Have you ever read about a court case, watched a crime show, or been to a legal consultation and felt like you were listening to a different language? All industries and professions have their own language. Legal jargon and abbreviations can be super confusing when you first hear them.
When it comes to workers’ compensation or other personal injury cases, there are a few words that come up more often than others. No one likes being in the dark, and knowledge is power; so let’s get down to the basics.
There are three benefits to workers’ compensation law: medical treatment, a portion of your AWW or average weekly wage while you heal or are unable to work, and a lump sum for the resultant disability or disfigurement. Remember that the law recognizes that most injuries leave some level of disability. Unfortunately, the system underpays big injuries and overpays small ones and you need an experienced personal injury attorney to make sure you get the maximum that the law allows.
Functional Capacity Evaluation (FCE)
An FCE is an evaluation that determines the physical limitations of the injured employee, such as how much can they lift, how long can they stand, can they bend limbs, etc. You might have to take one of these tests to see if you can go back to work, qualify for disability benefits, and to diagnose what you need medically.
Independent Medical Examination (IME)
IME’s are also used to assess the physical condition of an injured employee, but with particular attention to whether or not there is permanent damage. It is misleading to call these examinations “independent” as the insurance companies know which doctors will favor them and not surprisingly, those are the ones that get the call. By the same token, your lawyer will choose a doctor who will give the patient the benefit of the doubt, and those ratings tend to be higher. If you don’t have your own personal injury attorney to arrange an examination, you will be limited to the amount in the insurance company’s evaluation.
PPD, PTD, and TTD
Your workers’ compensation benefits are a reflection of the amount of permanent damage you’ve suffered from a workplace accident.
- If you have a Permanent Partial Disability (PPD), it means that your injury is permanent, but that you are still able to work to some capacity, possibly with some limitations. PPD is much more common than a Permanent total disability.
- A Permanent Total Disability (PTD) is a permanent injury that prevents the employee from returning to work. These are incredibly severe injuries, and can include the loss of limbs or a back or head injury that combined with other factors like your age and education take you out of the workforce. PTD pays weekly benefits for the remainder of your work life. PTD findings are more rare with younger workers who can retrain and do some work.
- Temporary Total Disability (TTD) applies to employees who can’t work at all while they are healing, but should eventually be able to return to full duty again once fully recovered.
Average Weekly Wage (AWW)
Your average weekly wage for the prior 13 weeks, up to a maximum amount set by statute.
Degree of disability or disfigurement.
The lump-sum disability rating is the final payment you receive in a work comp claim. The entire body, or Body as a Whole (BAW) is worth 400 weeks. If you are ten percent disabled due to a back injury, your lump sum payment is your 400 weeks times your AWW up to the maximum times the percent of disability (10% in this example or 40 weeks) Injuries to arms or legs are based on the same equations. Remember, if you do not have a rating exam report from a doctor on your side, the ALJ can only consider the report from the insurance company. If you have a facial or hand scar, the ALJ can also add in additional amounts.
Administrative Law Judge (ALJ)
An Administrative Law judge is the official who listens to, and then decides whether or not a worker’s compensation claim will be accepted, whether more medical treatment is required, and ultimately the level of permanent disability. Don’t be intimidated though; the majority of claims are accepted. If you were hurt at work and report the injury promptly, you are usually entitled to workers’ compensation benefits. Some actions, like refusing a drug test, can disqualify you from benefits. Other things that can significantly endanger your claim are delaying reporting your injury to a supervisor and following medical advice. It is best to hire an experienced worker’s compensation attorney early in the process to help you fill out the correct forms and guide you through the process.
Repetitive Stress Injury (RSI)
Repetitive stress injuries, which are also sometimes called repetitive motion injuries, are injuries that form slowly over time due to performing the same physical tasks over and over again for hours at a time. Some examples of these include:
- Carpal Tunnel Syndrome
- Tendinitis
- Trigger Finger
- Tennis Elbow
- Bursitis
- Stress fractures
Repetitive stress injuries can be difficult but not impossible to prove, with consistent and organized medical documentation and by consulting with the appropriate medical specialists.
MMI
Maximum medical improvement, or MMI, is the designation that further medical treatment won’t improve your recovery. Sometimes this is disputed because the insurance company wants to end treatment as soon as possible but more time or treatment may make a difference in your health. If you are declared to be at MMI and you need more treatment, an attorney can prepare your case for an Emergency Hearing.
An Emergency Hearing is an “emergency” in name only as these can take weeks to prepare for and schedule. While it is tempting to wait to hire an attorney until you are at the end of your treatment, this can cause huge delays in your case! It is better to hire a lawyer early in the process than wait until your claim is at a critical point- the preliminary legal work takes time to complete properly and it is better to have it done early.
To learn what you are potentially entitled to, check out the Missouri Chart on Permanent Partial Disability here.
If you have any questions about your workers’ compensation or work comp case and are in need of legal advice, contact our office for a free legal consultation with one of our experienced personal injury lawyers. They will be happy to explain any legal mumbo-jumbo you need to know, and help you obtain the compensation you deserve for lost wages, medical bills, and the disability you have when treatment is over.