Nothing on our site is legal advice. It certainly isn’t intended to be that way. To fit your exact situation, you should contact a worker’s compensation attorney in your area. You can certainly contact us, we’ll be glad to hear from you. We can sit down with you and figure out if there’s a way to help your case. Please, under no circumstances, send us anything confidential. Don’t do that until we’re in an official client-attorney relationship.
That being said, we know that there are some questions about how workers compensation attorneys work. We see it as one of our jobs to educate. We’ve collected a few industry terms that people may not be sure of and listed their definitions below.
AME or Agreed Medical Evaluation: When an injured workers attorney and a claims administrator have a dispute, they can choose to have a doctor try to resolve it. The doctor then would complete a thorough evaluation and then put together a detailed report.
Benefit Structure: When you sustain an injury at work that’s “arising out of and in the course of” your employment, you can receive compensation for it. This structure defines what workers are entitled to receive. There are multiple ways that this compensation can be given to you. Should you have any questions about this term (or really, any others) don’t hesitate to give us a call.
Compensation: we use this term quite a bit. We often use it as a synonym for “reparation.” You’ve been injured or hurt through doing the course of the job, so you deserve to receive this reparation or payment for that.
Cumulative Trauma Injury: these injuries are what they sound like. When you do the same motion over and over again, it can weaken your body. That’s how these injuries occur. Perhaps the most common example of these is Carpal Tunnel Syndrome.
Denied Claim: in this context, it means that you filed a worker’s compensation claim that the claims administrator thought wasn’t covered by workers compensation. Remember: just because this happened, that doesn’t mean you’re out of luck. We’ve helped many to get the compensation they deserve after their claims were initially denied.
Medical Care: for the purposes of workers compensation, this refers to all of the medical treatment that you’ve had to go through on account of your injury. That means everything: if you had to stay in the hospital, your physician, your dental care, any lab work, prescriptions, and x-rays – basically, anything that was ordered by the doctors treating you. When you’re hurt on the job, you’re entitled to receive all of the medical care that’s reasonably required to heal or relieve the ill effects of the injury. To be clear, that’s with no deductible or co-payments on your part.
Mod Work: sometimes, the treating physician says that the worker can’t go back to the job they had after an injury. In replacement of vocational rehabilitation benefits, the employer can offer you a modified job that meets the work restrictions placed by your doctor. This can be a great deal, as it is required to pay the same wages and benefits as your job, plus it has to last for twelve months.
Permanent Disability Benefits: sometimes, a worker is injured at work to the point where they can’t do their job anymore. In fact, it may be difficult for them to compete in an open labor market, period. These benefits can help to make up for that. The extent of the disability determines the amount the injured worker will receive. Quite a few factors go into this: what the injured worker’s job was, how old they were at the time of their injury, even when it happened. These benefit amounts are set by law.
QIW, or Qualified Injured Worker: this is a worker who can’t return to their job the way it was, but is thought to be able to find some kind of suitable job. Often, this is believed to be possible after they’ve gone through their vocational rehabilitation services.
S&W or Serious and Willful Misconduct: should you believe that your at work injury was due to your employer committing serious and willful misconduct, we can help.
TD or Temporary Disability: this is a kind of compensation that’s paid to you if you can’t go to work due to an injury or illness that came about due to your job. Determined by law, these amounts are two-thirds of an employee’s wages.
Settlement: This is an agreement between the claims administrator and the injured worker. It covers the medical care that will be provided to the worker as well as their compensation benefits. This is where we can really shine for our clients. We have a proven track record of getting our clients the settlements that they deserve.
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