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A Workers Comp Glossary to Help You Understand the Meanings of Abbreviations and Terms You Will See

 

You enter a new world when you suffer an occupational injury.

 

Workers compensation uses many terms and abbreviations you will hear for the first time.

 

And some words you recognize will have different meanings in workers comp than in other situations.

 

This article defines commonly used workers compensation terms and abbreviations.

 

We hope you use this workers comp glossary to learn about your legal rights, understand what is happening during the legal process, and negotiate a workers compensation settlement that provides for wage loss and medical treatment.  

 

Read on to learn what the workers compensation words you see mean.

 

Looking for help with your Virginia workers compensation claim? Join the thousands of injured employees who have relied on us for assistance.

 

Call one of our top-ranked work injury lawyers at (804) 251-1620 or (757) 810-5614 if you have workers comp questions.

 

 

Workers Compensation Terms and Meanings

 

Here is the list of common workers comp terms and their definitions:

 

20-day order payments made: A court document generated by the Virginia Workers Compensation Commission when a self-insured employer or claim administrator reports wage loss or medical payments to the Commission despite no award entered.  

 

30-day order claim filed: A court document generated by the Virginia Workers Compensation Commission that directs a self-insured employer, insurance carrier, or claim administrator to respond to your claim for benefits within 30 days. Claim acceptance or denial are appropriate answers.   

 

90-day rule: A procedural rule that says you cannot receive more wage loss benefits for any period more than 90 days before filing a change in condition claim.  

 

500-weeks: The maximum number of weeks you can receive compensation for wage loss or permanent partial disability in Virginia, except in cases of permanent and total incapacity under Virginia Code Section 65.2-503 (C). Other states have different caps on wage loss payments. 

 

A

 

Abandon: To give up something for good. For example, an insurance company may abandon one of its defenses. Or you may abandon part of your claim if you do not present evidence.  

 

Abandoned-pleading doctrine: A rule that a party may introduce into evidence past pleadings you filed as admissions. This is why it is important to file an accurate and complete claim from the start.  

 

Abeyance: To suspend legal proceedings. For example, you may ask the court to hold your workers comp claim in abeyance while you wait for a decision in a related civil action.  

 

Abide: To follow or obey. For example, you should abide by your treating doctor’s work restrictions.

 

Ab initio: From the beginning. For example, the court may find one of its orders void ab initio, meaning it was never valid.

 

Able to work: A doctor’s opinion that you can work without restrictions.

 

Abnormality: An irregular finding, such as on diagnostic imaging or testing.

 

Abuse of discretion: The standard of review for appellate courts on some matters. For example, you may have to show that a judge’s decision to exclude specific evidence was unreasonable before the appellate court will overturn that decision.  

 

Acceptance: The act of agreeing to the proposed terms. For example, you may accept the insurer’s pre-injury average weekly wage figure.

 

Accepted claim: A claim where the insurance company agrees that workers compensation covers your injury or illness (like accepted liability in an auto accident case). You may, however, still have problems receiving all the benefits asked for. 

 

Accident: An unintended and unforeseen event that arises from and during your employment, resulting in bodily injury. 

 

Accident date: The day, month, and year that your injury occurs. 

 

Accident reconstruction: The process of analyzing evidence from an accident scene and using math, chemistry, physics, or earth sciences to recreate the event.  

 

Accident description: A narrative that gives details about how your work injury happened. You may provide several accident descriptions during the claim process (such as during a deposition or trial testimony or when answering interrogatories).  

 

Accommodation: A change made to a specific job so that you can perform it within your medical work restrictions.  

 

Accrue: To accumulate. Past due benefits accrue while you wait for trial.

 

Acknowledge: To admit that you received something. For example, ask the insurer to acknowledge the date it had notice of your claim.

 

ACOEM: American College of Occupational and Environmental Medicine. 

 

Act: A term that refers to the Virginia Workers Compensation Act, the statutes governing occupational injury and illness claims

 

Act of God: A natural event (such as a flood, windstorm, tornado, hurricane, lightning strike, or earthquake) that causes injury, death, or property damage. Courts have said that an Act of God is a natural force so unexpected that no human could have anticipated it.

 

Action: A civil proceeding. This term also refers to a civil action, which is a lawsuit seeking a legal remedy or equitable relief.

