Quick Definitions: Administrative Law Judge

The Administrative Law Judge, or ALJ, is the judge that is assigned to preside over a workers' compensation case through the initial hearing. Prior to the hearing, the ALJ makes decisions on any motions filed by the parties and has the authority to schedule or continue the hearing, among other things. At the hearing, the ALJ hears and receives all evidence from both parties and issues a written decision determining the outcome of the case.

Quick Definitions: Panel of Physicians

The Panel of Physicians is a list of doctors and care providers which must be maintained and posted by the Employer in the event that a worker gets injured on the job. After an injury, a worker must treat with one of the physicians on the panel. In Georgia, there are three kinds of panels that may be utilized by an Employer: Traditional, Conformed, or MCO. 

For more information on the Panel of Physicians, please look here. 

Quick Definitions: Compensable Injury

This term is used to describe worker's compensation injuries and basically means "covered by workers' compensation insurance." A compensable injury is one that arose "out of and in the course of the Claimant's employment" and for which a Claimant can receive medical care and potentially income benefits.

Quick Definitions: Idiopathic Fall

The term "idiopathic fall" typically comes up as a defense asserted by the Employer.  Strictly defined, idiopathic means "of unknown cause or origin." Thus, an idiopathic fall is a fall caused by an unknown source. Essentially, when this defense to a workers' comp claim is used by an Employer, they are saying that the reason that the Claimant fell down was due to a reason that had absolutely nothing to do with the Claimant's employment, such as an epileptic seizure. An idiopathic fall defense is extremely complicated and very factually dependent, so if your Employer is denying benefits based on this theory, it is highly advised that you contact an attorney to discuss your options and rights.

Quick Definitions: Independent Medical Evaluation (IME)

An Independent Medical Evaluation, or IME, is a one-time examination that can be requested by either the Employer/Insurer or the Claimant. An IME is simply a way to obtain additional evidence, or simply some evidence to support the position of either party in the workers' compensation claim. For instance, if the Claimant's authorized treating physician (ATP) gives the opinion that the Claimant's injured back is fully healed, a Claimant may want to obtain an IME to contradict the ATP's diagnosis. This evidence can come in extremely handy at a hearing or during settlement negotiations.

Quick Definitions: "Catastrophic Injury"

Typically, a cap is placed on an injured worker's receipt of TTD benefits (unlike medical benefits, which are always the responsibility of the employer so long as it relates to the work injury). However, in the event of a "catastrophic injury," the 400 week cap is removed and the injured worker is entitled to TTD benefits for the rest of his or her life. Under Georgia law, there are 5 defined categories of catastrophic injuries--spinal cord, brain, serious burns, amputations, and blindness--and one "catch all" provision, which is factually specific and requires close examination of the true severity of the injury. In short, with regard to the "catch all" provision, if an injured worker is entitled to receive Social Security Disability benefits, he or she may (but not necessarily) be entitled to a "catastrophic" designation.

Quick Definitions: "MMI"

This stands for maximum medical improvement. This status is typically assigned to you by your ATP towards the end of your treatment. Essentially, this means that your doctor feels that you are as good as you'll ever be with respect to your work injury, and that your recovery has reached its peak.

Quick Definitions: "Impairment Rating"

Also sometimes called a "PPD rating," this is the percentage of impairment that the ATP assigns to the specific body part that was injured in a work accident, or to the body as a whole. It is usually assigned towards the end of your treatment. This rating, which must be based upon the American Medical Association's Guides to the Evaluation of Permanent Impairment (5th Edition), is used to calculate your entitlement to PPD benefits.

Quick Definitions: "PPD Benefits"

PPD is the abbreviation for Permanent Partial Disability.  This is one of three types of weekly benefits that may be payable after a work accident.  PPD benefits are designed to compensate the injured worker for the permanent physical impairment sustained to a particular body part or the body as a whole as a result of a work injury. They are based upon a percentage of impairment, or impairment rating, that your ATP assigns to your injury.

For more information on PPD benefits, please look here. To compare to the other two types of weekly benefits, TTD and TPD, please look here, here and here.

Quick Definitions: "Compensation Rate"

An injured worker's "compensation rate" is the amount of money which is payable to an injured worker on a weekly basis for either TTD, TPD or PPD benefits. It is derived from the worker's average weekly wage ("AWW").

For TTD and PPD benefits, the compensation rate is calculated by taking 2/3 of the AWW.

For TPD benefits, the compensation rate is calculated by comparing the AWW of the injured worker prior to the accident to the AWW after the accident. The precise compensation rate is determined by taking 2/3 of the difference between the two AWW's. Thus, if the pre-accident AWW was $400.00, and the post-accident AWW was $300.00, then the compensation rate would be 2/3 of $100.00, or $66.67 (this amount would be paid by the insurer in addition to the worker's regular paycheck).

Quick Definitions: "TPD Benefits"

"TPD" is short for Temporary Partial Disability. This is a type of weekly income benefit that may be payable after a work accident. It is "temporary" because there's a cap on the number of weeks that these benefits can be received by the injured worker, and it's "partial" because they're payable when the injured worker's ability to work a full schedule has been diminished--such as when you're only able to work 20 hours per week instead of 40. They are designed to compensate the injured worker for the partial loss of income as a result of the work injury.

For more information on this type of benefit, please look here. To compare to TTD benefits, please look here.

Quick Definitions: "Authorized Treating Physician"

The authorized treating physician ("ATP") is an injured worker's primary doctor (usually the first doctor you go to). Every injured worker has one ATP who provides routine care and can also "arrange for any consultation, referral, and extraordinary or other specialized medical services" (like a referral to an orthopedist or neurologist). The ATP holds a lot of power over your claim, not only because he or she is providing your primary treatment and can make referrals, but also because an administrative law judge will almost always honor the ATP's opinion or decision regarding your treatment. If you're not satisfied with your treatment, however, the law does allow for a one-time change of the ATP (with certain restrictions).

Quick Definitions: "Disability"

As used in the workers' compensation context, the word "disability" means impairment or diminution of earning capacity. In other words, an injury that has caused a worker to earn less than he or she did before the work accident constitutes a "disability."

Quick Definitions: "TTD Benefits"

"TTD" is short for Temporary Total Disability. This is a type of weekly income benefit that may be payable after a work accident. These benefits are designed to compensate the injured worker for the loss of income as a result of the work accident. They are "temporary" because there's a cap on the number of weeks that these benefits can be received by the injured worker, and they're "total" because they're payable when the injured worker cannot work in any capacity.

For more information on this type of benefit, please look here or here.