WC Basics
Who is responsible for providing worker's compensation insurance?
Employers
What document must an employee complete to officially start a workers' compensation claim?
A claim form or injury report
Which benefit provides compensation to the family of a worker who dies due to a workplace injury?
Death Benefits
Which state is ex parte?
Vermont
What is the most common type of workplace injury?
Sprains and Strains
What type of insurance is workers' compensation considered?
No-fault insurance
This exam is conducted by a physician chosen by the insurance company to evaluate the IW's condition.
IME
Which state does not require an IW to RTW LD if they chose not to?
Rhode Island
Which state agency typically handles disputes related to workers' compensation claims?
Workers' compensation board or commission
What is the purpose of a Functional Capacity Evaluation (FCE) in the rehabilitation process?
To assess an injured worker's ability to perform work-related tasks
This type of investigation focuses on verifying that the claimant was actually performing work duties at the time of the alleged injury
"arising out of and course of employment" investigation
This formal document is issued when an insurance carrier determines a claim is not compensable and explains the specific reasons for denial.
Notice of Denial or Controversion Notice
This benefit is paid when an injured worker has reached maximum medical improvement but has a permanent loss of function that affects their earning capacity.
What are permanent partial disability benefits?
This state was the first to enact a workers' compensation law in 1911.
Wisconsin
How can a medical case manager help reduce the duration of a workers' compensation claim?
By proactively managing the treatment process and addressing any barriers to recovery and return to work
These three types of benefits are typically provided under workers' compensation?
This complex legal doctrine allows a workers' compensation carrier to deny a claim when an employee's injury results from their deliberate intention to harm themselves or violate a known company policy with conscious disregard for safety.
willful misconduct or intentional self-inflicted injury defense
What type of benefit is provided when an injured worker is unable to work at all for a temporary period?
Temporary total disability benefits
Which federal act provides workers' compensation benefits to employees of private maritime employers?
The Longshore and Harbor Workers' Compensation Act
This is the NCCI code for a SLAP tear.
shoulder/fracture
This federal database requires employers to report work-related fatalities and severe injuries within specific timeframes to OSHA.
OSHA 300 Log or OSHA reporting system
This complex claims scenario occurs when an employee is injured while working simultaneously for multiple employers, requiring determination of which carrier bears primary responsibility and how liability should be allocated.
dual employment liability determination or concurrent employment coverage analysis
This alternative to traditional workers' compensation insurance allows qualifying employers to pay claims directly rather than purchasing insurance.
self-insurance or self-insured status
This regulatory mechanism allows states to penalize employers who fail to carry required workers' compensation insurance through fines and stop-work orders.
Uninsured employer penalties or compliance enforcement actions
This is the NCCI code for "spondylosis".
vertebrae/ all other specific or cumulative