If you have ever had the chance to review an adjuster's notes, you probably think they are written is some sort of foreign code. There are fragments of words and abbreviations all over the place, and for someone not in the business it can be hard to make sense of it all.
Every company has its own way of documenting, but below are some of the more common adjuster abbreviations, what they stand for, and, most importantly, what they mean in regard to a file. To add to the confusion some abbreviations mean one thing to one adjuster, and another thing to another adjuster. But typically the abbreviations below have a global meaning applicable in all claim cases.(WCxKit)
OTC — Over the counter. This applies to mentioning medications you can purchase without a prescription. Example — Claimant is taking OTC meds for condition.
RTW — Return to work. This is when the claimant is back to work. Example — Claimant RTW 8/4/11.
LOEC — Loss of earning capacity. This applies in litigated cases when a claimant is alleging that the injury has affected their ability to make a wage they were making at the time of the injury. Example — Claimant is alleging LOEC as part of their case against the employer.
R/C — Rotator cuff. This is part of the internal structure of the shoulder. Example — He injured his r/c lifting a box over his head.
LD — Light Duty. This is when a claimant is working in your light duty program. Example — he RTW LD on 8/4/11.
FD — Full duty. When claimant returns back to work with no medical restrictions. Example — he RTW FD 8/4/11.
AC — Acromioclavicular joint. Part of the internal structure in the shoulder. Example — she strained her AC joint lifting a tote of parts.
COE — Course of employment. Adjusters use this to say someone was doing something that was part of their normal job duties. Example — she was injured in COE on 8/4/11.
L/S — Lumbar spine. The lower part of your back. Example — he strained his L/S while mopping the floor.
L/Radic — Lumbar radiculopathy. This means the claimant has low back pain with associated pain/numbness going down one or both of their legs. Example — the EMG test shows the patient to have L/radic into his left leg.
AWW — Average weekly wage. This is a term used for calculating the work comp rate for a claimant. Example — His AWW is $500/week.
Deg — Degenerative changes. Adjusters use this to indicate non-occupational age related changes usually seen on an X-ray or MRI, Example — She has deg changes of her L/S per the X-ray report.
Clmt — Claimant. This is the person injured. Example — the clmt was injured 8/4/11.
Insd — Insured. This is the insured party or employer. Example — The insd is Chrysler automotive.
SLR — straight leg raise. This is a medical examination test to show if a person has radicular symptoms in their legs with pain in their back, typically associated with a lumbar disc herniation. Example — The SLR was negative for pain.
Neg — negative. This means what test the doctor performed was negative. Example — the MRI was neg for a disc herniation.
ROM — Range of motion. This shows the doctor how far the claimant can bend or move a certain body part. Example — her ROM was full with all motions.
L/t — Lost time. This means the worker is not working and accumulating wage loss. Example — He became L/t on 8/4/11.
R/t — referral to. This is when the doctor sends the claimant to another physician, usually a specialty doctor in the field of their expertise, such as orthopedics, hand surgery, etc. Example — he was given a r/t a hand surgery doc.
C/S — course and scope. This points to the worker doing something they do as part of their job duties. Example — He was injured in the c/s of his work.
Ax — accident. This refers to what the person was doing at the time they were hurt. Example — the ax occurred on 8/4/11.
Sx — surgery or symptoms. This meaning will depend on the adjuster or nurse. Example — His sx (surgery) is on 8/4/11, or, Her sx (symptoms) include pain, numbness and weakness in the left leg.
MVA — motor vehicle accident. Usually used when someone is injured in an automobile. Example — the MVA occurred when the claimant crashed into the other vehicle.
OV — other vehicle. Again used when describing an auto accident. Example — Our insd struck the OV on the driver's side door.
C/b — called back. Adjusters use this in their notes when returning a call. Example — I c/b the doctor and left a message.
L/m — left message. When you leave a voicemail for the person you are calling. Example — I tried to call the employee and l/m for c/b.
LMOM — left message on machine. When you leave a voicemail for someone. Example — I called the attorney and LMOM for c/b.
S/c — subjective complaints. This is when the doctor lists the complaints the claimant has before an examination is done, Example — the s/c include pain with bending, and tenderness.
Atty — attorney. Use when referring to an attorney. Example — The atty on file is Joe Smith.
PA — plaintiff attorney. Used when referring to the claimant's attorney. Example — The PA is Joe Blow.
DA — Defense attorney. This is the attorney that represents the insurance company. Example — the DA is Bill Plumber.
ALJ — Administrative Law judge. This is the judge that may hear work comp cases for a certain jurisdiction. Example — The ALJ for this case is Fenkell.
Sbro — Subrogation Dept. This dept pursues subrogation for an injury that may have occurred due to a faulty piece of equipment. Example — I have assigned Sbro to review the file.
Cov — Coverage. This points to insurance policy coverage for an insurance company. Example — We do have cov for this file.
DDD — degenerative disc disease. This is what doctors refer to when they indicate multiple levels of arthritis shown on an X-ray or MRI test. Example — The MRI showed multiple levels of DDD in the lumbar spine.
Juris — Jurisdiction. This is the state or city that the claim case is in. Example — The Juris is WI.
DOI — date of Injury. This is the date that the injury occurred on. Example — The DOI was 8/4/11.
DOL — date of Loss. Same as DOI.
FROI — First report of injury. This is the State form the employer completes when submitting an injury claim to their carrier. Example — the FROI indicates a DOI on 8/4/11.
C/o — complains of. This is what the injured party is saying they injured or symptoms they have. Example — The worker c/o back pain and spasm.(WCxKit)
This list can go on and on. If you become familiar with these abbreviations, you will be able to decipher adjuster notes on the file you may be looking at. Remember every company is different, but the abbreviations listed above are fairly common and used throughout the insurance industry.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
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