for processing and approval.

The Tennessee Permanent Total Disability Final Order Form is a document issued by the Tennessee Department of Labor and Workforce Development (TOLD) to certify that an employee has been permanently and totally disabled due to an injury or illness suffered while on the job. The form is used to document the employee’s disability and to request payment of benefits from the TOLD. There are three types of Tennessee Permanent Total Disability Final Order Forms: 1) Employee-Initiated Permanent Total Disability Final Order Form; 2) Employer-Initiated Permanent Total Disability Final Order Form; and 3) Dependent-Initiated Permanent Total Disability Final Order Form. The Employee-Initiated form is used when the employee is the one who has applied for and received the disability certification; the Employer-Initiated form is used when the employer has applied for and received the disability certification; and the Dependent-Initiated form is used when a dependent of the employee has applied for and received the disability certification. All forms must be completed in full and submitted to the TOLD for processing and approval.