 

Active duty: Current service in the U.S. Armed Forces or a law enforcement agency.  

 

Activities of daily living (ADL): This term covers basic tasks you do daily, such as bathing, dressing, grooming, and eating.  

 

Actuary: A person who uses math, statistics, and financial theory to analyze risks and costs for insurance companies.   

 

ADA: Americans with Disabilities Act. A federal law prohibiting discrimination against people with disabilities. 

 

Address: To speak to. For example, you may have to address the court during trial. Or this word may refer to your home address.

 

ADEA: Age Discrimination in Employment Act. A federal law that prohibits employers from discriminating against employees who are 40 years old or older.

 

Adequate: Sufficient. You must prove an adequate job search to receive payments in some situations.

 

Ad hominem: To attack your opponent’s character instead of their legal arguments. Avoid this to strengthen your case.

 

Adjourn: To end or postpone a legal proceeding (usually a hearing).  

 

Adjudicate: To make an official judgment resolving a legal dispute between two or more parties.  

 

Adjuster: An agent or employee of a self-insured employer or the insurance company who investigates and evaluates insurance claims, then negotiates with you on the benefit amount. This person is also called a claim adjuster or a claim representative. Read these articles to learn the tricks used by adjusters and how to scare insurance representatives into offering more money.  

 

Adjustment: To assess how much to pay to resolve an insurance claim.  

 

Administrative law: The law controlling administrative agencies (such as workers compensation commissions and boards) and their processes.

 

Administrative law judge (ALJ): A person who presides over administrative hearings and decides claims between government agencies and individuals after weighing the evidence.  

 

Administrative proceeding: A hearing or trial before an administrative agency.

  

Admiralty: The laws governing maritime torts, contracts, injuries, and losses. 

 

Admissibility: Whether the court will admit a piece of evidence into the record at a hearing or trial.  

 

Admit: To confess or recognize an unfavorable fact is true.

 

Advance: A cash payment from the insurer before the law requires it. You may ask for an advance of the settlement funds before the Workers Compensation Commission approves the settlement. However, the insurer will reduce your total reward or lump sum by the amount advanced.

 

Adverse: Something against you. For example, you want to research any adverse case law so you can distinguish the facts of your case.

 

Adversarial proceeding: This legal proceeding involves two or more parties asking a neutral person to decide a dispute.

 

Advise: To recommend an act.

 

Advocate: A person who helps you get the benefits you need. Your workers comp lawyer is an advocate.

 

Affidavit: A sworn statement under oath where you voluntarily declare the information in the document is true. You will need to file an Affidavit with the Workers Compensation Commission as part of the settlement process. 

 

Affirm: To approve a lower court’s decision. For example, the Full Workers Compensation Commission may affirm a deputy commissioner’s award granting benefits.  

 

Aggravation: A rule that your employer must pay benefits for medical care and disability when a work-connected injury worsens a pre-existing injury or condition. Workers comp often uses the terms aggravation and exacerbation interchangeably, although they are distinct.

 

Agreement: An understanding between two or more parties about their rights and responsibilities.

 

Aggregate limit: The maximum amount of coverage that an insurance policy will prove over a specific period or the life of a claim. For example, the Virginia Workers Compensation Act places an aggregate limit on how much the insurer may have to pay for home and vehicle modifications.  

 

Alias: A name you use or that others call you, other than the name on your birth certificate. The insurance company may ask you for all known aliases during pretrial discovery.

 

Alien: A person living within the borders of the United States but is not a citizen. Aliens may qualify for workers compensation benefits, particularly when disabled from all work because of an industrial accident.

 

Allegation: An unproven statement.

 

Allocation: The amount of a settlement given for a specific claim (if the settlement resolves multiple cases) or to a particular benefit (such as future medical expenses, permanent partial disability, or wage loss).

 

Allow: To permit a request or allow a piece of evidence into the record.

 

Alternative dispute resolution (ADR): Any method used by parties to resolve disputes outside of formal litigation. Mediation and arbitration are the most common ADR tools. Any party to the litigation may ask the presiding judge to refer the case to ADR.   

 

Alternative work: A new job with your pre-injury employer or a new company that you can perform despite having work restrictions from the occupational injury. Alternative work is sometimes called selective employment or alternative temporary duty.  

