Dr. Azouz reviews worker’s compensation definitions:
Nurse Case manager: A nurse who helps to coordinate all necessary services for the patient
MMI (Maximum medical improvement): This rating determines when healing or recovery from an injury is no longer expected. Usually an assessment is performed at the time of MMI to designate the permanent severity of an injury and determine the impairment rating.
Worker’s compensation carrier: An insurance coverage that gives income and medical benefits to employees who have work-related injuries or illnesses.
Compensable: A term that refers to the accident being “in keeping” with the injury at work.
Medically necessary: A treatment that is required for maximal recovery, and could negatively affect the patient if not done.
Adjuster: Someone who determines if the insurance carrier is liable for the claim and then pays outstanding benefits
Worker’s Compensation claim: A report of the injury that is filed by or on behalf of the employee.
Ombudsman: A specially trained employee who can help the patient for free should they have a dispute about their claim and do not have an attorney or legal representation.