Presumptive Disability Law in Tennessee

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CODE PART:
TENNESSEE CODE
Title 7 Consolidated Governments
Chapter 51 Miscellaneous Governmental and Proprietary Functions
Part 2 Employee Compensation and Indemnification
§7-51-201. Law enforcement officers and firefighters - Compensation for injury or death - Certain disabilities presumed to have been suffered in course of employment.
§7-51-205. Firefighters - Disease, cancer or death - Presumptions.
§7-51-209. Presumptive disability in acquiring human immunodeficiency virus in the line of duty by emergency rescue workers.
Title 8 - Public Officers And Employees
Chapter 50 - Miscellaneous Provisions
Part 1 - General Provisions
§8-50-119 Tennessee Public Safety Behavioral Health Act
Tennessee Legislative Website
DESCRIPTION:
§7-51-201.
Law enforcement officers and firefighters - Compensation for injury or death - Certain disabilities presumed to have been suffered in course of employment.

(b)(1) Whenever the state of Tennessee, or any municipal corporation or other political subdivision of the state maintains a regular fire department manned by regular and full-time employees and has established or hereafter establishes any form of compensation, other than workers' compensation, to be paid to such firefighters for any condition or impairment of health that results in loss of life or personal injury in the line of duty or course of employment, there shall be and there is hereby established a presumption that any impairment of health of such firefighters caused by disease of the lungs, hypertension or heart disease resulting in hospitalization, medical treatment or any disability, shall be presumed, unless the contrary is shown by competent medical evidence, to have occurred or to be due to accidental injury suffered in the course of employment. Any such condition or impairment of health which results in death shall be presumed, unless the contrary is shown by competent medical evidence, to be a loss of life in line of duty, and to have been in the line and course of employment, and in the actual discharge of the duties of such firefighter's position, or the sustaining of personal injuries by external and violent means or by accident in the course of employment and in the line of duty. Such firefighter shall have successfully passed a physical examination prior to such claimed disability, or upon entering upon governmental employment, and such examination fails to reveal any evidence of the condition or disease of the lungs, hypertension or heart disease.

§7-51-205.
Firefighters - Disease, cancer or death - Presumptions.
  1. For the purposes of this section, “firefighter” means any regular and full-time employee of a county with a metropolitan government with a population of four hundred thousand (400,000) or more, according to the 1980 federal census or any subsequent federal census, who is required to extinguish and control fires or fire-related incidents and other employees of fire departments who are required to perform their duties under and in a toxic environment.
  2. Any county with a metropolitan form of government with a population of four hundred thousand (400,000) or more, according to the 1980 federal census or any subsequent federal census, that maintains a regular fire department manned by regular and full-time employees, and has established or hereafter establishes any form of compensation, other than workers' compensation, to be paid to such firefighters for any condition or impairment of health that results in loss to life or personal injury in the line of duty or course of employment, may establish by ordinance a presumption that any impairment of health of such firefighter caused by disease or cancer resulting in hospitalization, medical treatment or any disability, shall be presumed, unless the contrary is shown by competent medical evidence, to have occurred or to be due to accidental injury suffered in the course of employment. Any such condition or impairment of health that results in death shall be presumed, unless the contrary is shown by competent medical evidence, to be a loss of life in the line of duty, and to have been in the line and course of employment, and in the actual discharge of the duties of such firefighter's position, or the sustaining of personal injuries by external and violent means or by accident in the course of employment and in the line of duty; provided, that such firefighter shall have successfully passed a physical examination prior to such claimed disability, or upon entering upon such firefighter's metropolitan government employment, and such examination fails to reveal any evidence of the condition of cancer.