 

Ambiguity: A word or phrase with multiple meanings. You should object to any interrogatory or question that is ambiguous because the meaning you choose may affect your answer.

 

Amend: To change something. For example, you must amend your answers to discovery as you receive more information.  

 

American Medical Association (AMA): A national professional association and lobbying group for physicians. The AMA publishes the “Guides to the Evaluation of Permanent Impairment,” which doctors and workers comp adjudicators use to determine the percentage of impairment from a work-related injury or an occupational disease. 

 

American rule: The general rule that each party pays their own attorney’s fees. Workers comp follows the American rule unless the Workers Compensation Commission finds the employer or insurer acted in bad faith or raised an unreasonable defense. This is why you will have to pay attorney’s fees from your settlement in most cases.  

 

Amputation chart: A form published by the Virginia Workers Compensation Commission that physicians may complete to show what body parts were amputated. The physician’s completed Amputation Chart determines how much you can receive in permanent partial disability benefits for the loss of a body part in an industrial accident.  

 

Anchoring effect: A negotiation method you can use to get a better settlement.

 

Ancillary: Subordinate. Your settlement may include a resignation and release or a confidentially agreement. These papers are ancillary to the settlement.

 

Annuity: A financial instrument that provides regular, periodic payments. The insurance company may include annuities as part of a settlement offer.  

 

Answer: A response to a question (during the deposition or trial), a written discovery request, or a pleading (usually the complaint in a civil action).  

 

Anti subrogation rule: The principle that a medical benefits insurance provider has no right of subrogation against your workers compensation benefits or settlement.

 

Appeal: To ask a higher court to review a decision from a lower court. For example, the losing party may submit an appeal to the Court of Appeals of Virginia when it disagrees with the Workers’ Compensation Commission’s decision. On appeal, the higher court will affirm, reverse, or remand the case to the lower court for more evidence.   

 

Appeal of right: An appeal which the appellate court must consider. In Virginia, injured employees have two appeals of right: one to the Full Commission and one to the Court of Appeals of Virginia.

 

Appeals Council (AC): A department of the Social Security Administration (SSA) that reviews disability determinations made by administrative law judges (ALJs).  

 

Appearance: A lawyer’s notice to the court that one of the parties has hired him or her as an advocate.

 

Appendix: Documents added to a legal pleading, such as a brief. For example, you may include an appendix of medical records when you submit a written statement to the Workers Compensation Commission.

 

Applicant: The party that opens a case with the Workers Compensation Commission by filing an assertion of rights or a claim for benefits. You – the injured worker – are the applicant.  

 

Applicant’s attorney (AA): An attorney who represents injured workers. 

 

Application: See claim.

 

Apportionment: A way to find how much of your permanent disability is from your work injury and how much comes from other disabilities or preexisting conditions.  

 

Approve: To grant a request.

 

Argument: An oral or written statement made to persuade the court why it should rule in your favor. Argument includes evidence to support your position.

 

Arising out of: One of the requirements you must meet to have your injury covered under workers comp. The phrase “arising out of” refers to the origin or cause of the injury.  

 

Arrear: An unpaid amount. For example, the insurer may have to pay benefits in arrears if you win at trial.

 

Assault: A threat of force that causes a person to have a reasonable fear of imminent harm or offensive contact. You may receive workers compensation benefits if you develop PTSD or other psychiatric conditions from a workplace assault.

 

Assertion of Rights: This is a claim for benefits accompanied by a request that the Commission not refer the claim to the hearing docket. Also known as a protective filing. 

 

Assign: To transfer the right to payments to another. You cannot assign workers compensation benefits to anyone else, including legitimate creditors.

 

Assumption of the risk: A defense to tort claims that no longer applies to workers compensation.

 

Attending physician’s report (APR): A form that your treating physician completes that describes the nature and extent of your occupational injury, including disability from the accident. 

 

Attest: To testify that something is accurate, such as an interrogatory answer.

 

Attorney: A person licensed to practice law who represents you, the employer, the claim administrator, the insurance company, or a medical provider.  

 

Attorney’s fee: The fee approved by the Commission for your attorney’s services. You are still responsible for this fee, even if you win at trial.   

 

Authority: In workers comp, this term refers to statutes or case law that supports a party’s legal position, or the Commission’s power to resolve a dispute.  

