A lot of terms and abbreviations get tossed around when you are talking about workers’ compensation claims. It gets down-right confusing! And we know the last thing you need right now is more stress, so….. I have compiled a few lists of the most common terms and abbreviations injured workers are likely to run across in the course of dealing with a work injury. A lot of these terms and abbreviations are used interchangeably so, hopefully, after studying this vocabulary, you will have a better understanding of the workers compensation terms being used and, therefore, have a better grasp with what is going on with your claim.
*Please remember these terms are provided to give you a clearer picture of what is going on with your workers’ compensation claim. The meanings given in this context are not necessarily the legal definition nor are they necessarily the only definition of that term.”
- RTW: Return to Work – This is when the doctor releases an injured worker to return to work. This can be full duty or light duty status.
- FD: Full Duty- The ability to work without any physical limitations.
- FCE: Functional Capacity Exam- An exam, typically performed by a physical therapist at the request of the workers’ compensation doctor, used to determine a person’s permanent limitations resulting from a work place injury. The workers’ compensation insurance carrier pays for this exam if it is to determine the claimant’s ability to return to work. This exam may also provide a Permanent Partial Disability impairment rating (“PPD” – see the blog on types of compensation for more). However, many FCE’s are performed without issuing an impairment rating. To get the impairment rating only, the injured worker must pay for the FCE.
- HI: Health Insurance – This is the personal health insurance that you pay for. Treatment for work related injuries should only be put through your regular health insurance if your claim has been officially DENIED. The best advice is talk to an attorney on how to handle this situation.
- IME: Independent Medical Exam- An exam an injured worker is mandated to attend at the request of the workers’ compensation insurance carrier for a second opinion of a doctor chosen by the workers’ compensation carrier. Generally, the IME doctor gives an opinion whether the current medical treatment is related to the work accident. The IME doctor evaluates the injured workers’s current condition and determines a selected course of medical treatment. The examiner will write a report and then his or her findings will be sent to the insurance company for review (if it is a negative report against the injured worker).If the IME doctor agrees with the treating physician, usually the adjuster or their attorney calls the doctor and requests that it is not put in writing. There is no doctor patient privilege and this doctor will not give any advice to the injured worker.
- LD: Light Duty- The ability to work within certain limitations as set forth by a doctor.
- MMI: Maximum Medical Improvement – When an injured worker reaches a treatment plateau where his or her condition cannot be improved any further, this can mean full recovery or the doctor has stated that there is nothing more that can be done for the injured worker with any expectation of significant medical improvement.
- NCM: Nurse Case Manager- An administrator hired by the insurance company to oversee the care, progress, recovery, and return to work ability of the injured worker. The NCM will attend the doctor’s appointments and be an active part in the injured workers’ medical care. Don’t forget to ask to have your examination with the doctor in private!
- OOW: Out of Work/Off of Work– When a doctor has taken you completely out of work due to your injury. This means you are unable to do any work at all, not just your specific job duties.
If you have questions about your benefits or if you would like more information on the Virginia workers’ Compensation system, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia” by clicking this link, or call our office today (804) 755-7755.
~Michele Lewane, Esq.