§7-51-209.
Presumptive disability in acquiring human immunodeficiency virus in the line of duty by emergency rescue workers.
  1. As used in this section, unless the context otherwise requires:
      1. "Body fluids" means blood and body fluids containing visible blood and other fluids to which universal precautions for prevention of occupational transmission of blood-borne pathogens, as established by the centers for disease control and prevention, apply;
      2. For purposes of potential transmission of human immunodeficiency virus, "body fluids" includes salivary and sinus fluids, including droplets, sputum, and saliva, mucous and other fluids through which human immunodeficiency virus can be transmitted between persons;
      1. "Emergency rescue worker" means any person employed full-time by the state or any political subdivision of the state, including any county having a metropolitan form of government as a firefighter, paramedic, emergency medical technician or emergency medical technician advanced;
      2. "Emergency rescue worker" does not include any person employed by a public hospital or any person employed by a subsidiary thereof;
    1. "High risk of occupational exposure" means risk that is incurred because an emergency rescue worker, in performing the basic duties associated with such worker's employment:
      1. Provides emergency medical treatment in a non-healthcare setting where there is a potential for transfer of body fluids between persons; or
      2. At the site of an accident, fire or other rescue or public safety operation, or in an emergency rescue or public safety vehicle, handles body fluids in or out of containers or works with or otherwise handles needles or other sharp instruments exposed to body fluids;
    2. "Infectious disease" means human immunodeficiency virus; and
    3. "Occupational exposure" in the case of infectious diseases, means an exposure that occurs during the performance of job duties that may place a worker at risk of infection.
    1. The general assembly finds that an emergency rescue worker, in the course of employment, runs a high risk of occupational exposure to infectious disease.
    2. For reasons stated in subdivision (b)(1), any emergency rescue worker who suffers a condition or impairment of health that is caused by human immunodeficiency virus, and that results in total or partial disability or death shall be presumed to have a disability suffered in the line of duty, unless the contrary is shown by a preponderance of the evidence. However, in order to be entitled to the presumption, the emergency rescue worker must verify by written declaration that, to the best of the emergency rescue worker's knowledge and belief: In case of a medical condition caused by or derived from human immunodeficiency virus, the emergency rescue worker has not:
      1. Been exposed outside the scope of the worker's employment, through transfer of bodily fluids, to any person known to have any sickness or medical condition derived from an infectious disease;
      2. Had a transfusion of blood or blood components, other than a transfusion arising out of an accident or injury happening in connection with the worker's present employment, or received any blood products for the treatment of a coagulation disorder since last undergoing medical tests for infectious disease, which tests failed to indicate the presence of any infectious disease;
      3. Engaged in unsafe sexual practices or other high-risk behavior, as identified by the centers for disease control and prevention or the surgeon general of the United States, or had sexual relations with a person known to the worker to have engaged in such unsafe sexual practices or other high-risk behavior; or
      4. Used intravenous drugs not prescribed by a physician.
  2. Whenever any standard, medically-recognized vaccine or other form of immunization exists for the prevention of an infectious disease for which a presumption is granted under this section, if medically indicated in the given circumstances pursuant to immunization policies established by the advisory committee on immunization practices of the United States public health service, an emergency rescue worker may be required by such worker's employer to undergo the immunization, unless the worker's physician determines in writing that the immunization or other prophylaxis would pose a significant risk to the worker's health. Absent such written declaration, failure or refusal by an emergency rescue worker to undergo such immunization disqualifies the worker from the benefits of the presumption established by this section.
  3. This section does not apply to benefits payable under or granted in a noncompulsory policy of life insurance or disability insurance, unless the insurer and insured have negotiated for such additional benefits to be included in the policy contract. However, the state or any political subdivision of the state, including any county having a metropolitan form of government, may negotiate a policy contract for life and disability insurance that includes accidental death benefits or double indemnity coverage for any condition or impairment of health suffered by an emergency rescue worker, which condition or impairment is caused by an infectious disease and results in total or partial disability or death.
  4. An emergency rescue worker shall file an incident or accident report with the emergency rescue worker's employer of each instance of known or suspected occupational exposure to infectious disease as such is defined in subdivision (a)(4). The employer shall maintain a record of the incident or accident report so filed. Such report must be filed by the employee within seven (7) days of the incident or accident occurring.
    1. In order to be entitled to the presumption established by this section, an emergency rescue worker must, prior to diagnosis, have undergone standard, medically-acceptable tests for evidence of the infectious disease for which the presumption is sought, or evidence of medical conditions derived therefrom, which tests fail to indicate the presence of infection.
    2. On or after July 1, 2012, an emergency rescue worker may be required to undergo a pre-employment physical examination that tests for any evidence of infectious disease. In order to be entitled to the presumption established by this section, the test shall be negative for evidence of infectious diseases.
  5. This section does not apply to the Tennessee consolidated retirement system.
  6. This section shall apply to any emergency rescue worker following termination of service for a period of one (1) year commencing with the last actual date of service.
  7. This section shall not apply to cases involving a death of an emergency rescue worker in the line of duty.
  8. The presumption established in this section shall not apply to the state death benefit.
  9. This section shall not apply to full-time or part-time instructors of the department of commerce and insurance.

