Tennessee's Standard Form Medical Report lets a treating or evaluating physician give direct testimony in writing instead of sitting for a deposition. The three-page form covers the course of treatment, time off work and restrictions, permanent impairment, and detailed causation questions. A party files it with the Court of Workers' Compensation Claims, and an opposing party may object and demand a deposition instead.
The treating or evaluating physician completes the whole form, checks which role applies, and signs the certification with an original signature. No other party completes a section.
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Standard Form Medical Report for Industrial Injuries
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Yes. The form says it may be used to introduce direct testimony in lieu of a physician's deposition under Tenn. Code Ann. 50-6-235(c), and it should bear the physician's original signature. An opposing party can object and demand a deposition, so the report must stand on its own as testimony.
For injuries on or after July 1, 2014, the injury is medically caused by employment if the employment activity, more likely than not, is primarily responsible for the injury or the need for treatment, both meaning greater than fifty percent. For earlier injuries, the form asks whether the injury more probably than not arose out of employment.