Being injured on the job can have a devastating impact on your life and ability to support your family. At the Law Office of Matthew C. Hines, we want to ensure you understand these terms so you can better understand the legal process.
Here, you will find some of the most common terms you will likely see when filing a workers’ compensation claim. Contact us if you have more questions or need help with your situation. We have a team of experienced and reputable workers comp attorneys and support staff to help ensure you receive the benefits you are entitled to.
Workers’ Compensation Terms
Let’s dive into the most common workers’ compensation-related terms and legal jargon you will hear when filing a claim.
Admitted or Accepted Claim
An admitted or accepted workers’ compensation claim is one that a claims administrator confirms. This means they have agreed that the worker’s illness or injury is covered by this insurance.
While having a claim accepted is a good first step, it doesn’t mean there won’t be issues. Several factors can lead to case delays and other issues in any workers’ compensation claim.
Average Daily Wage (ADW)
The ADW is the calculation of the average daily earnings of an injured worker. Sometimes, the figure is implemented to figure out if the individual should receive benefits for lost wages.
The average daily wage is a figure commonly used in situations where the average weekly wage (AWW) would not accurately represent the worker’s total earnings.
Average Weekly Wage (AWW)
The AWW is another method used to determine workers’ compensation wage loss benefits. With this, a worker’s average earnings, per week, for a specific amount of time are determined. At this point, wage loss benefits are computed based on the AWW.
Agreed Medical Evaluation (AME)
A doctor is chosen by the attorney for the injured worker and the workers’ compensation claims adjuster. The doctor is tasked with conducting a comprehensive medical examination and preparing the report to help resolve disputes that may arise during the claims process.
This refers to a new job with your employer. Your doctor may state that you can’t return to the same job you had when you were injured. They may recommend that your employer offer you alternative work rather than vocational rehabilitation benefits or supplemental job displacement benefits.
The recommended alternative work must comply with your work restrictions, last for a minimum of 12 months, pay at least 85% of the wages and benefits you received when your injury occurred, and be within a reasonable commuting distance from your residence when you sustained the at-work injury.
Americans with Disabilities Act (ADA)
This is a federal law that prohibits any discrimination against anyone with a disability. If a worker believes they have been discriminated against while working because of a disability, they can exercise their rights under the ADA.
Independent Medical Examination
Sometimes, employers or insurance companies may request that an injured worker see a physician to objectively evaluate their health. Initially, an injured worker may seek treatment from the company physician or a doctor they choose.
However, if a dispute or concern arises over an employee’s injuries or how severe they are (or if they actually exist), the insurer can require an IME with a doctor it chooses.
This method determines how much permanent disability benefits a worker should receive for their on-the-job injury and how much is caused by other disabilities.
A rating of the loss of normal use for injured body parts. These are determined by the guidelines published by the AMA (American Medical Association). Impairment ratings are used for calculating your permanent disability rating; however, it is unique from the permanent disability rating.
Temporary Disability (TD)
An injured worker can receive temporary disability benefits if their doctor verifies that the injured worker can’t return to work due to a work-caused injury or illness.
You won’t receive TD benefits for the initial three days of work you miss unless you are away from work for over 14 days or hospitalized. The total TD compensation you receive is two-thirds of your average wages. Payments are made every two weeks if the worker remains eligible. The benefits are ended if you go back to work or if you are released by your doctor because you reached maximum medical improvement.
Temporary Total Disability (TTD)
If an employee sustains injuries that leave them completely unable to work, then TTD benefits may be available. The benefits will end if an employee can return to work. If an employee is cleared to return to work at a wage reduction or partial hours, they may receive some TPD benefits after getting TDD benefits.
Temporary Partial Disability (TPD)
These benefits are payable to injured employees who can work even though they were injured. They are just paid at a reduced rate. TPD benefits are only available for a set amount of time, recognizing that the employee will be fully recovered at some point and able to return to full-time work without any wage reduction.
Statewide Average Weekly Wage (SAWW)
The statewide average weekly wage is a calculation of the average wages workers in a jurisdiction receive for a certain amount of time. It’s often used to determine the maximum and minimum worker compensation benefits an injured worker can receive.
Wrongful Termination (WT)
If a worker is terminated because an employee retaliates after they file a workers’ compensation claim, it is called wrongful termination. If an employee believes their employer did this, they can file a claim.
Vocational Rehabilitation (VR)
This is a type of workers’ compensation benefit. If you are injured and unable to return to your former job and your employer doesn’t provide other work options, you may qualify for VR benefits. With VR benefits, you receive job placement counseling, which helps you find and secure another job. It often includes retraining for your future position.
Suitable, Gainful Employment
Self-employment or any other type of employment that is considered attainable and that provides the chance for an injured worker to achieve maximum self-support (or as close to it as possible).
Permanent Partial Disability (PPD)
These benefits are paid to employees who sustain permanent but not total disability. The benefits usually apply to certain parts of the body or specific conditions.
Permanent Total Disability (PTD)
Employees can receive PTD benefits if they are totally and permanently disabled. This is something the individual’s doctor will determine.
Don’t Wait to Hire an Attorney for Help with Your Workers’ Compensation Claim
If you are injured on the job, it’s recommended that you hire an experienced and reputable workers’ compensation attorney. At the Law Offices of Matthew C. Hines, we are ready to help you with your claim and ensure you receive the benefits you are entitled to.
The first step is to contact our office to schedule a free initial consultation. We will fight for your rights and work to ensure you have the best chance of a full recovery.