§8-50-119 Tennessee Public Safety Behavioral Health Act
  1. This section shall be known and may be cited as the "Tennessee Public Safety Behavioral Health Act."
  2. As used in this section:
    1. "Mental health service provider" means a person who:
        1. Is licensed as:
          1. A professional counselor designated as a mental health service provider under title 63, chapter 22, part 1;
          2. A licensed clinical social worker under title 63, chapter 23;
          3. A psychiatric mental health nurse practitioner under title 63, chapter 7; or
          4. A licensed marital and family therapist under title 63, chapter 22;
        2. Is in good standing with:
          1. The board for professional counselors, marital and family therapists, and clinical pastoral therapists;
          2. The board of nursing; or
          3. The board of social worker licensure;
        3. Has successfully completed education and training in at least one (1) trauma therapy and can provide evidence of successful completion to a public safety employer; and
        4. Has a minimum of two (2) years of post-licensure work experience working with trauma patients; or
      1. Is licensed in good standing as a:
        1. Physician licensed under title 63, chapter 6 or 9;
        2. Psychological examiner licensed under § 63-11 201(a)(1);
        3. Senior psychological examiner licensed under § 63-11-201(a)(2); or
        4. Psychologist licensed under § 63-11-201(a)(3);
    2. "Post traumatic stress disorder" or "PTSD" has the same meaning as defined in the most recent publication of the Diagnostic and Statistical Manual of Mental Disorders;
    3. "Public safety employee" means an emergency medical worker or professional firefighter who is a paid, full-time employee of a public safety employer;
    4. "Public safety employer" means this state, a local government, or any other political subdivision of this state that employs public safety employees on a full-time basis; and
    5. "Trauma therapy" means, with respect to victims of trauma, at least one (1) of the following evidence-based trauma treatment practices: trauma focused cognitive behavior therapy, exposure therapy, stress inoculation therapy, or eye movement desensitization reprocessing.
  3. Public safety employers shall:
    1. In addition to any other behavioral or mental health benefits offered, provide not less than ten (10) visits or sessions with a mental health service provider for the purpose of treating PTSD through the employee's health benefits or otherwise. Public safety employers may require a co-pay or co-insurance for these visits that is no more than co-pays or co-insurance for other health benefits offered by the employer;
    2. Promote the use of a mental health service provider and other behavioral health professionals to public safety employees;
    3. Establish, in conjunction with a mental health service provider, support programs in an effort to mitigate behavioral health issues within the public safety employee community; and
    4. Maintain, and regularly provide public safety employees with, at a minimum of once per year, a list of mental health service providers who are qualified to provide trauma therapy under this section.
  4. Public safety employers shall not engage in the retaliatory treatment of public safety employees seeking or utilizing mental health service providers or behavioral health programs, including, but not limited to, discharge, denial of promotions, punitive work assignments, transfers, or other similar retaliatory actions.
    1. At a minimum of once per year, a mental health service provider providing services to public safety employees shall participate in training, within the jurisdiction in which the public safety employees work, that familiarizes the provider with the unique problems associated with each public safety profession lifestyle, including, but not limited to, critical incident response training, critical incident stress management, field exercises such as ride-alongs and visits to fire and emergency medical services (EMS) stations, and similarly appropriate training.
    2. This subsection (e) does not apply to a mental health service provider described in subdivision (b)(1)(B).
  5. Any benefits offered and provided for by this section do not apply to workers' compensation plans under title 50.


SECTION 2. This act shall take effect July 1, 2018, the public welfare requiring it.