Wage upon which weekly compensation rate is based. For full-time employees, AWW is based on 13 weeks of wages from all jobs and self-employment income prior to, but not including, week of injury. Divide total wages by number of weeks actually worked during 13-week period to get AWW. Use 26 weeks for part-time employees. For seasonal employees, use 52 weeks and divide by 52. Overtime pay and bonuses are averaged over length of employment up to 52 weeks. Include vacation pay.
Document filed to claim trial from pre-trial order; must be filed within 5 business days of pre-trial hearing.
Amount of weekly compensation benefit; calculated at 75% of Spendable Base Wage.
Additional compensation is paid for any permanent disfigurement that results from an injury, e.g., scar, deformity, limp. Amount of compensation is not subject to any formula.
The foundation for the payment of workers’ compensation benefits. Defined as the amount of wages which an employee is able to earn. Benefits are paid for the loss of earning capacity caused by an injury, not for the injury itself. If an injury does not cause a loss of earning capacity, then no compensation, other than medical benefits and specific compensation for scarring and loss of use , is payable.
An injury or condition that results from the original work related injury; benefits are payable for a flow-from as if it were any other type of work related injury.
Medical examination ordered by insurance company. Attendance is mandatory. Employee is entitled to reimbursement for transportation expenses.
Hearing scheduled after Claim for Trial from Pre-Trial Order. The purpose of the Initial Hearing is for attorneys to advise the judge as to what witnesses and other evidence they intend to present in the case. The injured worker and employer are not required to be present at the Initial Hearing.
Additional compensation is paid for the permanent loss of use of body part due to injury or surgery. Calculate as follows: multiply maximum number of weeks allowable for a total loss of the body part by the percentage loss of use expressed by the doctor to arrive at number of weeks of compensation for loss of use and then multiply that number by one-half of the average weekly wage (but no less than $90/week and no more than $180/week). For example, medical report shows 15% loss of use of upper extremity; Total loss of arm allows for 312 weeks of compensation. 312 x15% = 46.8 weeks. Assuming an average weekly wage of $400, 46.8 weeks x $180/week = $8,424 of compensation for loss of use.
That point in time when an injury has become stable and no further treatment is reasonably expected to materially improve the condition. Finding of MMI permits the employer to petition the Court for permission to reduce the compensation rate by 30%. Defense to petition is that the employee has actively been making a good faith effort toward seeking employment.
Document under which compensation is paid with liability established upon the insurance company. Benefits may not be reduced or discontinued without written agreement of employee (see Suspension Agreement and Mutual Agreement) or order of the Court.
Form used to make changes to Memorandum of Agreement or Court order that established liability for injury, e.g., change average weekly wage, modify from total disability to partial disability or vice-versa, change description of injury, etc
Document under which compensation is paid without the establishment of liability upon the insurance company. Benefits may be paid for up to 13 weeks. Liability and continuing disability are conclusively established if payments are made for more than 13 weeks.
Term used to define an employee who is medically partially disabled but, due to the injury combined with his/her age, education, background, abilities and training, is unemployable for any work; such an employee will receive benefits for total disability.
Petition filed with the Workers' Compensation Court to establish liability upon an insurance company for an injury.
The inability to do one’s regular job but able to perform light duty; availability of light duty at workplace is immaterial. Compensation rate is 75% of difference between Spendable Base Wage before injury and spendable base wage after injury. Maximum period of benefits is 312 weeks (6 years) unless employee can prove that the injury poses a “material hindrance” to finding work.
Petition filed with the Workers’ Compensation Court to request relief from a Memorandum of Agreement or Court order that established liability for an injury. For example, employer may file to discontinue or reduce benefits, etc; employee may file to increase disability status from partial to total, seek order for payment of medical bill, etc.
Informal hearing scheduled 21 days after filing of petition. No testimony is taken. Court will make binding determination at pre-trial which may be appealed to full hearing by either party (see Claim for Trial).
A list of doctors maintained by an insurance company which the employee may see if he/she chooses to switch doctors. An employee is free to choose his/her initial doctor after an injury. That initial doctor may refer the employee to a specialist. If the employee then wants to see a different doctor, he or she must go to a doctor that is on the PPN or get approval of the insurance company to see a doctor who is not on the PPN.
Form required to be completed by injured worker at request of Insurance company to report all wages earned for specific period of time. Failure to report or false reporting is subject to finding of fraud.
Form signed by injured worker and insurance adjuster to document payment of compensation for specific compensation, i.e., disfigurement and loss of use.
Compensation to which an employee is entitled for disfigurement, loss of use and loss of sight and hearing.
Calculated from average weekly wage to provide basis for calculation of compensation rate. Similar to take home pay. Tables of average weekly wage and conversion to spendable base wage are published yearly and are conclusive as to calculation. View Spendable Base Wage Tables.
Job which an employee is physically able to perform and will not exacerbate his/her health and which bears a reasonable relationship to his/her qualifications, background, education and training. Acceptance of offer of SAE is not mandatory if it would result in the inequitable forfeiture or loss of seniority with the employer or of a monetary benefit. If refused, the Court shall reduce benefits based on the amount of wages that would have been paid pursuant to the offer of SAE. If accepted and then terminated by the employer for reasons other than the employee’s misconduct, then weekly compensation will be reinstated.
Document which reflects agreement of injured worker that weekly compensation may stop as of date indicated. Medical benefits continue.
The inability to perform any and all work due to the effects of the work injury. Compensation is 75% of Spendable Base Wage plus $15.00 per week for each dependent. Cost of Living Adjustments are paid as of May 10 of each year for employees who have received benefits for total incapacity for the prior 52 consecutive weeks.
Document which lists weekly earnings used as the basis for calculation of the average weekly wage.