Workers Compensation Vocabulary
Temporary Total Disability, TTD
"Generally" means that a person is unable to do any type of work for a temporary period of time. Workers' compensation payments are usually paid while the injured worker is out of work.
Temporarily Partial Disability, TPD
"Generally" means that the injured worker is only able to do some type of limited work for a short period of time and that further recovery is expected.
Governing body (2of2)
"Public body" means the state, any Regional Council, County, city or District, or any municipal or public corporation, or any board, Department, Commission, counsel ,Bureau, committee or subcommittee or Advisory Group or any other agency thereof. (ORS 192 .610(4))
Aggravation
A claim for aggravation is a workers request for additional disability compensation stemming from a worsening or previous accepted condition. (ORS 656.4273)
Guaranty contract
A contract between the insurer and the department guaranteeing workers' compensation insurance coverage for an employer.
Notice of closure, NOC - Form 1644
A document sent by the insurer to the injured worker that closes the claim, ends time-loss benefits, and states the extent of the disability. (ORS 656.268(5)) (OAR 436-030-0005(7))
Impairment
A medical term which is sometimes confused with disability. Impairment is what is automatically or physically wrong with an individual and is a means where the medical care provider assigns a numerical rating for whatever type of bodily function has been lost.
Impairment Findings
A permanent loss of use or function of a body part or system as measured by a physician. (OAR 436-035-0005(7))
Attending physician
A physician primarily responsible for the treatment of an injured worker. (IRS 656.005(12)) note; not necessarily your PCP.
Private Rehabilitation organization, PRO
A private Rehabilitation organization is a business that contracts with insurers to provide or manage vocational counseling and return to-work-services, to Injured Workers.
Workers Benefit Fund
A special fund created by 1995 legislation for financial management of cents-per-hour assessment revenue and expenses. A number of programs are supported through this fund e.g. handicapped workers program, Reemployment assistance program, reopen claims program, & retroactive program. (not on test)
Chronic Pain Syndrome
A subconscious psychological stress state prolonging pain through operate conditioning and pain behavior.
Scheduled Disability(1of2)
A term used to rate impairment type. It includes the complete or partial loss of the use or function of an arm, hand, finger, leg, foot, toe, or other extremity of the body or the loss of vision or hearing ability.
Employability
A term which defines or is used to express whether or not a person is employable in certain fields or in the general labor market.
Claim
A written request for compensation from a subject worker or someone on the workers' behalf, or any compensatory injury of which a subject employer has notice of knowledge. (ORS 656 .005(6))
Compensation
All benefits, including Medical Services, provided for a compensable injury to a subject worker or the workers beneficiaries by an insurer or self-insured employer. (pursuant to this chapter ORS 656.0058)
Comprehensible Injury(1of2)
An accidental injury, or accidental injury to prosthetic appliances, arising out of and in the course of employment requiring Medical Services or resulting in disability or death;
Employer at injury
An employer in whose employ the workers of sustained the conpensable injury, or occupational disease.
Independent Medical Examiner, IME
An examination of an injured worker by position other than the workers attending physician upon the request of the insurer.
Comprehensible Injury(2of2)
An injury is accidental if the result is an accident, whether or not due to accidental means, if it is established by medical evidence supported by objective findings. (ORS 656.005(7))(subject to limitations-C ORS 656.005(7))
Managed Care Organization, MCO
An organization with which an insurer may contract to provide medical services. (OAR 436-015 ORS 656.260)
Ancillary Care
Care such as; physical or occupational therapy provided by a medical service provider other than the attending physician.
Time-loss payment
Compensation paid to an injured worker who loses time or wages as a result of compensable injury.
Lost Wages(1of2)
Consists of temporary payments made when injuries are severe enough to prevent the injured from working. The term "temporary total disability," "lost wages," and "workers' compensation payment," generally means the same thing.
Employer-at-Injury-Program, E.A.I.P
Designed to encourage early return to work by helping employers use transitional work assignments for Injured Workers who are recovering from their injury light-duty work
Form 801; First report of injury.
First report of injury. The workers and the employers report of occupational injury or disease
Permanent Disability(2of2)
Generally, a determination of "permanent" disability will not be made until the injured worker is considered to be "medically stationary" or "medically stable." Depending on the nature of the injury, a permanent disability award will either be "scheduled" or "unscheduled."
