Workers’ Compensation Glossary
Workers’ Compensation cases can seem complicated because of all the unique terms and phrases commonly used by lawyers, adjusters, and judges who handle these claims.
Here is a list of some commonly used Workers’ Compensation terms.
Claimant
An injured worker who has filed a Workers’ Compensation claim.
Respondent
The insurance company responsible for providing Workers’ Compensation benefits on behalf of the employer of the injured worker.
Indemnity benefits
Money benefits paid to the injured worker by the insurance company. These benefits are paid weekly to compensate for lost wages or permanent injury.
Medical benefits
The payment for medical treatment by the insurance company.
Work Status
The level of work an injured person can perform. This must be determined by a doctor.
Temporarily Totally Disabled (T.T.)
This is a work status for an injured person who cannot perform any level of work. In an accepted case, a person who is TT will receive a weekly check.
Temporarily Partially Disabled (T.P.)
This is a work status for an injured person who can work but with some level of restriction. This is frequently referred to as “light duty”. A doctor should specify the level of activity appropriate for the injured person.
Full duty
This is a work status for an injured person who can work without restrictions.
Permanent Partial Disability (P.P.D.)
A percentage of disability to an injured body part. This is assigned by a doctor once the injured person has reached maximum medical improvement.
Maximum Medical Improvement (M.M.I.)
The point at which all reasonable medical treatment has been provided for an injury. This usually coincides with a doctor releasing the patient from care or saying that the patient may follow up as needed.
31-308a
A type of weekly benefit paid to an injured worker who has returned to work but is not earning as much money as before he or she was injured. These benefits must be awarded by a judge. The judge has discretion over the duration and amount of the benefit.
Settlement
Closing a Workers’ Compensation claim in exchange for a one-time lump sum of money. The settlement is calculated by adding up all foreseeable medical and indemnity benefits that may need to be paid to the Claimant. Once the claim is settled, the Respondent will no longer be responsible for any future indemnity benefits or medical treatment. This is also sometimes referred to as a “Full and Final Stipulation”.
Survivor’s benefits
Payment of weekly indemnity benefit to the surviving spouse or dependent children of a Claimant who dies as a result of a work related injury. These benefits are payable to surviving spouse for life (provided he or she does not remarry) and to depended children until the age of 22.
Stipulation to Date
Closing out certain issues in a Workers’ Compensation claim up until a certain point in exchange for a one-time lump sum of money. This is usually used as a way to resolve a disputed issue. For example, the parties may enter into a Stipulation to Date to resolve a dispute about the amount of past indemnity benefits owed. This can be a way to compromise and resolve a dispute issue without needed to resort to a Formal Hearing. A Stipulation to Date does effect the claim after the date of the approved agreement.
Average Weekly Wage (AWW)
The average of your gross wages for one year (52 weeks) prior to your date of injury. This is used to calculate your Workers’ Compensation rate. This average includes bonuses and overtime.
Compensation Rate
The rate of pay at which you will be paid Workers’ Compensation indemnity benefits. This is calculated by using your average weekly wage and your tax filing status for the year in which you are injured. The benefit tables used to calculate compensation rates can be found here.
Respondent’s Medical Examination (RME)
Medical evaluation scheduled by the insurance company (Respondent) with a doctor of its choosing. Insurance companies are allowed to schedule such appointments when they want to challenge a medical opinion relating a work injury or condition, work status, permanency rating or recommended medical treatment.
Commission’s Medical Examination (CME)
Medical evaluation ordered by a Workers’ Compensation judge with a doctor of his or her choosing. This will be scheduled to resolve a difference of opinion between a Claimant’s treating doctor and a Respondent’s Medical Examiner (RME). The judge will usually side with the opinion of the CME to settle the disputed issue or medical question.
Judge (formerly Commissioner)
The decision maker in a Workers’ Compensation claim. Formerly referred to as “Commissioners”, they are now officially judges.
Form 30C
Form that needs to be filed in order to properly start a new Workers’ Compensation claim. It notifies the employer and the Workers’ Compensation Commission of the claim for benefits and certain details about the claim. The document can be found here. This form must be sent via Certified Mail.
Form 30D
Form that needs to be filed in order to properly file a claim for Workers’ Compensation survivor’s benefits. This form can be found here.
Form 36
Form filed by the Respondent to indicate intent to reduce or stop payment of indemnity benefits to the Claimant. The Claimant or Claimant’s lawyer can object to the motion to say why the Claimant’s benefits should not be reduced or stopped.
Form 42
Form that can be sent to a doctor to request a permanency rating.
Informal Hearing
This is the first level of a Workers’ Compensation claim hearings. At an Informal Hearing, the Claimant or lawyers for the Claimant will meet with a lawyer or representative from the insurance company to discuss the status of the case and any disputed issues. The meeting is held before a workers’ compensation judge. It is common for multiple informal hearings to happen over the course of a Workers’ Compensation claim.
Pre-Formal Hearing
This is the intermediary level of Workers’ Compensation hearings. A PreFormal may be scheduled if a dispute about an issue was not resolved at a prior Informal Hearing. At PreFormal Hearings, lawyers and the Workers’ Compensation judge will look to determine if an issue can be resolved or needs to proceed to the next level.
Formal Hearing
This is the Workers’ Compensation equivalent of a trial. At a Formal Hearing, a Workers’ Compensation judge will hear evidence about a disputed issue. Once the hearing has concluded, the judge will issue a written decision deciding the issue.