Certificate of readiness tennessee form 2026

1. Click ‘Get Form’ to open the Certificate of Readiness Tennessee form in the editor.
2. Begin by entering the 'Date of Injury' and the 'Employee’s Social Security Number' in the designated fields. Ensure accuracy as this information is crucial for processing.
3. Indicate whether a Request for Benefit Review Conference was previously filed by filling in the date next to that section.
4. Provide details regarding Maximum Medical Improvement (MMI) by entering the MMI Date and Impairment Rating, along with specifying the affected Body Part.
5. Confirm that all parties have exchanged necessary information and agree on no further discovery. Mark 'Yes' or 'No' for whether the weekly compensation rate has been established.
6. List three agreed-upon dates and times for mediation, circling your preferred time slot.
7. Fill out contact information for all relevant parties, including Employee, Employer, and their respective attorneys. Ensure all fields are completed accurately.
8. Finally, both parties must print their names and provide signatures at the bottom of the form to certify that all information is true.

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