Exam 18: Workers Compensation

The spouse of a worker killed on the job is eligible for death benefits: A)for life regardless of whether or not the spouse remarries. B)until the spouse remarries. C)until the spouse remarries plus a lump sum payment of 1 year. D)until the spouse remarries plus a lump sum payment of 2 years.

A spouse is eligible to receive death benefits for life unless he or she remarries.

The form used to report information about the employee's limitations in performing his or her job duties is the: A)Work Capability Report. B)Injury Status Report. C)Work Status Report. D)Disability Status Report.

The prospective approval of health care based solely on medical necessity is called: A)preapproval. B)prior approval. C)preauthorization. D)precertification.

Each __________ regulates and administers its own workers' compensation program.

The determination made by the treating doctor that describes the degree of permanent damage done to a worker's body as a whole as the result of a job-related injury is the: A)degree of injury. B)injury rating. C)disability rating. D)impairment rating.

To qualify for Social Security Disability Insurance (SSDI), individuals must be unable to work because of a medical condition that is expected to last at least: A)30 days. B)60 days. C)90 days. D)1 year.

If an employee feels that his or her work environment is unsafe, he or she may file a complaint with the: A)American Medical Association. B)Occupational Safety and Health Administration. C)Department of Health and Human Services. D)Consumer Protection Agency.

After the designated doctor has examined the worker, all communication with him or her about the worker's injury or condition must be made through the: A)injured worker. B)employer. C)workers' compensation office handling the claim. D)treating doctor.

OSHA stands for the: A)Occupational Standards for Health Administration. B)Optional Safety and Health Act. C)Occupational Safety and Health Administration. D)Optional Standards for Health Act.

Eligible children can receive death benefits until age 18, or age 25 if they are a full-time college student.

The earliest workers' compensation programs were opposed by organized labor because they did not encourage a(n) __________ work environment.

What is the time frame for filing a workers' compensation claim?

The Black Lung Benefits Reform Act provides benefits to current coal mine employees as well as payments to surviving dependents of deceased workers.

The workers' compensation insurance carrier must pay for services if an independent review organization decides that the care was medically necessary.

Employers can obtain workers' compensation insurance policies through all of the following EXCEPT: A)federal programs. B)state workers' compensation funds. C)private insurance carriers. D)self-funded plans.

A Work Status Report must be sent in with the insurance claim each time the injured worker is seen by the treating doctor.

Supplemental income benefits are paid for a maximum of: A)52 weeks. B)104 weeks. C)208 weeks. D)401 weeks.

A provider in a managed care network who does NOT provide a sufficient level of treatment to patients because of a capitation agreement is committing which type of fraud? A)Underutilization B)Overutilization C)Internal fraud D)Unbundling

In the event that a worker and insurance company decide to engage a different designated doctor than the one named by the state WC Department, they must agree to select the new doctor within: A)5 business days of the date of the state's notice. B)1 week of the date of the state's notice. C)10 days of the date of the state's notice. D)30 days of the date of the state's notice.