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Term
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Definition
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early return to work
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situation where the worker’s job duties are modified to meet work restrictions from the injury, thus resulting in a return to work sooner than if only usual and customary duties were available
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early return to work program
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formalized strategy to generate early return to work opportunities
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elective coverage
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WC coverage purchased by a business that is not required by state law to have it
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emergency hearing
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special type of hearing to handle situations which require especially quick action, most often on issues of medical necessity or compensability
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employee (EE)
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worker performing duties essential to the business and under the employer's direction of the means and methods to accomplish the work -- an employee is always a worker, but workers are not always employees (they can be independent contractors)
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employee leasing
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scenario where a labor contractor leases workers to a special employer
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Employee Leasing Client Endorsement
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endorsement to the WC policy that extends coverage to the special employer that is leasing employees from the named insured
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Employee Leasing Client Exclusion Endorsement
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exclusion endorsement to the WC policy where the named insured’s policy does not provide coverage to the special employer leasing its employees
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employer (ER)
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any person, corporation, firm, partnership, voluntary association, joint stock association, or government entity using the services of one or more employees for pay
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employer mutual association
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specific type of self-insurance group permitted in some states
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employers liability coverage (EL)
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this coverage, provided by Part Two of the standard WC policy (or as an endorsement to a general liability policy in monopolistic states), responds to injury claims from workers for damages not covered by state WC statutes
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Employers Liability Coverage Endorsement
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typically used in monopolistic states where private insurers cannot write Part One WC coverage - see employers liability coverage (EL)
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Employment Retirement Income Security Act (ERISA)
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ERISA regulates some non-occupational disability benefits but does not apply to WC benefits
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endorsement
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added language that explains, increases, or limits a WC policy
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ergonomic evaluation
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physical inspection of a worker's work area, either by someone trained in ergonomics or the worker's supervisor, to identify modifications that can be made to reduce physical stressors, especially repetitive ones
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ergonomics
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science of reduction of physical stress in a work area, especially through proper alignment of the human body to tasks
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ergonomist
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specialist in ergonomics
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ERISA
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see Employment Retirement Income Security Act (ERISA)
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error of fact
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in a WC appeal, an allegation that the administrative law judge wrongly interpreted a fact in making a decision
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escrow fund
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a claim payment fund used by a claims administrators to pay claims
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error of law
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in a WC appeal, an allegation that the administrative law judge wrongly interpreted the law in making a decision
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estimated premium
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the premium shown on the information page is an estimated premium; the final premium is determine after the policy period ends
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excess loss insurance
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for self-insurers, a way to limit claim costs above a specific amount
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excess loss premium (ELP)
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for retrospective rated WC plans, a premium paid to limit single losses within the plan
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excess loss premium factor (ELPF)
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same as excess loss premium
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excess losses
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in the experience modification factor, the part of any one incurred loss that exceeds $5000
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excess WC insurance (XWC)
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insurance coverage purchased by self-insured employers to cover losses that exceed the maximum amount that the state allowed the employer to self-insure
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exclusion endorsement
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added language that restricts a WC policy
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exclusion form
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legal document that sole proprietors, partners, officers, or directors use in some states to choose to NOT have their own work injuries or illnesses covered by WC
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exclusive remedy doctrine
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A principle that holds that the injured worker's only legal recourse against the employer for the injury is the WC benefits provided by the state WC statutes – some states have exceptions to the exclusive remedy doctrine
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exemplary damages
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same as punitive damages
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expected costs
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for underwriting purposes, the estimated total cost for the policy period based on expected losses
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expected losses
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for underwriting purposes, the amount of losses likely during the next policy period
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expense constant
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a charge that covers expenses common to all WC policies, regardless of the premium amount
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experience modification factor (Ex Mod, experience modifier)
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adjustment to manual premium, calculated by an advisory organization such as NCCI, based on historic loss and payroll data of a particular insured
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experience modifier
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same as experience modification factor
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experience-rated policy
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WC policy based on experience rating
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experience rating
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Comparison of an employer’s WC losses to other businesses that do similar work; mandatory for most employers; results in an experience modification factor
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Experience Rating Modification Factor Endorsement
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endorsement to a WC policy used when the experience modifier is not available at the time the policy is first issued; says the ex mod will be endorsed onto the policy once available
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extra-hazardous occupation
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misnomer that really means any business required to furnish WC benefits; in a few states, only extra-hazardous industries have to purchase WC coverage (the term comes from the early days of WC, when many businesses were not required to have WC coverage)
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extraterritorial provision
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reciprocal agreement between two state regulators that prevents nonresident workers from filing WC claims as long as they are covered for WC in their residence state
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