Workers’ compensation claims require careful documentation. However, sometimes it can be difficult to understand the requirements and paperwork.
Prepare to file a claim for your work injury by learning these common California workers’ compensation terms.
Agreed medical evaluator
In a dispute with your employer, this doctor provides a medical examination for evidence. The insurance company and your attorney must choose the AME together.
Your doctor may clear you to perform alternative work duties. If you need to seek a new job, you do not have to accept alternative work unless the workplace is within a reasonable commuting distance and pays at least 85% of your previous salary. You do not have to accept jobs that will last less than a year.
These common acronyms stand for arising out of and occurring in the course of employment. In simpler terms, you must show that your injury happened on the job while doing job-related duties.
This individual works for the insurance company. He or she will review your case and decide if you qualify for workers’ compensation benefits. This person can also offer settlements for workers’ comp cases.
Disability Evaluation Unit
This department manages permanent disability benefits. The DEU will review medical reports to determine a benefit percentage.
Your employer will give you this claim form. You must fill it out and return it to start your claim. The DWC1 allows you to access all eligible California state workers’ compensation benefits.
Medical treatment utilization schedule
Known as MTUS, this term describes the California guidelines for medical treatment. Workers’ compensation doctors must use specific therapies proven by evidence depending on your injury.
Abbreviated as UR, utilization review looks at treatments to decide if they are medically necessary. This depends on your condition, the MTUS and other factors.
During this process, you have the right to representation by a workers’ compensation lawyer. He or she can help you fill out the required forms to qualify for benefits and gather the evidence you need for hearings and appeals.