Worker Liaison(1of2)
Helps workers understand the reconsideration process. Explains options, answers questions, and helps you complete a Request for Reconsideration. Assistance is free.
Worker Liaison(2of2)
However, the liaison is not an advocate and cannot provide legal advice. To ask for a work liaison, contact the appellate review unit (503-947-7816).
Vocational Rehabilitation(1of2)
If an injured worker cannot return to his or her job at injury and they have a permanent disability they may be entitled to Vocational Rehabilitation assistance. The level of assistance varies greatly between jurisdictions.
Permanent Disability(1of2)
If the injured worker suffered permanent disability as a result of his or her injury, he or she will often be able to recover a permanent disability payment.
Expedite Claims Service
If you disagree with actions taken in your claim, and your claim qualifies, you may receive an expedited hearing by the Hearings Division of the Workers' Compensation Board within 30 days of your request for hearing. For information contact the Ombudsman for Injured Workers (at 800-927-2710)
Average weekly wage, AWW (2of2)
In cases involving temporary total disability or temporary partial disability benefits, the AWW rate used is the rate of the last quarter of the calendar year preceding the fiscal year in which compensation is paid. (IRS 656.210, 656.212)
Form 1502; Insurer Report
Insurer Report form. Used by insurers to make status report to WCD or to report new developments on active claims.
Claim Adjuster
Insurer representative who processes that claim filed by an injured worker. Also referred to as a claims examiner.
Exacerbation
It temporary flare-up of something related to a pre-existing condition, usually after an injury but resides to its formal level within a reasonable period of time.
Unscheduled Disability(2of2)
It, also includes psychological conditions. The amount of benefits paid depends on how the disability affects the workers ability to earn a wage by considering age, education, and ability to perform work. (ORS 656.214(6))
Obtained Employment Purchases, OEP
Items required by an employer such as tools, equipment, clothing, and tuition that can be purchased through the Preferred Worker Program.
Appeal Rights
Legal rights that any party may exercise when not satisfied with an insurer's decision, action, WCB order, or WCD determination. (ORS 656.283, 656.289, 656.298)
Medical Care
Medical Care is generally provided on workers' compensation benefits without any deductible. Generally, the claimant can choose his or her physician. However, due to the advent of Managed Care Organization, MCOs, the injured workers ability to choose a doctor has been somewhat limited.
Palliative Care
Medical services rendered to reduce or moderate temporarily the intensity of an otherwise stable medical condition, but does not include those medical services rendered to diagnose, heel or permanently alleviate or eliminate a medical condition. (ORS 656.00520)
Award Payments
Monthly payments made to a worker or a workers' beneficiaries until the full amount of the award has been paid. (ORS 656.216, 656.218)
Lost Wages(2of2)
Most systems provide for payment of two-thirds of the wage workers gross wages up to a predetermined limit. These benefits are generally paid every 2 weeks, and are not taxable.
Medically Stationary
No further material improvement would reasonably be expected from medical treatment,or the passage of time. (ORS 656.00517)
Form 1644; Notice of closure, NOC
Notice of closure, NOC. A document sent by the insurer to the injured worker that closes the claim, ends time-loss benefits, and states the extent of disability. (ORS 656. 26885. Oar 436 0300005(7))
Medical mileage
Payment to the injured worker for mileage to and from the doctor's office exists in most workers' compensation systems. Medical mileage is generally considered to be a medical benefit.
Preferred Worker Program, PWP(2of2)
Preferred workers can't return to the jobs they were doing at the time of the injury because of their disabilities and haven't refused appropriate work with their employers at injury.
Reconsideration
Reconsideration is a review of your claim closure, at your request, by an appeal to the reviewer in the Workers Compensation Division, WCD. A worker liaison is available to help you through the process.
Division
Refers to the Workers' Compensation Division, WCS, of the Department of Consumer and Business Services, DCBS.
Apportionment
Refers to the permanent disability benefit from part of the disability resulting from one injury and part from another, which may or may not have been work-related. Causation is not apportioned and the cost of medical and temporary disability usually is not apportioned.
Oregon Administrative Rule, OAR
Rules and regulations from DCBS, filed with the secretary of state, used to administer workers' compensation laws in Oregon.
