I had a unpaid collection from 2003 all of the sudden crop up on my EQ report.

I'm wondering which way would be the best to attack this....

Should I pay it with the HIPPA Insert A letter to the OC.... or should I dispute it based on SOL (this thing is almost 6 years old and in TN the SOL is 3 years on open accounts). I am not sure if this would be considered an open account though.

I would double check your SOL. A quick google search kept saying in multiple sites that the SOL on open accounts is 6 years in TN.

I got that off of Why Chat's web site:

Tennessee STATUTE OF LIMITATIONS (IN YEARS)

Open Acct.: 3

Written Contract: 6

Domestic Judgment: 10

Foreign Judgment: 10

Opt out
http://whychat.5u.com/OPTOUTINST.HTML
Delete old addresses, if possible

Send any CRA where this has "cropped up" the dispute letter

http://whychat.5u.com/hipaadisp.html

If verified, send the reporting CA this
http://whychat.5u.com/ltrcavalhipaa.html
And follow up with this

http://whychat.5u.com/ltrcavalhipaa.html#DISPUTE
You are being scammed by a "garbage" CA who obtained your data from a data miner, have you recently applied for a mortgage??

Yes. About 3 weeks ago.

UPDATE: Equifax deleted this today!!!!!! Thanks again Why Chat!

Awesome, congrats!