Workers’ compensation is a form of insurance for employees. This coverage provides wage replacement and medical benefits to employees injured in the course of employment in exchange for the employee’s right to sue their employer for negligence. When involved in a case dealing with workers’ compensation, there are many confusing terms. Here are just a few to know if you are dealing with a workers’ compensation claim.
Arising out of and in the course of employment (AOE/COE): Two necessary conditions that must be met to establish a work-connected accidental injury; an injury that “arises out of” is one that results from a hazard of the employment, while an injury “in the course of employment” is one that occurred at a time, place and under circumstances related to the employment.
Average Weekly Wage: The average wage of an employee, according to the worker’s compensation laws.
Beneficiary: An injured worker’s spouse, domestic partner, child, or dependent entitled to receive payments, in the event of death of the injured worker.
Claim: A written request by the worker, or on the worker’s behalf, for compensation.
Cumulative injury: An injury caused by repeated events or repeated exposures at work.
Deferred claim: A claim not yet accepted or denied by the insurance company or self-insured employer.
Deputy Commissioner: An employee of the Industrial Commission who makes decisions about workers’ compensation disputes and approves settlements.
Ergonomics: The study of how to improve the fit between the physical demands of the workplace and the employees who perform the work.
Family and Medical Leave Act (FMLA): A federal law that provides certain employees with serious health problems or who need to care for a child or other family member with up to 12 weeks of unpaid, job-protected leave per year.
HIPAA (Health Insurance Portability and Accountability Act): A federal law that ensures the privacy and security of protected health information and patients’ access to their health-care records.
Non-disabling claim: A worker’s compensation claim that does not result in time-loss or permanent disability, but requires only medical treatment.
Occupational disease: A disease or infection, arising out of and occurring in the course and scope of employment.
Occupational Safety and Health Administration (OSHA): The federal agency that oversees workplace safety and health in federal offices and in states without state OSHA programs.
Regular work: The job the worker held at the time of injury or a substantially similar job.
Settlement: An agreement between a worker and the insurance company about workers’ compensation payments and future medical care.
Suspension of benefits: An interruption of payment of benefits to an injured worker.
Temporary Total Disability: The amount of weekly compensation payments paid to a worker who cannot work because of a work-related injury.
Worksite modification: The changes made to an injured worker’s job, tools, tasks, or worksite to accommodate the worker’s injury-caused limitations.
Contact us today if you have any questions about workers’ compensation.
Oliver and Sherrie M. – Car Accident
“We were hit head-on by someone who run a red light. I got bruised up real bad inside and I had just had shoulder surgery and it inflamed that. My wife was hurt the worst. It disfigured her right arm. We were referred to Mr. West through our son-in-law so we went up and set an appointment with him. We went in and met him for the first time and he is a very nice gentleman to say the least. He took over the case and found out who the [driver] was. It had totaled the car and I had just gotten it paid off. They didn’t even get hurt. Mr. West took the case and went way out of his way to help. The lady who hit us … they had only the cheapest insurance to get the car on the road … so he helped us get more money to help us pay the bills. We are very happy with how it turned out. Kelly and West, they’re good people. You can talk to them and they’re down home people.”