An injured worker’s guide to common workers’ comp words and phrases
Most injured workers in Arizona first learn of workers’ compensation abbreviations and definitions when discovering different disability benefit categories like permanent partial disability (PPD) or temporary total disability (TTD). The confusing lingo does not end there. Knowing what words and acronyms stand for is helpful when collecting your benefits.
The following glossary contains common acronyms and terms used in workers’ compensation cases both here in Arizona and nationwide.
Workers’ compensation glossary of terms
407 – This is the form number for a worker’s injury report. An injured worker or representative claims benefits by filing this Worker’s Report of Injury form with the Industrial Commission of Arizona (ICA). The completed form includes the injured worker’s employer’s name and address and the accident’s location or address. Omitting that information causes a delay in the process.
Administrative Law Judge (ALJ) – In the U.S, the administrative judge is the trier and judge of facts who adjudicates disputes or claims and presides over trials involving administrative law. The administrative judge is the person who hears appeals if a worker’s claim is denied.
AMA guidelines – These are guides used in the Evaluation of Permanent Impairment since 1958. These principles are the acceptable standard for disability and impairment assessment. With these guides, the AMA strives to provide essential references for healthcare workers charged with evaluating disability and impairment. The latest standard is the 6th edition.
Average Monthly Wage (AMW) – This is the amount a worker generally earns in any given month. AMW includes anything of value an employee receives that constitutes an economic gain.
Arizona Revised Statutes (ARS) – Section 23-1062.01 is the workers’ compensation law for billing. There are certain criteria a healthcare provider must follow to submit a bill to receive payment. It provides timeframes for bill submission and criteria for denying a bill.
Deposition – A workers’ comp deposition is a formal session where a lawyer asks questions of a party who is under oath. It’s the same as testifying at a trial. Insurance carriers frequently depose injured employees.
Industrial Commission of Arizona (ICA) – The commission administers and enforces Arizona laws related to Arizona employees’ welfare, safety, health and lives. It includes child labor, payment of wages, occupational health and safety and workers’ compensation. The Claims Division is not a provider of accounting or legal advice.
Loss of earning capacity – Benefits for loss of earning capacity provide financial assistance to a worker and the worker’s family, and increases a worker’s recovery. The calculation of benefits is the same as benefits for permanent partial disability (PPD).
Labor market consultant – A labor market consultant provides expert reports and testimony, research and consultation in the areas of life care planning, loss of earning capacity and rehabilitation counseling. The consultant evaluates the injured employee’s ability to work and helps find them employment within their physical ability limits.
Maximum Medical Improvement (MMI) – This is the term physicians use to indicate a worker’s injury recovery is as good as it gets. It doesn’t mean the claim is over, nor does it limit a worker’s ability to return to the doctor.
Monthly Status Report Form – When an injured worker is on modified duty by their treating physician, benefits are paid on a 30-day basis (not a 14-day basis like other lost wage benefits). If you return to work and earn the equivalent of your average monthly wage (AMW), then you will not be entitled to benefits. Regardless, you must still report your earnings on this form. If you return to work, but at a lower rate of pay or fewer hours, then the form must report the earnings made during the 30-day period. If you earn less than your AMW during this 30-day period, the insurance company must pay two-thirds (66 ⅔ percent) of the difference between your AMW and earnings. If your doctor returns you to modified duty but your employer is unable to accommodate your restrictions, you must perform a “good faith” work search for a position within your restrictions. This work search must be documented on the Monthly Status Report Form in order to obtain payment from the insurance company.
Notice of Claim Status (NOCS) – The notice of claim status acknowledges the acceptance or denial of a claim, the amount of lost wage benefits or the reduction or termination of benefits.
Request for Hearing – A written request for a hearing needs the signature from or by someone on behalf of a party that includes the party’s address and the request stating the desire for a hearing. You must file the request with the ICA.
Interrogatories – Interrogatories are questions sent in writing from 1 party to another in the workers’ compensation process. They are a powerful discovery tool for a claimant in a workers’ comp case. The interrogatories narrow the legal issues in a case.
State Compensation Fund (SCF) – Carriers of workers’ compensation insurance have to belong to a national rating organization. The Arizona organization is the National Council on Compensation Insurance. “State Compensation Fund” is the former name of Copperpoint. Copperpoint is a leading workers’ compensation insurance provider in Arizona.
The Arizona Workers’ Compensation Act (“The Act”) – The Act is an Arizona law that outlines the primary responsibilities for workers’ compensation to include making timely disability, hospital, surgical and medical payments. It mandates the evaluation and initiation of cost containment programs and coordination of statewide Return-to-Work Programs.
Temporary Partial Disability (TPD) – A person who becomes ill or injured and loses the ability to work temporarily has a temporary partial disability. The person may perform less strenuous tasks or a smaller amount of work during that time. Short-term disability insurance covers such circumstances.
Temporary Total Disability (TTD) – A total disability is an illness or injury causing a person to be disabled for a fixed amount of time. Distinguishing between the definitions of permanent and temporary disability is relevant in workers’ compensation claims.
Vocational rehabilitation – Vocational rehabilitation is a workers’ compensation benefit that includes tuition reimbursement for schooling or training in preparation for another job when a person is unable to do former work due to permanent restrictions.
Workers’ compensation – Workers’ compensation is a form of insurance providing medical benefits and wage replacement to employees injured at work in exchange for relinquishment of rights to sue an employer for the civil legal liability of negligence.