Workers’ Compensation Glossary

Understanding workers' compensation terminology is essential for navigating claims and benefits effectively. An experienced workers’ compensation attorney can guide you through all of the steps of your claim, but it is helpful to understand what each of these terms means. 

It’s important to note that different states may refer to a similar process using different terms. For example, in New York, treating physicians must be authorized by the state’s Workers’ Compensation board, called “board-authorized physicians”. In Tennessee, physicians that can treat workers’ compensation injuries are referred to as, “authorized treating physicians”, and do not have to be authorized by the state board. Additionally, the examples given under each definition may not be accurate in your state. Always speak to an attorney if you have questions related to your claim. 

Accepted Claim

A claim for which an insurer has accepted liability, acknowledging that the injury or illness is work-related.

Example: After reviewing the medical records and accident report, the insurance company approved my accepted claim, ensuring I would receive medical benefits and wage replacement.

Accident Report

A formal document detailing the circumstances of a workplace injury or illness that may be required for filing a workers' compensation claim.

Example: After slipping on a wet floor at work, I submitted an accident report to my employer within 24 hours.

Accident, Notice, and Casual Relationship (ANCR)

For a workers' compensation claim to be approved, it must be shown that a work-related accident happened, the worker reported it on time, and the injury or disability was caused by the accident.

Example: My workers' compensation claim was approved because I met all three ANCR conditions—I had a documented work injury, provided timely notice, and medical evidence supported the causal relationship between my injury and workplace accident.

Actual Earnings

The wages a worker earns while on light duty or working at a reduced capacity due to a work-related injury.

Example: My actual earnings decreased after my workplace injury forced me to take a lower-paying desk job.

Authorized Treating Physician 

A medical provider that has been approved to treat workers who become injured or ill on the job. In some cases, they can be selected from a “panel of physicians” offered to an injured employee. 

Example: I went to see my authorized treating physician to treat my workplace injury. 

Average Weekly Wage (AWW)

The average amount that an employee earned per week before the injury. This is used to determine workers' compensation benefits.

Example: My workers’ compensation benefits were based on my average weekly wage, which was calculated from my last 12 weeks of earnings.

Benefit Rate

The amount of compensation an injured worker receives, usually calculated as a percentage of their average weekly wage.

Example: My benefit rate was set at 66% of my AWW after my workplace injury.

Board-Authorized Provider

A medical provider approved by the Workers' Compensation Board to treat workers who become injured or ill on the job.

Example: After my workplace injury, I was required to visit a board-authorized provider for treatment to ensure my medical expenses would be covered.

Board Panel

A group of workers' compensation board members who review and decide on disputed claims.

Example: My claim was initially denied, but the board panel ruled in my favor after review.

Claim

A request for workers' compensation benefits due to a work-related injury, illness, or death.

Example: After falling from a ladder at work, I filed a claim with my employer’s workers' compensation insurance.

Claimant

The injured worker who files a claim for workers' compensation benefits.

Example: I became a claimant after filing for benefits due to a back injury at work.

Compensable

A term describing claims, injuries, or illnesses for which workers' compensation benefits are payable.

Example: My injury was deemed compensable after a thorough review of workplace safety records confirmed the accident happened on the job.

Compensation Rate

The rate at which benefits are paid to an injured worker, often a percentage of their AWW. See, “Benefit Rate”. 

Example: My compensation rate allowed me to receive 66 ⅔% of my wages while I recovered.

Contested Claim (or Denied Claim) 

A claim that the employer or insurance company disputes, requiring further legal proceedings.

Example: My contested claim led to a hearing after my employer disputed the severity of my injury.

Disability Benefits

Financial compensation provided to workers who suffer from work-related disabilities, either temporary or permanent.

Example: After my injury, I received disability benefits to help cover lost wages.

Disability Classifications

Categories of disability in workers' compensation claims, including temporary total disability (TTD), temporary partial disability (TPD), permanent total disability (PTD), and permanent partial disability (PPD).

Example: I was assigned with a PPD rating after losing partial function in my right hand due to a workplace accident.

Established Claim

A claim where the Board has determined that an injury, condition, or illness is work-related.

Example: After several hearings and medical evaluations, my claim was finally established, and I started receiving benefits.

Exclusive Remedy

The legal principle that workers' compensation benefits are the only recourse for an injured employee, preventing lawsuits against the employer in most cases.

