Language of Workers’ Compensation Part Two: 17 New York Acronyms Everyone Should Know
Spend a few hours navigating the WC (excuse me, workers’ compensation) industry for a day and you’ll be bombarded with enough acronyms to last a lifetime.
In Part One of our The Language of Workers’ Compensation series, we defined the 15 most common stakeholders in a workers’ compensation case and outlined each individual’s role and primary objective.
In Part Two, we’re tackling the most important acronyms to help employers, carriers and injured workers more easily navigate the workers’ compensation industry here in New York.
17 New York Workers’ Compensation Acronyms
DOI: Date of Injury. The date an injured worker claims to have been injured on the job.
AWW: Average Weekly Wage. This is the injured worker’s average weekly take-home salary prior to the date of injury.
MTG: Medical Treatment Guidelines. A single standard of medical care for the treatment of specific injuries experienced by injured workers set by the NYS Workers’ Compensation Board. For more information on the NYS Medical Treatment Guideline process, check out our guide to navigating New York State Medical Treatment Guidelines here.
PPO: Preferred Provider Organization. A PPO is an organization of medical doctors, hospitals and additional health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the insurer's or administrator's clients.
PBM: Pharmacy Benefit Manager. An organization contracted by a carrier or TPA to manage all aspects of pharmaceutical services for their claims.
MED: Morphine Equivalent Doses. Compares opioid doses to an equivalent morphine dose to create one standard value across drugs. Built to help identify high-risk opioid doses and tackle the nation’s rising opioid epidemic
MMI: Maximum Medical Improvement. A decision on the highest level of recovery that a claimant can achieve from a work-related injury. For more info, check out the New York State Workers’ Compensation Board’s Impairment Guidelines.
IME: Independent Medical Examination. A medical evaluation that is used to resolve questions about medical conditions, including but not limited to what treatment is necessary and the degree of permanent impairment, if any.
FCE: Functional Capacity Evaluation. A medically ordered test to determine the tasks a worker can and cannot perform after being injured on the job. Physicians, lawyers, employers and carriers may request an FCE for an injured worker. After the FCE, a medical document is produced to objectively record the findings and outline adaptive strategies.
NYS WCB: New York State Workers’ Compensation Board. The New York state agency that processes and monitors the administration of all workers’ compensation claims in New York. The New York State Workers’ Comp Board also provides administrative and judicial services to aid in the resolution of disputes that come about as a result of claims made.
NCM: Nurse Case Manager: The nurse responsible for coordinating an injured worker’s medical care, guiding the injured worker to recovery and ensuring that each stakeholder is accurately informed of an injured worker’s medical status and estimated treatment trajectory. There are telephonic nurse case managers (TCMs) and field case managers (FCMs). May also be referred to as Medical Case Manager (MCM).
NOD: Notice of Decision. When a claim is disputed by a carrier and the issue cannot be resolved by a workers’ compensation board claim examiner or conciliator, it will go before a workers’ compensation law judge. The judge will decide the treatment, compensability or issues raised for or against the claimant
FROI: First Report of Injury. This form must be filled out by the employer upon notice of a workplace injury. In New York, this form doesn’t have to be submitted to the Workers’ Comp Board if the insured’s carrier submits to the Board on the insured’s behalf.
INJ: A double threat! This acronym can refer to either an Injury or Injection.
An injury is any damage done to the body—helping injured workers heal is the reason we’re here.
An injection is an act of using a needle and syringe to inject liquid or a substance into the body
SLU: Scheduled Loss of Use. A percentage assigned to certain body parts that were injured and indicates how much function was lost as a result of that injury. An SLU is aligned with an additional cash payment for the loss of ability of that body part.
DDBL: Degree of Disability. A percentage value that indicates how disabled an injured worker is. This value serves an important role in determining indemnity benefits.
BOP: Burden of Proof. Broadly, Burden of Proof is the responsibility of a party to prove the claims they have made against another party. Burden of Proof comes to play at two crucial points during a NYS workers’ compensation claim. First, it is the responsibility of the injured worker to prove the existence of a disability and the connection of that injury to a work related incident. Second, when filing a request for treatment, a provider must prove that treatment is necessary to effectively treat an injury.