Workers’ Compensation: General Terms You Should Know

Getting injured at work or being diagnosed with an occupational disease may be an awful and unpleasant experience. Amidst such a distressing situation, encountering numerous confusing jargon and abbreviations utilized during the workers’ compensation claim process can make the experience more overwhelming. However, workers’ compensation is vital for safeguarding employee rights and securing workplace safety. Thus, understanding the fundamental phrases used in workers’ compensation is critical for companies and employees. So, to help you facilitate this complex process, we have mentioned below a list of general terms related to workers’ compensation, emphasizing their meanings and significance. Let’s dive in!

Common Abbreviations You Need to Know

• Workers’ Compensation

Workers’ compensation is a type of insurance providing wage replacement and medical benefits to employees who suffer an injury or illness while on the job. This system offers the comprehensive support they need to recover and resume their duties. Moreover, it protects both employers and employees by offering a streamlined process for addressing workplace injuries.

If you experience on-the-job injuries, it’s best to seek assistance from a workers compensation attorney in Reno to help you navigate the system and stay in the loop with updates in your case.

• Claimant

The claimant is the wounded employee who submits a workers’ compensation claim to obtain benefits. This individual plays a critical role in the claims procedure.

• Average Weekly Wage (AWW)

The weekly compensation of an employee is often computed by dividing their annual profits by 52. This amount, known as AWW, is used to establish the claimant’s temporary disability compensation.

• Independent Medical Examination (IME)

An IME is an assessment performed by a healthcare expert not involved in the claimant’s treatment. Insurance companies typically demand IMEs to assess the severity of injuries and establish reasonable reimbursement.

• Permanent Partial Disability (PPD)

A condition known as PPD can result in a permanent disability that doesn’t hinder an employee from returning to work but does leave them with a long-term impairment. It makes an employee eligible for partial disability benefits. However, compensation for PPD usually depends on the severity of the disability.

• Impairment Rating (PPD)

If a doctor treating an injured worker concludes that the injury occurred at the workplace and led to a permanent impairment, the disability will be classified as an IR. This rating can affect judgments about the worker’s compensation and eligibility for benefits for a given period.

• Controverted Claim

When a workers’ compensation insurance provider opposes a claim for a specific reason, it is called a controverted claim. In such instances, the concerned parties are mandated to appear at a pre-hearing to present evidence and arguments before a workers’ compensation judge, intending to get a fair judgment.

• Compensable Injury

A compensable injury refers to an injury qualified for compensation under workers’ compensation legislation. Additionally, it is critical to understand what defines a compensable injury before filing a claim, as not all injuries may qualify.

• Occupational Diseases

An occupational illness is a health problem triggered by direct exposure to certain job dangers or circumstances. This phrase refers to long-term health conditions such as respiratory problems or persistent stress injuries.

• Maximum Medical Examination (MME)

The term MMI refers to the point at which your injury has been treated to the maximum degree possible with medical assistance. Once you achieve MMI, your doctor will determine whether or not you have a permanent handicap.

How to Apply for Workers’ Compensation

Workers’ comp claim procedure typically entails a series of actions intended to guarantee that injured workers receive the benefits they rightfully deserve. However, while the process may differ based on the jurisdiction, there’s a general method for applying for workers’ compensation, listed below:

• Report the Injury

When an accident happens on the job, the foremost step is to notify your employer immediately. Since many jurisdictions stipulate time constraints for reporting occupational accidents, it’s imperative to inform your employer as soon as feasible.

• Seek Medical Attention

Get medical care for your injuries. Sometimes, your employer may have assigned a medical practitioner for workers’ compensation claims. So, ascertain that you comply with all the recommendations offered by your employer or workers’ comp insurance provider.

• Complete a Claim Form

Your employer or workers’ compensation insurance company will give you a claim form. This form generally requests that you submit information regarding the injury, the accompanying circumstances, and any medical care obtained. Ensure to fill out the form precisely and carefully. You may seek professional and knowledgeable assistance from a personal injury attorney in Reno who specializes in handling on-the-job injuries to offer comprehensive support throughout the process.

• Submit the Form

Now, submit the filled form to your employer or the workers’ compensation insurance provider. Remember to keep a copy for your records. Some jurisdictions may have specified submission dates, so be aware of any time limits.

• Employer’s Report

Your employer is obligated to file a report with the workers’ compensation insurance provider, highlighting the details of the injury and the events surrounding it. This report aids in the initialization of the claims procedure.

• Claim Review

Your workers’ compensation insurance insurer will review your claim. During the inspection, they may scrutinize the circumstances leading to the injury and seek more information from you, your employer, or medical providers.

• Decision on the Claim

The workers’ compensation insurance provider will decide your claim based on the facts submitted. This decision may include approving or refusing benefits. The nature and scope of benefits will be determined if your claim is accepted.

• Appeal Process (If Necessary)

If your claim is refused or you disagree with the decision, you may have the option to appeal. The appeals procedure varies by jurisdiction, but it usually includes presenting new evidence, attending hearings, or mediation.

• Receive Benefits

You’ll start receiving workers’ compensation payments if your claim is granted. These benefits may include medical expenditures, pay replacement, vocational rehabilitation, and other relevant benefits.

• Resume Work

Once you are back to normal, your healthcare professional may allow you to return to work. Your employer may make concessions for any job restrictions caused by your injury.

The Bottom Line

Workers’ compensation plays a pivotal role in ensuring the well-being of employees in the event of on-the-job injuries. Acquainting yourself with the glossary of workers’ compensation terms can aid businesses and employees in maneuvering the complex realm of workers’ comp more successfully and with less hassle. Engage an experienced and reliable personal injury attorney who has also handled job injuries to obtain the reasonable compensation you are entitled to. So, safeguard your rights and seek justice with the comprehensive support of a worker’s comp attorney.