Acronyms and Abbreviations for Workers’ Compensation Claim

Knowing your acronyms and abbreviations is a key to understanding what's going on in your workers' compensation act claim. In workers' compensation claims you will often hear lawyers, judges and adjusters use acronyms: WC, TTD, AWW, IME, PPD, MSA, MMI, S&A... Below I will briefly describe each. Learn them and your lawyers will realize you've been doing your research...and they'll respect you.

Definition of ACRONYM: a word (as NATO, radar, or laser) formed from the initial letter or letters of each of the successive parts or major parts of a compound term; also: an abbreviation (as FBI) formed from initial letters. on line dictionary.

WC: Workers' Compensation. A quick reference to the workers' compensation act and the process itself.

AWW: Average Weekly Wage. This is the number used to calculate all of the non-medical benefits you receive in a wc claim. This is a very critical number and a good attorney can often convince the arbitrators that the AWW is higher than what the insurance company claims. It usually does not include overtime calculations unless they meet a criteria depending on frequency and whether the overtime was mandatory. When it is included in calculating the AWW the overtime is added at the straight time rate. Before you see your lawyer make certain you have copies of the last year's pay stubs, or as many as you can find. Your previous year's tax return can also help in calculating the AWW rate. The rate is increased when the worker has multiple jobs of which the employer is aware.

TTD: Temporary Total Disability: This is the weekly benefit an employee gets in Illinois when he is temporarily totally disabled from work. The TTD rate is 66 2/3% of the AWW. It does not start until the employee has missed three consecutive days due to a work related injury. To get TTD you will need a doctor's note or record stating that you are currently disabled from all work as the result of your work related accident. Therefore, it is critical you give the doctor a detailed understanding of the type of work you do (how much lifting, climbing, bending, walking, tools used...), how you were injured, when you were injured. Disputes often arise when the company's chosen doctor claims you can return to full duty, or the company claims they have light duty within your doctor's restrictions...but they don't. One of the biggest fights in WC is over payment of TTD.

IME: Independent Medical Examination. All wc claimants are required to submit to an IME from "time to time." So, you might have to attend several IME's through the course of the claim. These are not your doctors; they are chosen by the insurance company and are paid by the insurance company and are not to be trusted.

PPD: Permanent Partial Disability. This is the percentage of permanent injury and is calculated using a PPD rate (60% of your AWW) and multiplied by a percentage of loss of function of a particular body part. This is where we figure out how much a case is worth for settlement purposes. The percentage depends on many factors; among them: the body part involved, the permanent restrictions, the type of work performed, whether there were prior injuries to that part of the body, whether the employee can return to his former job, the judge involved (some give more than others), the skill and reputation of the attorneys involved...

MMI: Maximum Medical Improvement: literally, as good as your going to get. MMI is reached when the doctors believe that the worker will not significantly benefit from additional medical care of any kind. It is understood that the worker will likely have some permanent injury, perhaps some ongoing pain. The fight usually occurs when the treating doctor says the employee still needs medical treatment and the insurance company's IME doctor says that the employee doesn't need any more care. This usually results in depositions and a mini-trial (called a 19(b)) where the workers' lawyer fights to get the arbitrator to award ongoing medical care.

PTD: Permanent Total Disability benefits. When a worker is so injured that he is unable to return to any form of permanent gainful employment. The PTD benefit pays the employee for the remainder of his/her life, typically, but not always, at the same rate as the TTD benefit.

SSD: Social Security Disability. A federal government benefit plan to aid injured or disabled people. Note: the worker usually cannot get simultaneous SSD and TTD. However, an experienced lawyer can often get a worker a significant lump sum benefit and allow the employee to keep all or most of his SSD award. It requires careful drafting of the settlement contract language.

MSA: Medicare Set-Aside. This is a medical trust that must be established to pay for certain work injury medical treatment before the Medicare system will pay for future care. The trust is funded in addition to the amount the lawyer gets the employee in a lump sum settlement. If an employee applies for SSD and later gets a wc settlement, the Social Security Administration might deny payment for medical care for the injured body part unless they had previously approved an MSA and it was fully funded.

S&A: Sickness and Accident. This is a private benefit program often paid for by an employer or union or purchased independently by the worker. S&A is intended to provide payment for medical care and to provide supplemental income when an employee is injured or unable to work due to a non-work comp claim. It is often used when work comp benefits have been denied by the employer or insurance company. If a wc claim is later accepted and benefits paid then the S&A provider might want their money back. You can get S&A benefits or TTD, but not both at the same time. The worker's attorney should know this and should make arrangements to have S&A repayment as part of any settlement negotiation.

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