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Adjustor - an insurance company employee who oversees insurance benefits; a claims examiner.

ALJ (Administrative Law Judge) - a Federal judge who presides over Federal workers' compensation cases.

AME (Agreed Medical-Legal Examination) - a medical-legal examination, performed by a physician who is hired jointly by the applicant's lawyer and the insurance company to write a report which is then usually used to settle a workers' compensation case; applies only to the California state system.

AOE/COE - "arising out-of employment or in the course of employment;" an injury determined to be work related; applies only to the California state system.

Applicant - an injured worker who files a claim or "applies" for benefits (applies only to the California state system).

Apportionment - a legal determination that employment did not cause all of the problems related to an illness or injury (a finding that some other event contributed to the disability).

Causation - the legal determination that employment resulted in (or "caused") an illness or injury.

Claims Examiner - an insurance company employee who oversees insurance benefits; an adjustor.

Constant - under California law describes the frequency of a pain as occurring from 95% to 100% of the time; of "occasional," "intermittent," "frequent," and "constant."

DEU (D isability Evaluation Unit) - a California state office which calculates disability ratings based upon medical reports.

Disability Rating - a numeric percentage (from 1% to 100%) that reflects an injured worker's loss of ability to compete in the labor market; the percent of jobs he/she can no longer do; applies only to the California state system.

Doctor's First Report of Injury - a form completed by a doctor after your first visit; describes the cause of injury, treatment advice, etc.

DWC-1 - a form completed by a patient to report an injury to an employer.

EDD (Employment Development Department) - a California department that provides disability benefits and placement help.

Frequent - under California law describes the frequency of a pain as occurring 75% of the time; of "occasional," "intermittent," "frequent," and "constant."

IME (Independent Medical-Legal Examination) - a medical-legal examination, performed by a physician, who is hired by a lawyer or insurance company; creates a report which can be used to settle a lawsuit or some workers' compensation cases.

Impairment - a numeric percentage (from 1% to 100%) that reflects an injured worker's capacity; applies to the Federal system and some state systems, other than California.

Information and Assistance Officer - a California state official who is available to answer your questions.

LC §4600 - The section of California law section that applies to the rights of injured workers.

Intermittent - under California law describes the frequency of a pain as occurring 50% of the time; of "occasional," "intermittent," "frequent," and "constant."

LTD (Long Term Disability) - a private disability insurance policy that pays when people are unable to work for a "long" period (usually more than three to six months).

Loss of capacity - decreased ability to perform work tasks, one component of the disability rating.

Maximal Medical Improvement - under Federal and some non-California systems, when improvement stops and impairment can be calculated.

Medical-Legal Examination - an examination, performed by a physician, to determine legal issues such as disability.

Minimal - under California law describes the severity of a pain as an annoyance; of "minimal," "slight," "moderate," and "severe."

Moderate - under California law describes the severity of a pain as causing a marked hinderance in performing an activity; of "minimal," "slight," "moderate," and "severe."

Negligence - responsibility; having caused an injury.

Nurse Case Manager - a registered nurse (R.N.), assigned by the lawyer or insurance adjustor, to monitor medical treatments.

Nurse Practitioner - a registered nurse who provides care to patients; usually works with a physician to give care.

Objectives - physical examination abnormalities found by the doctor, one component of the disability rating.

Occasional - under California law describes the frequency of a pain as occurring 25% of the time; of "occasional," "intermittent," "frequent," and "constant."

Panel QME - a medical legal examination by a physician selected by the California WCAB computers.

Physician - under California workers' compensation law this includes medical doctors, osteopaths, chiropractors, and acupuncturists.

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WC Glossary
P&S Permanent and Stationary) - a point in time when problems related to an injury are relatively stable and most treatment has been completed; the time when temporary disability payments stop and permanent disability payments start; the time when the disability rating can be assessed; applies only to the California state system.

PD ( Permanent Disability) - a numeric percentage rating (from 1% to 100%) that reflects an injured worker's loss of ability to compete in the labor market; the percent of jobs he/she can no longer do; applies only to the California state system.

Plaintiff - a person claiming injury in a lawsuit, not workers' compensation.

PR-2 - a form completed by a doctor after each visit; describes the current complaints, examination findings, treatment advice, etc.

PR-3 - a form completed by a doctor after a patient is "permanent and stationary;" describes the "subjectives," "objectives," "loss of capacity," and other disability issues.

PTP (Primary Treating Physician) - the one doctor, usually selected by the injured worker, who is primarily responsible for giving care and reporting to the insurance company; applies only to the California state system.

QME (Qualified Medical-Legal Examination - a medical-legal examination, performed by a State "qualified" physician (who has passed a qualification exam), and who is hired by a lawyer or insurance company, to write a report which can be used to settle a workers' compensation case; the examination may be requested by either the applicant or defense.

QIW (Qualified Injured Worke) - a person injured on the job who cannot go back to their usual work and must either be given either modified work or retrained for a new job; applies only to the California state system.

Sanctions - monetary fines imposed when a party violates the law; applies only to the California state system.

Serious and Willful - applies to an injury caused by an employers failure to follow the law; applies only to the California state system.

Severe - under California law describes the severity of a pain as causing an inability to perform an activity; of "minimal," "slight," "moderate," and "severe."

Slight - under California law describes the severity of a pain as causing some hinderance in performing an activity; of "minimal," "slight," "moderate," and "severe."

Special Report - a report submitted to the insurance company by the doctor when requested by the insurance company or required by law; describes the current complaints, examination findings, treatment advice, etc., or answers specific questions; applies only to the California state system.

State Compensation - a California state program which provides coverage for individuals disabled from work due to problems other than work injuries.

Subjectives - complaints or problems reported by the patient, one component of the disability rating; applies only to the California state system.

Totally and Temporarily Disability (TTD) - the time period when an injured worker must remain off work and also the money paid for the time off; applies only to the California state system.

Usual and Customary - referring to a job; one's ordinary work.

Vocational Counselor - an expert in retraining who helps an injured worker retrain and find a new job.

VR (Vocational Rehabilitation) - the process of retraining an injured worker retrain and helping them find a new job.

Words-of-art - specially defined legal terms.

Work Restrictions - limitations of work activities which are imposed by your doctor.

Workers' Compensation - an insurance system which provides benefits to workers injured on the job.

WCAB (Workers' Compensation Appeals Board) - a group of judges, appointed by the State of California, who review cases and interpret the law.

WCJ (Workers' Compensation Judge) - a California judge who presides over California state workers' compensation cases, including those settled without a trial.

 
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