Workers’ Compensation Vocabulary: A Worker’s Essential Glossary

                               

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We were curious as to what AI would think are the key words workers need to know when it comes to AI. Here's what it told us.

Understanding these terms can help injured workers navigate a workers' compensation claim with greater confidence.

A

Accepted Claim

A workers' compensation claim that the insurance company has approved for benefits.

Adjuster

The insurance professional who investigates and manages a workers' compensation claim.

Average Weekly Wage (AWW)

The amount a worker earned before the injury. This figure is commonly used to calculate wage replacement benefits.

B

Benefit

Any payment or service provided through workers' compensation, such as medical treatment or lost-wage compensation.

Burden of Proof

The requirement that a worker provide sufficient evidence showing that an injury or illness is work-related.

C

Claim

A formal request for workers' compensation benefits after a workplace injury or occupational illness.

Compensable Injury

An injury or illness that qualifies for workers' compensation benefits under state law.

Compensation Rate

The amount of weekly wage replacement benefits an injured worker receives.

Controverted Claim

A claim that the employer or insurer disputes.

D

Denied Claim

A claim that the insurer has rejected, usually because it disputes work-relatedness, medical evidence, or coverage.

Disability

A loss of earning capacity resulting from a workplace injury or illness.

E

Exclusive Remedy

The legal principle that workers' compensation is generally the sole remedy against an employer for a work-related injury.

Employer's First Report of Injury (FROI)

The form submitted to report a workplace injury to the workers' compensation insurer and state agency.

I

Independent Medical Examination (IME)

An examination performed by a physician selected by the employer or insurer to evaluate the worker's condition.

Indemnity Benefits

Payments made to compensate for lost wages resulting from a workplace injury.

L

Light Duty

Modified work that accommodates an injured worker's medical restrictions.

Lost Time Claim

A claim involving missed workdays because of a workplace injury or illness.

M

Maximum Medical Improvement (MMI)

The point at which additional medical treatment is not expected to substantially improve the worker's condition.

Medical Benefits

Treatment expenses covered by workers' compensation, including doctor visits, surgery, prescriptions, therapy, and medical equipment.

N

Notice of Injury

The notification an injured worker provides to the employer regarding a workplace injury.

O

Occupational Disease

An illness caused or aggravated by workplace conditions or exposures over time.

P

Permanent Partial Disability (PPD)

A permanent impairment that partially limits a worker's ability to function or earn wages.

Permanent Total Disability (PTD)

A permanent condition preventing a worker from performing gainful employment.

Preferred Provider

A physician or medical facility authorized by the workers' compensation insurer or employer.

R

Return to Work

The process of resuming employment after a work-related injury.

Restricted Duty

Work performed under medical limitations imposed by a treating physician.

S

Settlement

An agreement resolving some or all aspects of a workers' compensation claim.

Statute of Limitations

The legal deadline for reporting an injury or filing a workers' compensation claim.

Subrogation

The insurer's right to recover benefits paid when another party is responsible for the worker's injury.

T

Temporary Partial Disability (TPD)

Benefits paid when an injured worker can work but earns less than before the injury.

Temporary Total Disability (TTD)

Benefits paid when a worker is temporarily unable to work because of a workplace injury.

Third-Party Claim

A lawsuit against someone other than the employer who may have caused the injury, such as a contractor, manufacturer, or negligent driver.

Treating Physician

The doctor primarily responsible for the worker's medical care.

W

Workers' Compensation

A no-fault insurance system that provides medical and wage-loss benefits to employees injured on the job.

Work-Related Injury

An injury arising out of and in the course of employment.

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Top 10 Terms Every Injured Worker Should Know

1. Workers' Compensation
2. Claim
3. Adjuster
4. Average Weekly Wage (AWW)
5. Temporary Total Disability (TTD)
6. Light Duty
7. Independent Medical Examination (IME)
8. Maximum Medical Improvement (MMI)
9. Permanent Partial Disability (PPD)
10. Settlement

Quick Tip: If an injured worker understands these ten terms, the worker will be able to follow most conversations with doctors, claims adjusters, employers, attorneys, and workers' compensation judges.