Key Terms to Know for Your Workers’ Compensation CaseBy Kenton Koszdin Law Office on March 26, 2013 | In Workers Compensation Claims
If you’re seeking workers’ compensation benefits in California, you know that workers’ comp has its own language – some of which can be very confusing. Your workers’ compensation benefits attorney can explain many of the terms, but here are a few commonly-used ones.
- AOE/COE: These stand for “arising out of and occurring in the course of employment,” which is the requirement for any injury or illness to qualify for workers’ compensation.
- Benefit notice: Also called a “notice,” this letter or form comes from the insurance company and explains what workers’ compensation benefits you may be entitled to receive.
- Claim form: Also known as DWC-1, the form you use to report a work injury or illness to your employer.
- Dispute: A disagreement between you and the insurance company about your right to payments, services, or other benefits.
- Essential functions: The duties that are crucial to the job you want or have.
- Findings & Award (F&A): A written decision by an administrative law judge about your case. Often come at the end of a “hearing,” which is a legal proceeding to settle one or more disputes.
- Impairment rating: An estimate of how much of the normal use of an injured body part you have lost. Usually expressed as a percentage, your impairment rating is used to calculate your permanent disability rating.
- Permanent and stationary (P&S): A medical condition that has reached maximum medical improvement.
- Petition for reconsideration (Recon): A legal request to appeal a decision made by an administrative law judge.
- Utilization review: A process insurance companies uses to decide whether or not it will pay for the treatment your physician recommends.