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. |