 

Average weekly wage (AWW): Your earnings in the job you had when you were injured. Different calculations apply depending ono how long you worked for the employer in that position before the accident date. The AWW decides the benefit rate for temporary total, temporary partial, permanent total, and permanent partial disability benefits.  

 

Award: The grant or denial of workers compensation benefits by the Workers Compensation Commission or a higher court. An Award is sometimes called an Award Order. These terms are interchangeable. 

 

Award agreement (agreement to pay benefits – form #CSD-50): The claim administrator completes and signs this form, then sends it to you, when the employer or insurer accepts your claim for benefits. A signed Award Agreement form prompts the Commission to enter an award.  

 

B

 

Backdate: To make work restrictions valid retroactively. The Workers Compensation Commission frowns on this. Therefore, you should ask for an updated disability slip at each appointment. 

 

Bad faith: The insurance carrier’s unreasonable denial of coverage or benefits. 

 

Bailiff: A court officer who helps the judge run court proceedings safely.

 

Balance billing: This occurs when a healthcare provider bills you for the difference between the provider’s charge and the amount paid by the insurance company. It is unlawful for a healthcare provider to balance bill you under workers comp.  

 

Barred: Prevented from prosecuting a claim or raising a defense. For example, not filing a claim within the statute of limitations may result in the court finding you are barred from receiving benefits.  

 

BATNA: Best alternative to a negotiated agreement. Books on negotiation and mediation recommend that the parties determine a BATNA when setting acceptable settlement ranges.

 

Battery: An unwanted touching that you did not consent to and that is unjustified.  

 

Bear: To produce. For example, the party that bears the burden of proof must produce evidence at trial.  

 

Bench: The judge presiding over your case.

 

Beneficiary: A person entitled to receive benefits under the law. Usually the injured worker or their dependents are the beneficiary of workers comp coverage. 

 

Benefits: This term covers all potential cash payments, medical treatments, and rehabilitation services you can receive under the Workers Compensation Act.  

 

Bias: Prejudice. You can attack an unfavorable defense medical examination by showing the doctor’s bias based on how much the insurer paid them.

 

Binding: Creating an obligation. The Workers Compensation Commission’s orders are binding.

 

Birth injury: Harm to the fetus during labor and delivery. In Virginia, the Workers Compensation Commission administers and resolves disputes involving the Birth-Related Neurological Injury Compensation Fund.

 

Black box: A computer device that records and stores data in cars, trucks, motorcycles, and airplanes. You can use this data to show how the incident happened and who must pay for the damage.

 

Blackletter law: A well settled legal principle.

 

Board: Workers Compensation Appeals Board. In addition, the term board refers to lodging your employer may provide as part of your employment. You can include the value of this lodging when calculating your pre-injury average weekly wage. 

 

Bona fide: Made in good faith. You must make a bona fide job search to receive temporary total disability payments if your doctor releases you to modified duty work.

 

Breach: A violation. The insurer may argue that you breached a safety rule and should not receive benefits.

 

Brief: A written statement giving your version of the facts and explaining your legal position so the court will give you what you ask for or deny the other party’s request for relief. A brief is sometimes called a written statement or a position statement.  

 

Broker: A licensed person or business paid to look for insurance coverage for some other person, business, or entity. Defense attorneys have reported increased broker involvement in claim decisions. 

 

BUE: Bilateral upper extremities (the arms). 

 

Burden of Proof: This term refers to two concepts: the burden of persuasion and the burden of production. But strictly speaking, the burden of proof is the standard that a party trying to prove a fact in court must satisfy. In most workers comp cases, you must prove by a “preponderance of the evidence” that you suffered an injury by accident arising out of and in the course of your employment.   

 

Bureau of Insurance: In Virginia, the Bureau of Insurance licenses, regulates, investigates, and examines insurance companies providing workers compensation and other types of insurance coverages.  

 

Bureau of Labor Statistics (BLS): The BLS is part of the United States Department of Labor. It is a fact-finding agency for the federal government in labor economics and statistics.  

 

C

 

Cancellation: Termination of an insurance policy before its end date. In the alternative, an annulment of a check. For example, the insurer may cancel a check if you did not receive it in the mail, then issue a new one.

 

Candidate: A person seeking a job.  

 

Capacity: The ability to do a specific job.

