Ten Common Workers' Compensation Definitions

When you file a workers’ compensation claim, you’ll likely hear a number of words and terms thrown around that you may have never heard before. For most people this means it’s easy to become confused, and for some this could even become intimidating and stressful. Want to avoid this confusion and keep up with what’s going on? Here are ten common workers’ compensation law terms and their definitions that you should know.

Benefits: Benefits are compensation for injuries that are paid from the insured (your employer or their insurance company) to the claimant (you, as the injured employee). These can come in many forms, including having your medical bills and treatments covered, replacement income from missed work, and even coverage for some re-training if you can’t return to your job in a new capacity.

Appeal: A motion filed by either side of a workers’ compensation case that objects to a decision handed down by the Workers’ Compensation board, and requests a review at a higher level in order to either reverse or amend the decision.

Accident date: This can refer to one of two things: 1- the date of the accident which caused your injury, or 2- the date in which you discovered or were diagnosed with your condition (in occupational disease or repetitive stress cases). This date is super important because you must file your initial claim with your employer within 30 days of this date or your case will likely be dismissed.

Maximum Medical Improvement: This is the point in which, in the opinion of a medical professional, you can’t be expected to recover or improve in your condition within any reasonable amount of time. Once you have reached this point, you will likely be evaluated for some form of permanent disability award.

Schedule: The different types of injuries, their severity, and the impact they will have on someone’s life are classified into units called “schedules.” The schedule in which your injury falls will determine what kind of benefits you will be eligible to receive and how long you will be able to receive them for. The more severe your injury and the more permanent and debilitating your condition, the more benefits you’ll be allowed to receive.

Symptomatic Treatment: These are medical treatments that are purely designed to treat the pain and suffering you are experiencing as a result of your disease or injury, rather than providing a direct remedy for the injury itself. Workers’ compensation should cover these treatments as well if your doctor recommends or orders them.

Total Disability: When you lose the ability to be gainfully employed in any capacity without severe pain or the inability to perform the duties of any substantially gainful position, you are declared totally disabled.

Partial Disability: When you lose some of your ability to work in a substantially gainful capacity without severe pain or discomfort, then you are awarded partial disability. The extent to which your ability is impacted is given as a percentage. You can be as low as one percent disabled or as high as 99 percent, but the number is more often somewhere in between. This number does have an impact on the benefits you are eligible to receive.

Wage Replacement: This is the amount of your wages that you were earning before your injury which are replaced by workers’ compensation benefits. You may not receive all of your pre-injury wages as part of workers’ compensation, but you will be given a certain amount based on the circumstances of your case.

Misrepresentation: These are actions employers take to attempt to reduce or absolve themselves of liability for an injury and thus the responsibility to pay. This can include a number of different actions, including not keeping accurate payroll records, paying “off the books,” misclassifying workers as “independent contractors,” or stating that the position of an injured party is less dangerous than it actually is. If you and your attorney can show that your employer was deliberately misrepresenting you or your work duties in your case, your employer could be subject to fines for non-compliance and even a criminal conviction.