If you are pursuing a workers’ compensation claim, you’ll likely encounter unclear terminology and legal jargon along the way. At Dyer Law, we work to cut through the confusion for our clients and make the claims process as straightforward as possible. To simplify the legal lingo, we’ve compiled a glossary of commonly used words and phrases to reference while navigating your workers’ comp case.
A
Accepted/Admitted Claim
A claim in which the insurance company accepts or agrees that your injury or illness will be covered by workers’ compensation.
AOE/COE
An injury “arising out of employment” (AOE) or that happened during the “course of employment” (COE) may be protected under the Nebraska Workers’ Compensation Act.
Average Weekly Wage (AWW)
The injured employee’s average weekly earnings prior to the injury. In order to determine the average weekly wage, you typically calculate how much the injured worker earned during the 26 weeks prior to the date of the accident and average it on a weekly basis. The proper calculation of the average weekly wage is extremely important to your claim! An incorrect calculation of this number can result in thousands of your dollars being put back into the insurance company’s pocket.
C
Claims Adjuster/Administrator
A professional assigned to manage a workers’ compensation claim on behalf of the insurance company.
Compensation Rate
The compensation rate is two thirds of the injured employee’s average weekly wage.
D
Date of Injury (DOI)
The date an employee suffered a work-related injury.
Death Benefits
Benefits, such as funeral cost reimbursement, that an employee’s dependents may be entitled to if said employee suffers a fatal work-related injury.
Denied Claim
A claim in which the insurance company or employer does not accept or believe that they have a responsibility to provide compensation for your injuries.
F
Form 50
A document created by the Workers’ Compensation Court intended to advise clients of their rights to treat with their family doctor and to facilitate the changing of doctors. The document is entitled “Notice of Employee’s Right to Choose a Doctor.”
H
Hearing
A court proceeding that is intended to resolve an issue between the parties.
I
Impairment Rating
A percentage amount assigned to an injured body part by a medical practitioner. The percentage amount is intended to determine the number of weeks the injured worker is entitled to compensation.
Indemnity Payments
Monetary benefits (either temporary or permanent) meant to compensate an employee for losses due to their work-related injury.
Independent Contractor
An employment designation that makes a laborer ineligible for workers’ compensation benefits under the Nebraska Workers’ Compensation Act. The term “independent contractor” is loosely defined in Nebraska’s legislation, so determinations are made on a case-by-case basis using prior case law and a ten-factor test.
Independent Medical Examination
A medical exam performed by a physician who was either agreed upon by the plaintiff and the defendant or assigned by the court. During this examination, the physician will review the injured employee’s provided medical records, make their own assessment of the claimant’s condition, and compile a report with their findings.
L
Loss of Earning Power Evaluation (LOEP/LOEC)
An evaluation performed by a vocational rehabilitation counselor to determine an injured worker’s percentage of earning power lost related to an injury that impacts the whole body where there are permanent physical restrictions.
M
Managed Care Plan
A plan certified by the court that provides for the delivery and management of treatment to injured employees.
Maximum Medical Improvement (MMI)
Once it is unlikely that the injured employee’s condition will change or improve with or without further medical treatment, an “MMI” date is determined. Maximum medical improvement is determined by a physician. Usually, when the injured employee reaches maximum medical improvement, he/she is released from their doctor’s care.
Modified/Light-Duty Work
Temporary employment offered by the employer to the injured employee while they are on restricted duty by a physician.
O
Occupational Disease
An illness or injury, whether physical or mental, that occurs as a result of causes or conditions that are peculiar to a particular trade, occupation, process, or employment and are not ordinary diseases of life to which the general public is also exposed. If the disease is a mental disease, in order for it to be covered under workers’ compensation, the employee must also have suffered some form of physical injury*.
*First responders and frontline state employees may be eligible for benefits for mental injuries and mental illness unaccompanied by a physical injury.
P
Permanent Partial Disability (PPD)
Benefits are paid for the loss or loss of use of body parts, like a knee or shoulder, calculated using the statutory schedule for that specific body part, the percentage of loss or loss of use and two-thirds of the worker’s average weekly wage.
Permanent Partial Disability—Body As Whole (PPD BAW)
Benefits for “body as a whole” injuries in terms of employability and loss of earning capacity are calculated upon the percentage of loss times two-thirds of the worker’s average weekly wage. These benefits are limited to a maximum of 300 weeks minus the weeks of temporary and permanent disability previously paid.
Preexisting Condition
Describes any disease, injury, or health issue affecting an employee prior to a work-related injury.
R
Return-to-Work Services
Also known as vocational rehabilitation benefits, return-to-work services—such as training, education, and job counseling—are meant to aid injured employees in getting back to work.
S
Settlement
An agreement between an injured employee, their employer, and/or their employer’s insurer, typically in which the employer’s insurer provides the employee with a sum of money to cover injury-related damages and resolve the workers’ compensation claim.
T
Temporary Partial Disability (TPD)
Benefits paid when an injured worker returns to work at less than full duty or for a reduced wage after the injury. The disability payments are two-thirds of the difference between the injured worker’s average weekly wage and those wages earned while working less than full duty after the injury.
Total Disability (TTD/PTD)
Disability compensation provided to the injured employee for his/her inability to work. The disability payments are provided at the employee’s compensation rate. Benefits may be temporary or permanent.
V
Vocational Rehabilitation
If you are permanently unable to do your usual job, and your employer does not offer other suitable employment, you will qualify for this benefit. It may include job placement counseling, retraining/education and indemnity payments while you are participating in an agreed upon and approved plan of rehabilitation.
W
Wrongful Termination/Demotion
Under Nebraska law, if an employer terminates or demotes an employee because that employee is seeking workers’ compensation benefits, then that employee is wrongfully terminated or demoted. The wrongfully terminated or demoted employee may sue the employer for the wrongful act.
To reference a physical glossary of workers’ compensation terminology, and to read more about successfully pursuing your workers’ comp case, request a free copy of our book: 7 Common Mistakes That Can Destroy Your Workers’ Compensation Case. If you’d like to learn more about Dyer Law’s unique approach to workers’ comp, visit our Workers’ Compensation page or call (402) 393-7529 for your free consultation.