Example: Because workers' compensation was my exclusive remedy, I couldn’t sue my employer for additional damages.

Functional Capacity Evaluation (FCE)

A medical assessment used to determine an injured worker’s ability to perform job tasks following an injury.

Example: I underwent an FCE to assess whether I could return to my previous job duties.

Indemnity Benefits

Compensation paid to an injured worker (or relative) due to their loss of wages because of a work-related injury or illness. See “Disability Benefits” for more information.

Example: I received indemnity benefits while I was recovering from surgery and unable to work.

Independent Medical Examination (IME)

An evaluation by a doctor who is not the worker’s treating physician. These can be requested by the employer, insurance company, or injured employee to assess the worker’s condition. These may be requested by an attorney on an employee’s behalf for a second opinion on the extent of the worker’s injury. 

Example: The insurance company required me to undergo an IME to verify my disability claim.

Insurance Carrier

A company that provides insurance coverage. Employers who are not self-insured for workers' compensation purchase policies from insurance carriers to provide workers' compensation benefits to injured workers.

Example: My employer's insurance carrier initially denied my claim but later approved it after further review.

Injury Date

The date on which a workplace injury occurred or the date a worker became aware of a work-related illness.

Example: My injury date was recorded as March 5, the day I fell from a ladder at work.

Light-Duty Work

A modified job or set of tasks assigned to an injured worker who is unable to perform their regular duties due to medical restrictions.

Example: After a back injury, I was given light-duty work that involved only administrative tasks.

Loss of Wage-Earning Capacity

A determination made by the Workers’ Compensation Board as to the extent that a permanent partial injury or disability affects an injured worker's ability to earn wages.

Example: Due to my back injury, my loss of wage-earning capacity was assessed at 40%, reducing my earning potential significantly.

Maximum Medical Improvement (MMI)

The point at which an injured worker's condition has stabilized and is not expected to improve further with medical treatment.

Example: Once I reached MMI, my benefits were adjusted based on my level of permanent disability.

Medical Benefits

Coverage for authorized medical expenses related to a workplace injury, including doctor visits, surgery, and rehabilitation.

Example: My workers' compensation covered all medical benefits for my physical therapy sessions.

Notice of Injury

A formal notification provided by an injured worker to their employer regarding a workplace injury, typically required within a specific time frame.

Example: I filed my notice of injury within 10 days, ensuring I met my state’s reporting deadline.

Occupational Disease

A condition that develops over time due to workplace exposure to harmful conditions or substances, such as repetitive strain injuries or respiratory diseases.

Example: I developed an occupational disease after years of exposure to toxic chemicals at my factory job.

Permanent Partial Disability (PPD)

A long-term impairment that partially limits a worker’s ability to perform job tasks but does not completely prevent employment.

Example: I was diagnosed with PPD after losing partial mobility in my left hand.

Permanent Total Disability (PTD)

A condition where an injured worker is unable to return to any form of gainful employment due to a workplace injury.

Example: After a severe spinal injury, I was deemed to have PTD and received lifetime benefits.

Petition for Benefits or Petition for Benefit Determination

A formal request filed by an injured worker to obtain workers' compensation benefits when a claim has been denied or delayed.

Example: I filed a petition for benefits after my employer’s insurance company refused to pay her claim.

Temporary Partial Disability (TPD)

A condition where a worker has temporarily lost some ability to work and earn full wages. 

Example: I was 25% disabled with a TPD, so my weekly benefit was calculated as two-thirds of my average weekly wage multiplied by 25%. 

Temporary Total Disability (TTD)

A condition where a worker cannot work and earn wages, but only on a temporary basis. The worker is entitled to the full allowable wage benefit during this period.

Example: After breaking my leg at work, I was classified as having TTD and received full-wage benefits until I could return to work.

Waiting Period:

The mandatory time an injured worker must wait before receiving workers' compensation benefits, often a few days after the injury occurs.

Example: My benefits began after a three-day waiting period, as required by state law.

Work-Related Injury

An injury or illness that arises out of and occurs in the course and scope of employment.

Example: My back injury from lifting heavy boxes was classified as a work-related injury.

Workers’ Compensation Board

A state agency that oversees workers' compensation claims, resolves disputes, and ensures compliance with workers' compensation laws. This may also be referred to as, “Court of Workers’ Compensation Claims”. 

Example: When my claim was denied, I appealed to the Workers' Compensation Board for review.