 

Caption: The part of a court paper or pleading saying the name of the court or administrative agency hearing the case, the names of the parties, the docket or claim number, and the paper’s title.

 

Cargo: Goods or items transported by a vehicle. Many workers comp claims involve commercial truck accidents or injuries while moving cargo.

 

Carrier: Another name for the insurance company providing workers compensation coverage to your employer. The insurer “carries” the insurance for the employer.  

 

Cartman: A person who transports goods. Also called a teamster.

 

Case: A legal action brought before a court or an administrative tribunal.  

 

Case evaluation: A lawyer’s assessment of a case’s strengths, weaknesses, and potential value at trial or through settlement.

 

Case-in-chief: The evidence you present at trial to support your claim.

 

Case theory: The evidence and story you present to persuade the judge or jury that you deserve a remedy under the law. 

 

Catastrophe: An event that causes severe loss, pain, and suffering. Catastrophic injuries result in permanent disability.  

 

Caucus: A private meeting. For example, you and your attorney will break into a caucus during mediation.

 

Causally related: A connection between the work incident and your injury, disability, and need for medical care. Usually proven by medical evidence.   

 

C&R: Compromise and Release. This is the official name for the final settlement papers in workers compensation.   

 

Cease and desist: A court order that requires a person or business to stop doing something. For example, in workers comp, the court may order an employer to cease and desist all business transactions if it does not carry insurance. 

 

Certainty: Anything proven true. Medical providers should give opinions to a reasonable degree of medical certainty.

 

Challenge: To dispute. For example, you may challenge the insurer’s positions.

 

Change in condition: A worsening of your mental or physical health that deserves an increase in the benefits awarded currently.

 

Check: A draft written, dated, and signed by the drawer that directs a bank to pay a specific sum to you on demand.

 

Child: An unemancipated person under the age of 18. A deceased worker’s child may qualify for death benefits under workers compensation.

 

Circumstance: A fact or event that increases the probability of another fact or event. You can win your case with circumstantial evidence.

 

Citation: A reference to another document, judicial opinion, or statute to support your argument.

 

Citizenship: Having citizen status.

 

Civil procedure: The rules governing claims and litigation.

 

Claim: A demand to recover under an insurance policy for a loss. The terms claim and case are used interchangeably in workers compensation law.   

 

Claim form: The paper you complete to preserve your right to benefits under the Workers Compensation Act.

 

Claim examiner: See adjuster.

 

Claim number: The number assigned to your claim when you file it with the court clerk.  

 

Claim reserve: The amount of money that an insurance carrier decides it should set aside to cover future payments for a claim that still is open.   

 

Claimant: A person who sends a claim to an insurer for a loss.   

  

Claimant’s attorney: An attorney who represents injured workers.  

  

Claims administrator: A company responsible for managing insurance claims for an insurance carrier or self-insured employer.  

 

Clean hands doctrine: An ancient maxim of equity courts. Under this doctrine, “a litigation who seeks to invoke an equitable remedy must have clean hands.”

 

Clerk of court: A court officer who stores papers filed with the court, issues documents and process, and keeps records of court proceedings.

 

COBRA insurance: The Consolidated Omnibus Budget Reconciliation Act of 1985 mandates an insurance program that gives you the ability to continue health insurance coverage after leaving employment.   

 

Code of conduct: An employer’s written set of rules for how employees must act.

 

Collateral estoppel: A legal doctrine barring a party from relitigating an issue already decided against the party.

 

Collective bargaining agreement (CBA): A contract between an employer and members of a labor union specifying wages, benefits, grievance procedures, and other employment conditions.  

 

Commission: Virginia Workers Compensation Commission

 

Commissioners: A three-member group that manages the Virginia Workers Compensation Commission and decides appeals of deputy commissioner opinions.

 

Common law: Law made by judges in their judicial decisions, in contrast to statutes, constitutions, or regulations.

 

Commutation: To substitute a lump sum for the present value of a series of future payments. You may commute your permanent partial disability benefits using a four percent interest rate. 

  

Comp: A slang term for workers compensation.   

 

Compel: To force someone (such as a witness or the opposing party) to do something. For example, you may move (ask) the court to compel the employer to answer discovery requests. Or the insurer may ask the court to compel your attendance at a deposition.   

 

Compensable consequence: An injury or medical condition that results from the first injury suffered in a work accident. For example, the development of arthritis in the left knee from overuse due to a torn ACL in the right knee is a compensable consequence of the right knee injury.    

