Term

Definition

date of injury (DOI)

date a specific injury occurs or, for cumulative injuries or occupational disease, the date of partial or total incapacity to work

de novo review

in an appeal of a WC decision, a board, commission, or court that makes a de novo review can make a new determination without considering the initial finding; de novo review is the standard in some states but not in others

death benefits

funeral benefits, subject to a maximum limit in the WC statutes, as well as wage replacement benefits for relatives who were partially or wholly dependent on the worker's income, also subject to state maximums – wage replacement benefits generally end when a spouse remarries or when the youngest child reaches age 18 (25 if still in school), whichever is later

death certificate

legal document issued by a state or county confirming the death of an individual

Death on the High Seas Act (DOHSA)

the wrongful death provisions of the Merchant Marine Act of 1920

debit

for experience rating, an increase in (debit) the premium paid due to an experience modification factor greater than 1.0 (loss experience is worse than that of similar employers)

dec page, dec sheet

see information page

deductible

see large deductible plan and medical benefit deductible - these are deductibles paid by the employer; for WC, the worker does not typically pay any medical deductible

default

For WC, a default of the employer does not prevent payment of benefits by the insurer

Defense Base Act (DBA)

WC coverage for private employees working on US defense bases or supporting war efforts; claims handled within the Longshoremen’s & Harbor Workers Compensation Act federal system

Defense Base Act Coverage Endorsement

endorsement providing Defense Base Act (DBA) coverage

dependency benefits

same as death benefits

dependent

employee's family member who was wholly or partly dependent upon the employee's earnings at the time of the employee's injury, disease, or death (same as survivor)

deposit premium

for retrospectively rated WC plans, the initial premium paid

developed losses

for underwriting purposes, raw losses adjusted to reflect inaccuracies in reserves of known losses, losses which have occurred but have not yet been reported, and closed claims likely to reopen

deviation from scope

for WC, a situation where compensability is questioned because the worker engaged in activities not related to the job

diagnostic related groups (DRGs)

groupings of related hospital procedures for purposes of medical billing; outpatient medical providers use Physicians Current Procedural Terminology (CPT) codes

direct writer

insurer that does not work through independent insurance agents or brokers (agents for direct writers are employees of the insurer)

director

a member of a board of directors who is not automatically eligible for WC benefits

disability management

for WC, strategies and tactics designed to promote an early return to work and maximum medical improvement

discount from charges

older method in use in some states to determine reimbursement rates for medical procedures

disfigurement

impairment of or injury to the beauty, symmetry, or appearance of a person that renders the person unsightly, misshapen, imperfect; or, a detrimental change in the external form of the person

disfigurement benefits

some states allow benefits specifically for scarring or other disfigurement; the basis for awarding such benefits varies widely

district

specific geographic area within a WC system

dividend plan

premium refund plan, calculated after policy expiration, based on the overall favorable performance of the insurer or of a group of policyholders, or an individual employer (dividends cannot be guaranteed in advance although they are often shown on proposals for insurance)

domestic

older term for residence employee

domestic sovereign

federally recognized American Indian tribe, pueblo, or nation-- under the US Constitution, such a group has sovereign rights to self-governance, including in workers compensation matters

Domestic and Agricultural Workers Exclusion Endorsement

exclusion endorsement to a WC policy sometimes used in states where residence employees, agricultural workers, and casual employees are covered by the WC law

domestic worker

older term for residence employee

downcoding

for WC, assigning a different CPT code to reduce the rate of reimbursement

drug testing

for WC, some employers use post-accident drug tests to screen for possible influence of alcohol use or illegal drug use (employers should consult a labor law attorney before instituting such policies)

drug use

for WC, injuries that occur while the worker is under the influence of illegal drugs raise compensability issues

dual capacity claim

for WC, a civil suit alleging that the employer had more than one legal relationship with the employer (e.g., an employee of a soft-drink bottler is injured by the employer's product consumed during non-work hours)

dual purpose trip

for WC, a trip where the worker performs non-work actions as well as duties for the benefit of the employer (e.g., an employee who makes a bank deposit for the employer on her way home) – same as special errand rule

dueling docs

slang term referring to a battle of independent medical examiners, each of whom tries to provide more persuasive opinion about a WC case than other independent medical examiners for that claim

duty to cooperate

WC insurance policy requirement that the employer cooperate with the insurer’s claim investigation and resolution

duty to give notice

WC insurance policy requirement that the employer timely notify the insurer of new claims and certain changes in risk exposure