Term

Definition

ratable losses

same as subject losses

rate

one of the components of a WC premium computation; in the simplest example, rate times remuneration equals premium

rating bureau

older term for advisory organization

rating guidelines

see impairment rating guidelines

raw losses

loss amounts taken from loss runs that have not been trended or developed

reasonable accommodation

under the Americans with Disabilities Act (ADA), employers must make reasonable accommodation for qualified individuals

rebuttable presumption

see presumption, rebuttable

reciprocal agreement

agreement between two parties such as an extraterritorial provision

recorded statement

unedited recording, usually on audio tape, of questions to and answers from an injured worker, employer, or witness to an accident or injury

recovery from others

generic insurance policy phrase that includes subrogation

recovery

see offset

recreational activities

injuries to workers during company-connected recreational activities may or may not be covered by WC law

redemption

in some states, a permanent disability settlement

rehabilitation benefits

physical or vocational rehabilitation benefits provided to an injured worker, intended to restore the person to a point where paid employment is possible

rehabilitation plan

plan for vocational rehabilitation, usually prepared by a trained counselor, that includes specific goals for retraining, reeducation, or reemployment

rehab unit

see vocational rehabilitation unit

reinsurance

contract where another insurer (or insurers) accepts part of the financial risk of an insurance policy

reinsurer

insurer who provides reinsurance; the reinsurer may be part of the voluntary WC market or a residual market plan

relative value scale

see Resource-Based Relative Value Scale (RBRVS)

remarriage dowry

for WC, a lump-sum payment made to a surviving spouse upon remarriage because ongoing death benefits have ended as a result of the remarriage

remuneration

basis for calculating WC premium, remuneration is primarily payroll, but may also include other forms of employee compensation (WC premium is computed by applying varying rates per hundred dollars of remuneration)

reopenings

state laws vary as to when WC cases can be reopened or case decisions modified; there are often time limits that apply

reserves

money set aside, as required by law, to pay the anticipated ultimate cost of claims

residence employee

worker (either full-time or part-time) who performs household services

residual market loading

additional charge for voluntary market WC policies to help offset losses in the state’s residual market plan

residual market plan

WC program for employers that cannot obtain coverage voluntarily from an insurer - state programs differ, insuring these employers through allocation to private insurers, joint underwriting associations, or assignment to a competitive state fund

Resource-Based Relative Value Scale (RBRVS)

system of ranking the difficulty and expense of medical procedures against each other -- Medicare's medical reimbursement has been based on an RBRVS system since 1992 and state WC medical fee schedules are increasingly adopting RBRVS approaches

respondent

for WC, an older term for the employer or its insurer; more generally, whoever has to respond to a legal action

retaliation

in WC, an employer is not allowed to take adverse action against a worker merely because the worker files a WC claim; retaliation can result in penalties or a civil lawsuit

retaliatory discharge

improper termination of a worker’s employment in retaliation for some claim made or benefit sought by an employee

retention plan

WC program that adjusts the premium up or down based on losses and associated costs that occur during the policy period

retro adjustment

additional premium or premium refund based on a retrospective WC rating plan that reaches a valuation date

retro formula

formula used for a retrospectively rated plan, often expressed as {retro premium = (basic premium + excess loss premium + converted losses) x tax multiplier}

retroactive period

the number of days or weeks of lost time required before the claim administrator is required to reimburse the initial waiting period

retrospective additional premium

premium owed by the employer as a result of an unfavorable result in a retrospectively rated WC plan

retrospective development premium

in retrospectively rated WC plans, premium charges used to smooth out fluctuations that can occur between the first and subsequent retro adjustments

retrospective return premium

premium refund to the employer as a result of a favorable result in a retrospectively rated WC plan

Retrospective Premium Endorsement One Year Plan

endorsement to the WC policy that explains the one year retrospective rating plan in effect

Retrospective Premium Endorsement One Year Plan - Multiple Lines

endorsement to the WC policy that explains the one-year retrospective rating plan in effect for multiple lines of insurance

Retrospective Premium Endorsement Three Year Plan

endorsement to the WC policy that explains the three-year retrospective rating plan in effect for multiple lines of insurance

Retrospective Premium Endorsement Three Year Plan - Multiple Lines

endorsement to the WC policy that explains the three-year retrospective rating plan in effect for multiple lines of insurance

retrospective rating plan (retro)

WC program that makes subsequent adjustments to premium, after policy expiration, based on losses – the adjustment can go up or down within set parameters

return to work (RTW) program

employer offers of light-duty work or modified work to reduce lost-time days and improve injured worker outcomes

reverse offset

in some cases, WC wage benefits are offset (reduced) by SSDI benefits; in other situations, SSDI wage benefits are offset by WC benefits (a reverse offset)

right and duty to defend

the insurer has the right and duty to defend lawsuits covered by Part Two employers liability coverage

right to settle

the insurer has the right to settle claims, without the employer’s consent, that are covered by Part Two employers liability coverage

Roosevelt, Theodore

US president most associated with efforts to institute workers compensation systems in the US

round-table reserving

process where a group of claim professionals discusses a case and establishes reserves by consensus or averaging