Submit a request – Tennessee Department of Labor and Workforce Development

Click a form below to submit a request.

Your email address

Subject

Description

First name

Last name

Phone number

Employer Name

Last four digits of Social Security Number

Date of Injury

Nature of Dispute

State File Number

Privacy Policy - You must agree to these terms to continue

The privacy, confidence, and trust of individuals who visit the State of Tennessee web site are important to us. No personal information is collected at this site unless it is provided voluntarily by an individual while participating in an activity that asks for the information. The following link discloses the information gathering and usage practices for the web site. (COPY AND PASTE IN YOUR INTERNET BROWSER) https://lwdsupport.tn.gov/hc/en-us/articles/206967957-Privacy-Policy

Attachments

Add file or drop files here