Form C-42G Employee's Choice of Physician - Tennessee

Form C-42G Employee's Choice of Physician - Tennessee

What Is Form C-42G?

This is a legal form that was released by the Tennessee Department of Labor and Workforce Development - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form C-42G?
A: Form C-42G is Employee's Choice of Physician form.

Q: What is the purpose of Form C-42G?
A: The purpose of Form C-42G is to allow employees in Tennessee to choose their attending physician for workers' compensation cases.

Q: Who needs to complete Form C-42G?
A: Employees who have sustained a work-related injury or illness in Tennessee and are seeking workers' compensation benefits need to complete Form C-42G.

Q: How should Form C-42G be completed?
A: Form C-42G should be completed by providing your personal information, the date and description of your injury or illness, and the name and contact information of the attending physician you choose.

Q: Can I change my choice of physician after submitting Form C-42G?
A: Yes, you can change your choice of physician by submitting a new Form C-42G to the Tennessee Bureau of Workers' Compensation.

Q: Are there any deadlines for submitting Form C-42G?
A: Yes, Form C-42G must be submitted within 15 days of the date of injury or the date you became aware of your work-related illness.

Q: What should I do if I have questions or need assistance with Form C-42G?
A: If you have questions or need assistance with Form C-42G, you can contact the Tennessee Bureau of Workers' Compensation or consult with an attorney specializing in workers' compensation.

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Form Details:

  • Released on August 1, 2014;
  • The latest edition provided by the Tennessee Department of Labor and Workforce Development;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form C-42G by clicking the link below or browse more documents and templates provided by the Tennessee Department of Labor and Workforce Development.

Download Form C-42G Employee's Choice of Physician - Tennessee

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  • Form C-42G Employees Choice of Physician - Tennessee, Page 1
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