Legal Dictionary
Accepted Claim
A claim in which the insurance company accepts that your injury or illness will be covered by worker’s compensation. Even if your claim is accepted it is possible there will be delays or other problems until the claim is paid.
Also referred to as: admitted claim.
Agreed Medical Evaluator (AME)
If you are represented by an attorney, an AME is the doctor both the attorney and insurance company agree on who will conduct a medical examination to evaluate an injury in order to resolve a dispute. If you are not represented by an attorney, you will likely be evaluated by …
Alternative Work
A new job with your current employer. If your physician indicates you will not be able to return to work at the time of injury, your employer is encourage to offer you alternative work instead of displacement or vocational rehabilitation benefits. The alternative work an employer may provide must meet …
Americans with Disabilities Act (ADA)
A federal law that prohibits discrimination against people with disabilities. If you believe you may have been discriminated against at work because you’re disabled, you may be able to file a claim. For more information on the rights you may have under ADA laws, contact the U.S. Equal Employment Opportunity Commission …
AOE/COE: Arising out of / occurring in the course of employment
Claims that require AOE/COE generally require an injury to be caused by and happen on the job.
Applicant’s attorney
A lawyer that can represent you in your workers’ compensation case. Applicant refers to you, the injured worker.
Apportionment
A method used to assign the causes of a permanent disability. Apportionment may attribute a certain percentage of cause to a work related injury and percentage of cause to other disabilities.
Bad Faith
Neglecting or refusing to fulfill a promise, this may be the basis for a law suit if it has caused a person harm. Judicial decisions have labeled ‘bad faith’ as the following: concealment; fraud; evasion of the spirit of the bargain; lack of diligence or slacking off; willful rendering of …
Benefit Notice
A required letter or form sent to you by an insurance company to inform you of potential benefits you may be entitled to receive.
Also referred to as: notice.
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