Terms You Should Know When Building A Workers Compensation Cost Containment Program

Terms You Should Know When Building A Workers Compensation Cost Containment Program 

There is a wide variety of workers compensation insurance terms anyone should be familiar with.  Here are a few basic workers compensation claims terms  to help you manage your workers compensation cost containment program. 

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Average Daily Wage (ADW) Average daily earnings of an employee before an injury. Use to calculate benefits payments in situations where AWW would not provide an accurate reflection of actual wages.

Average Weekly Wage (AWW) Average weekly earnings of an employee before an injury, which is used as a basis for determining weekly benefits payments.

Date of Injury (DOI) Date when injury or illness occurred or, in the case of repetitive exposure injuries or illness, when it first became apparent that symptoms were work related.

Independent Medical Examination (IME) Requested by an employer or insurer to serve as an objective evaluation of an injured employee’s condition. IMEs are used in situation where the findings of an employee’s self-selected doctor need to be verified.

Maximum Medical Improvement (MMI)  Point in an injured employee’s treatment when recovery has reached a plateau with no reasonable expectation of continued improvement.

Permanent Partial Disability (PPD) Benefits paid to an employee who has suffered compensable work-related injury or illness to one or more parts of the body. Most states have a preset payment schedule (Schedule of Injuries) based on specific body parts or conditions.

Permanent Total Disability (PTD) Benefits paid to employees who face lifelong total disability from compensable work-related injury or illness.

Social Security Disability Benefits (SSDI) Benefits paid to disabled individuals through the Social Security Administration, separate from workers’ compensation. Most state workers’ compensation statutes regulate whether an individual can receive both benefits at the same time. If both benefits are awarded, there are limits in place to ensure that an individual cannot receive more money than they are entitled to from either program independently.  

Statewide Average Weekly Wage (SAWW) Average wages paid to workers in a set jurisdiction for a period of time, used to set the maximum and minimum for workers’ compensation benefits paid out to injured workers.

Temporary Partial Disability (TPD) Benefits paid to an injured worker who is temporarily unable to fulfill the full requirements of their job but is able to perform at a reduced level. Benefits paid in such instances are based on possible pay differences between the regular and temporary position.

Temporary Total Disability (TTD) Benefits paid to employees who are totally unable to work for a period of time but will make a full recovery. Though TTD payments stop when the employee is cleared to return to work, they may be eligible for TPD benefits if they still face some work restrictions.

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