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    Archive for March, 2023

    Common Terms Used In Workers’ Compensation Claims

    Being injured on the job and having to file a claim for workers’ compensation benefits is a process most people hope to avoid over the life of their careers. However, workers are often injured and workers comp is there to help them provide for themselves and their loved ones. 

    The process of filing for benefits can be intimidating if you have never had to file for benefits before, and the assistance of an experienced Lancaster job injury lawyer cannot be over-emphasized. It also helps to be familiar with some of the terms that are used in the workers’ comp arena. Following are some of the words and phrases you are likely to hear when you file a claim for workers’ compensation benefits. 

    Alternative Work

    You may hear this phrase used when you are no longer able to perform your previous job duties but you are able to perform a different job. This is allowed when the alternative work complies with any medical limitations or restrictions as determined by a medical professional. 

    Appeal Board

    If the workers’ comp judge (WCJ) decides against you, you may have your appeal heard by the appeals board. Your Lancaster job injury lawyer will help you comply with the requirements to ensure your appeal is timely and well-supported.

    Arising Out Of and Occurring In The Course of Employment (AOE/COE)

    If your workers’ comp claim is denied, it may be because your injury does not comply with the AOE/COE requirement which states that a work-related injury, death, or illness must arise out of and occur in the course of employment. For example, if you are a receptionist but decide to show your co-workers how you can do a cartwheel, and you break your arm while doing that cartwheel, your injury would not be covered by workers’ compensation.

    Average Weekly Wage (AWW)

    Generally speaking, injured employees receive ⅔ of their average weekly wage while they are unable to work. This may be different in cases where the injured party died or suffered a permanent injury. 

    Benefit Structure

    The benefits an injured worker receives may include various components, including compensation, rehabilitation, and medical expenses. It is defined by the workers’ compensation insurance policy.

    Delay Letter

    When delays occur in the workers’ comp process, the administrator will send a delay letter with an explanation of what the delay has occurred. This letter may also state any additional documentation or information that is needed to proceed with the claim. 

    Impairment Rating

    Injured workers are assigned an impairment rating which is based on just how injured they are. This rating is expressed as a percentage, and the percentage assigned to you will affect the amount you are able to receive in benefits. 

    Independent Medical Examination (IME)

    In most cases, you will start by being treated by a physician that has been approved by your employer, although you may be able to switch providers over time. An IME may be requested by the insurer to determine the extent of your injuries and your ability to work. The doctor conducting the IME is not there to treat you but to report back to the insurer on your condition. In most cases, the insurer is able to request an IME every six months. Your Lancaster job injury lawyer will advise you on how often you must have these exams and what to expect. 

    Maximum Medical Improvement (MMI)

    When it has been medically determined that you have recovered from your injury or illness as much as possible, you are said to have reached MMI.

    Permanent Partial Disability (PPD) Benefits

    If your injury has left you partially disabled, and you are not expected to recover from your disability, you may receive PPD benefits. Typically a worker with a PPD is able to perform some type of work, and the amount they receive in benefits is intended to make up the difference in pay from what they previously earned and what they are now able to earn. There is a time limit on how long PPD benefits can be received, and a Lancaster job injury lawyer from Vanasse Law, LLC, can help you determine how much you should receive and for how long. 

    Permanent Total Disability (PTD) Benefits

    If your on-the-job injury has left you unable to with a permanent and total disability, you will typically receive ⅔ of the weekly salary you were receiving prior to the injury, although there is a maximum amount that can be received which is established by the state. However, the amount received may be less than that if you are also receiving Social Security disability benefits. Your Lancaster job injury lawyer can help determine the amount you will receive.

    Temporary Partial Disability (TPD) Benefits

    TPD benefits are very similar to PPD benefits, with the exception being that to qualify for TPD benefits it has been determined that you may be able to return to work at some point in the future. 

    Temporary Total Disability (TTD) Benefits

    When your work-related injury or illness has caused you to be unable to work at all, you may be eligible for TTD benefits as soon as one week from the date you were last able to work. While TTD can continue indefinitely, the insurer may request an Impairment Rating Evaluation (IRE) after 104 weeks. The results of the IRE may cause the type and amount of benefits you receive to change. 

    It is best to speak with a Lancaster job injury lawyer to determine the amount of TTD benefits you are able to receive as the state of Pennsylvania has a formula that is used for this purpose. 

    Speak With a Lancaster Job Injury Lawyer at Vanasse Law, LLC

    If you have been injured while working, don’t hesitate to contact Vanasse Law, LLC, and make an appointment to speak with a Lancaster job injury lawyer. We are a Pennsylvania law firm devoted to helping injured workers recover the workers’ compensation benefits they are due. We may be reached by calling 717-397-1010 or via our contact page.