  

Compensable injury: A legal definition. A compensable injury refers to an injury by accident arising from and during your employment.   

 

Compensation period: The length of time you can receive workers comp payments.

 

Compensation rate: 66 and 2/3 of your pre-injury average weekly wage. This is the rate at which the insurer pays temporary total and permanent partial disability benefits.   

 

Complaint: The pleading that starts a civil action and states what legal remedy you want and why you should get it.

 

Compliance: Agreeing with a command, order, or request. For example, the insurer may stop paying benefits if you do not follow your doctor’s recommendations.

 

Compromise settlement: A settlement where you receive a lump sum and become responsible for paying for future medical treatment.

 

Compulsory insurance: Insurance required by federal or state law. Workers compensation insurance is compulsory for most employers and government entities.   

 

Conciliation: The settlement of a legal dispute.

 

Conclusion of law: A judge’s final decision on a specific question.

 

Concurrence: A judicial opinion that agrees with the judgment in the case, but for reasons other than those given by the majority opinion.

 

Concurrent: Having authority over two or more matters. For example, two states may have concurrent jurisdiction over your occupational injury claim.

 

Conduct: Behavior.

 

Confer: To have a conference with the opposing party before seeking court intervention.

 

Conference: A meeting between the parties. This may include the judge assigned to the case.

 

Confidential: Kept secret.

 

Confidentiality agreement: An agreement not to show or tell the terms of the settlement to others.

 

Conflict check: An attorney’s decision on whether past or present representations prevent them from representing a new client.

 

Conflict out: To disqualify a judge or lawyer because of a conflict of interest with the parties, a witness, or the subject of the dispute.

 

Consideration: Something of value given. Usually money. You will likely see this word if you sign a resignation and release to settle your claim.

 

Consolidation: Combining two or more claims into one so the court hears all the issues at once. You may want to ask for consolidation of claims if both involve the same employer or the same body part.

 

Construction: The interpretation of a statute or other legal document.

 

Consultation: A meeting with your doctor or lawyer to ask for advice.

 

Contemporaneous objection rule: The principle that you must make a prompt and proper objection to the admission of evidence so the court may consider the dispute. Otherwise, you waive the objection.

 

Contempt: The act of defying a court’s order.

 

Contingent fee: An attorney’s fee that depends on whether you recover benefits through litigation or settlement.

 

Continuance: A postponement of a scheduled court hearing or trial.   

 

Controversy: A legal dispute.

 

Controverted claim: An alternative way to say the insurance company denies and disputes the claim.

 

Cost: The amount charged for medical care or durable medical equipment.

 

Cost of living adjustment (COLA): A yearly increase in temporary total, permanent total, or death benefits based on inflation. You must request a COLA increase. The Commission, however, will grant it automatically if the combination of workers comp and Social Security benefits is less than 80% of your pre-injury earnings. 

 

Counsel: Advice from an attorney.

 

Counteroffer: The insurance company’s new offer after receiving your response to the last offer.

 

Court: The building where a judge will hear evidence in your case.

 

Court of Appeals of Virginia: The intermediate appellate court in Virginia. Each party to a workers compensation case has an appeal of right from the Workers Compensation Commission to the Court of Appeals of Virginia.

 

Coworker: Someone you work with.

 

Credibility: Whether someone (such as a witness) is believable.

 

Credit: A deduction from your regular workers compensation checks due to an overpayment.

 

Crime: An act punishable under the law.

 

Criminal Injuries Compensation Fund: See the Virginia Victims Fund.

 

Cross examination: The right to question a witness offered by the opposing party to discredit the witness or get testimony that proves your claim.

 

Cumulative trauma: An injury or medical condition resulting from multiple traumas or exposures.

 

Cure: To fix. For example, you can cure a refusal of selective employment by marketing.

 

K

 

Kin: Family; relatives. Certain kin may qualify for death benefits.

 

Knowledge: An understanding of a fact or circumstance

 

Y

 

Your honor: The formal way to address a judge.

 

Z

 

Zero tolerance: A total ban. The insurer may raise a willful misconduct defense if you violated one of your employer’s zero tolerance rules (such as against drug use or violence).

 

Zone of employment: The physical places of employment you were expected to be.