Iowa workers’ compensation rules can be overwhelming. One of the biggest challenges injured workers face after being hurt on the job is understanding work comp language. There seems to be an acronym for everything.
Here is a quick reference guide to Iowa workers’ compensation lingo, so you’re not left in the dark:
IME: Independent Medical Examination.
This is an evaluation of an injured worker performed by a doctor. The doctor is not asked to provide treatment, but rather to offer opinions about very specific issues in a workers’ compensation case. This opinion can include:
- Whether a physical condition or injury was caused by work
- The injured worker’s physical impairment rating and permanent physical restrictions
- Any potential future treatment recommendations.
In certain circumstances, both the insurance company and an injured worker can seek an IME. When certain conditions are met, the workers’ compensation insurance company is required to pay for an examination of the injured worker by a doctor of his or her choosing.
Some independent medical examiners are better than others. You should seek out the advice of an Iowa workers’ compensation attorney before selecting a doctor for your independent medical evaluation.
FCE: Functional Capacity Evaluation.
This is an evaluation of an injured worker typically performed by a physical therapist. The therapist administers a series of physical tests to measure the injured worker’s physical limitations. During the evaluation, the therapist may ask the injured worker to push, pull, lift, grip, grasp, walk, sit, stand, etc., to measure their physical abilities.
There are different reasons to have an FCE. A physical therapist may be provided a job description and asked to give an opinion about whether an injured worker is physically capable of returning to that job after an injury. Or the therapist may do a more general exam to determine a worker’s limitations without regard for a specific job.
No matter the reason for the test, it’s important that the injured worker try their best to perform the test the physical therapist is administering.
MMI: Maximum Medical Improvement.
This term signals that a doctor believes the injured worker is no longer going to improve medically. It does not mean that treatment is no longer necessary; rather, it means the injured worker will not likely experience an improvement in symptoms with additional care. More medical care may be necessary to maintain the injured workers’ level of symptoms and functioning.
Being placed at MMI can also trigger a conversion of temporary disability benefits to permanent disability benefits if the injured worker has a permanent injury.
MSA: Medicare Set-aside Account.
Federal law states you can’t ask Medicare to pay for medical care that is related to a work injury. If an injured worker needs ongoing medical care, and the insurance company offers a settlement that includes closing out the injured worker’s right to medical benefits, then an MSA should be established. This is simply money in a checking account that is paid out for medical care related to the work injury.
Special recordkeeping and reporting to Medicare must take place. This is to document how the money is spent. If proper steps are not taken to protect Medicare’s interest, the injured worker may risk their access to future medical care that is paid for by Medicare.
TTD and PPD: Temporary Total Disability and Permanent Partial Disability.
Both of these are weekly cash Iowa workers’ compensation benefits. The difference between them is when they are paid out to an injured worker.
Temporary benefits are paid while the injured worker is still healing from a work injury and the injured worker is restricted from working completely. Permanent partial disability benefits are paid if the work injury results in a permanent physical disability.
The amount of each weekly benefit is determined by a calculation of the injured worker’s average weekly wage. This is a calculation that involves some judgment and sometimes insurance companies get it wrong. How much an injured worker receives in permanent disability benefits is also a matter of debate.
If you feel like your weekly amount is not being calculated correctly, or the amount of permanent disability benefits the insurance company is offering seems low, you should contact an experienced Iowa workers’ compensation attorney.
Hopefully this glossary of terms helps you more easily translate the workers’ compensation rules and language. If you need additional information, download our free Law Guide to Iowa Workers’ Compensation Claims at www.fightingforfairness.com.