A Guide To Workers’ Compensation Terminology

A Guide To Workers’ Compensation Terminology

The health care industry routinely uses acronyms and terms which often confuse not only our patients but employees too. The same can be said about those of us who work in the world of workers’ compensation. A list of common workers’ compensation terms and acronyms can be found below.

Agreed Medical Evaluator (AME)
Doctor agreed upon between parties to conduct the medical examination that will help resolve disputes.
AOE/COE (Arising out of and occurring in the course of employment): Injury must be caused by and happen on the job.

Apportionment
Allocation of Permanent Disability based on cause
Date of injury: Date employee was injured or became ill. If the injury was caused by one event, the date it happened is the date of injury. If the injury or illness was caused by repeated exposures (a cumulative injury), the date of injury is the date the injured worker knew or should have known the injury was caused by work.

Specific Injury
An injury caused by one event at work. Examples: hurting your back in a fall, getting burned by a chemical splashed on your skin, getting hurt in a car accident while making deliveries.

Cumulative Injury (CT)
An injury that was caused by repeated events or repeated exposures at work. For example, hurting your wrist doing the same motion over and over or losing your hearing because of constant loud noise.

Essential Functions
Duties considered crucial to the job being performed.

Future Medical
On-going right to medical treatment for a work-related injury.

Panel Qualified Medical Evaluator (QME)
A list of three independent qualified medical evaluators (QMEs) issued by the DWC Medical Unit.

Permanent and Stationary (P&S)
A Medical condition has reached maximum medical improvement. Once P&S is reached, a doctor can assess how much, if any, permanent disability resulted from the work injury.
Permanent Disability (PD)
Any lasting disability that results in a reduced earning capacity after maximum medical improvement is reached.

Permanent Disability Rating (PDR)
A percentage that estimates how much a job injury permanently limits the kinds of work a person can perform. It is based on the employee’s medical condition, date of injury, age when injured, occupation when injured, how much of the disability is caused by the job, and diminished future earning capacity.

Primary Treating Physician (PTP)
The doctor having overall responsibility for treatment of your work injury or illness.

Permanent and Stationary Report (P&S Report)
A medical report written by a treating physician that describes your medical condition when it has stabilized.

Utilization Review (UR)
The process used by claims examiners to decide whether to authorize and pay for treatment recommended the treating physician or another doctor.
Work restrictions: A doctor’s description of the work an employee cannot perform, i.e. no lifting greater than 10#’s.

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