Disability
Sometimes confused with impairment. Disability represents how an impairment combined with the person's age, educational background, vocational background, and other factors, affect an injured workers' ability to return to work. Impairment is one part of assessing an overall disability.
Oregon revised statutes, ORS
Statutes published by the Legislative Council committee that include ORS 656; the Oregon Workers' Compensation law, and ORS 654; the Oregon Safe Employment Act.
Unscheduled Disability(1of2)
Term to rate impairment type. Applies to impairment of body parts not listed as scheduled. e.g; cervical upper & mid-back, shoulders & lower-back & hips. Includes injury & disease affecting body systems of the; lung, heart, stomach, bladder, bowel, brain & nervous; blood,hormone,skin,tier & immune.
Functional Capacity Evaluation
Testing of a person specific physical activities, of lifting, bending, pushing, pulling etc, and the relationship to the ability to perform the demands of various jobs.
Americans with Disabilities Act, ADA
The ADA is a federal civil rights law enacted in 1990 to protect individuals with disabilities from all types of discrimination, including that which is related to employment; recruiting, the hiring process, terms and conditions of employment, promotion and training procedures.
Ombudsman for Injured Workers, O.I.W
The Office of a Ombudsman for Injured Workers was established as an independent advocate for Oregon's Injured Workers. It helps Injured Workers dealing with the workers' compensation system at no cost.
Average weekly wage, AWW (1of2)
The Oregon average weekly wage of workers in covered employment, as determined by the Employment Department. (ORS 656. 211). The AWW is used to figure out the rate of benefit in cases involving death or injury or death during permanent total disability. (IRS 656.208).
Pure Premium Rate
The average rate employers pay to their insurance company for workers' compensation coverage.
Cumulative trauma
The concept that repeated minor stresses either of a small or inconsequential nature over a period of time result in an injury or disability.
Regular work
The job the worker held at the time of the injury or subsequently similar job.
Adminstrative Law Judge, ALJ
The legal representative employed by workers' compensation board, who reviews appealed administrative orders, holds impartial hearings, and issues legal opinions. Formerly called; Hearing Referee.
Vocational Rehabilitation(2of2)
The level of assistance ranges from simple help with the drafting of a resume all the way through full payment of time loss while the person gets two years of training. There is a set maximum amount paid towards schooling costs.
Permanent Impairment
The loss of use or function of a body part due to a compensable injury.
Governing body (1of2)
The members of any public body which consists of two or more members, with the authority to make decisions for/or recommendations to a public body on policies or administration (ORS 192. 610(3)).
American Medical Association Guides
The most widely used method of rating functional impairment. They are a system of writing anatomical impairment for Injured Workers
Federal Employer Identification Number, F.E.I.N
The number assigned to a business by the Internal Revenue Service, IRS. This number is the primary identifier for employers in electronic data interchange, EDI, reporting
Permanent partial disability, PPD
The permanent loss of use or function of any portion of the body (defined by ORS 656.214). note: Determined by a doctor.
Preferred Worker Program, PWP(1of2)
The preferred worker program encourages the Reemployment of Oregon workers whose on-the-job injuries have resulted in permanent disability.
Scheduled Disability(2of2)
These body parts are on a schedule listing dollar amounts applied per body part so that all Oregon Injured Workers receive the same payments for the same disability regardless of what job they performed at the time of the injury. (ORS 656. 214)
Chemically Induced Asthma
This asthma is caused by exposure to isocyanates, a two-component paint. Exposure to sufficient levels will cause some people, generally 5 to 20% exposed, to develop various acute reactions, e.g. shortness of breath, nausea vomiting & abdominal pain. Also, neurological problems may develop.
Board certified
This is different than being licensed. In addition to licensing, some physicians may be board certified in their specialty after typically completing a period of training (residency) in a particular specialty and passing an examination given by the board of that specialty.
Modified work
When the physical or duration demands of employment do these must be altered to accommodate patients impairment, that worker is said to require modified work.
Form 827; Workers and Physicians report for Workers' Compensation Claims
Workers and Physicians report for workers compensation claims. Includes first report of injury, report of aggravation, notice of change of attending physician, progress report, closing report, and palliative care request.
