Workers’ Compensation Alphabet Soup

Workers’ Compensation Alphabet Soup

If you’ve been injured at work, chances are you’re learning a new language full of acronyms you’ve never heard before. So, what does it all mean?

DOI: Date of Injury. While an injury can occur in a single event, Injured Workers may suffer from repetitive use or latent injuries, which can complicate when notice of an injury must be given to an Employer, since typically written notice must be given within 15 days of the date of an injury.

HCP: In the state of New Mexico, the Employer has the right to make the initial selection of authorized Health Care Provider. However, chances are, your Employer may have directed you to treat with a particular medical provider, like Concentra, even though you’ve received a letter “giving” you the right to make the initial selection of authorized Health Care Provider. This ruse defeats the concept of choice. Worse still, if you treat with a medical provider who is not an authorized Health Care Provider, then the records of your medical treatment may not be admissible at trial. 

AWW: Average Weekly Wage is determined by calculating gross wages over the 6 months prior to DOI.

TTD: If you’re unable to work because of a workplace accident, and you’ve not yet reached Maximum Medical Improvement, then you should receive weekly Temporary Total Disability benefits equal to 2/3 of your pre-injury Average Weekly Wage. 

MMI: Maximum Medical Improvement does not mean that an Injured Worker has been restored to their previous condition, prior to the workplace accident. Rather, MMI simply means that an Injured Worker has reached a stable condition, or plateau, in their medical treatment, beyond which no significant improvement is expected, to a reasonable degree of medical probability. 

IR: Impairment Rating is the percentage of permanent disability, as determined by an Injured Worker’s authorized Health Care Provider or in an Independent Medical Examination, upon an Injured Worker reaching Maximum Medical Improvement. A permanent Impairment Rating should be based on an accurate assessment your medical condition, based on the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment. 

PPD: An Injured Worker is entitled to Permanent Partial Disability modifier benefits upon reaching Maximum Medical Improvement. The type and amount of PPD benefits to which you are entitled depends on the body part(s) affected and the nature of the injuries, as well as a host of other factors, including your age, level of education, job training, whether your employer has offered you post-injury employment, and your post-injury, permanent work restrictions or safe lifting capacity. If you have a Whole Person Injury, or injuries, and your Employer has not made an offer of employment at or above your pre-injury Average Weekly Wage, the Permanent Partial Disability benefits to which you are entitled are expressed as a formula. Contact Lueker Law, LLC, to estimate the Permanent Partial Disability formula modifier benefits to which you’re owed. 

LOU: Loss of Use benefits are available for Injured Worker’s with Scheduled Injury claims, i.e., injuries to an extremity or multiple extremities. Upon reaching Maximum Medical Improvement, an Injured Worker with a Loss of Use claim is entitled to a specific number of weeks of indemnity benefits, depending on which part of their body was injured. 

WPI: A Whole Person Injury is any injury to the head, shoulders, neck, torso, and hips. Injured Workers with whole person injuries are entitled to different indemnity, or monetary, benefits than Injured Worker’s with Scheduled Injury claims, for Loss of Use. 

FCE: Upon reaching Maximum Medical Improvement, an Injured Worker is often sent to Functional Capacity Evaluation to determine their permanent work restrictions. Like an IME, an FCE is not performed by a treating provider. Additionally, the FCE has built in tests designed to indicate if an Injured Worker is or is not giving their full, maximum effort. If you’re scheduled for an FCE, there are things you will want to know before you go. 

IME: An Independent Medical Examinations is a medical records review and/or physical examination performed by a physician or a medical provider who is not the Injured Worker’s regular treating provider, or authorized Health Care Provider. There is no doctor-patient relationship, or privilege, that attaches to such examinations. Unless the parties to a Workers’ Compensation case agree to an IME, a Workers’ Compensation Judge must approve the IME, upon application from either the Worker or the Employer/Insurer. IMEs are conducted where the cause of an injury, the nature and extent of injuries, and/or reasonable, necessary, and causally related medical treatment are disputed or unclear. 

Call Lueker Law, LLC, today. We’ll spell it out for you.