Deck 17: Workers Compensation

Question 1

When a workers' compensation claim is denied, the employee (or eligible dependents) can appeal the denial to the state workers' compensation board and undergo a process called __________, which is a judicial dispute resolution process in which an appeals board makes a final determination.

A) adjudication
B) arbitration
C) mediation
D) negotiation

Answer 1

adjudication

Question 2

Survivor benefits claims provide death benefits to eligible dependents. These benefit amounts are calculated according to the employee's earning capacity __________.

A) at the time of the illness or injury
B) during the person's expected lifetime

Answer 2

at the time of the illness or injury

Question 3

Workers' compensation insurance provides weekly cash payments and reimburses health care costs for covered employees who develop a work-related illness or sustain an injury while on the job. It also provides payments to qualified dependents of a worker who dies from a compensable illness or injury. Each state establishes a workers' compensation __________, which is responsible for administering workers' compensation laws and handling appeals for denied claims or cases in which a worker feels compensation was too low.

A) board
B) fund
C) plan
D) program

Answer 3

board

Question 4

First Report of Injury forms are completed by the __________ when treatment for a work-related illness or injury is sought.

A) patient or patient's representative
B) physician or other health care provider
C) state insurance fund or compensation board
D) workers' compensation board

Question 5

Which is an Office of Workers' Compensation Programs (OWCP) program?

A) Federal Black Lung Program
B) Federal Employment Liability Act
C) Mine Safety and Health Administration
D) Occupational Safety and Health Administration

Question 6

Who is required to personally sign the original and all photocopies of reports submitted to the workers' compensation board?

A) attorney representing the patient
B) both the patient and physician
C) patient or legal representative
D) physician or other health care provider

Question 7

OSHA has special significance for those employed in health care because employers are required to obtain and retain manufacturers' Material Safety Data Sheets (MSDS), which contain information about __________ used on site. Training employees in the safe handling of these substances is also required.

A) chemical and hazardous substances
B) oral, IM, and IV medications
C) possibly harmful agents only
D) vaccinations and drugs

Question 8

Temporary disability claims cover health care treatment for illness and injuries as well as payment for __________.

A) employer benefits
B) lost wages
C) medical services
D) pain and suffering

Question 9

Which is filed with the workers' compensation board to document any significant change in the worker's medical or disability status?

A) copy of the entire patient's medical record
B) detailed narrative progress/supplemental report
C) financial records, including encounter forms
D) other documents that are not related to a disability

Question 10

The U.S. Labor Department's Mine Safety and Health Administration (MSHA) helps reduce deaths, injuries, and illnesses in U.S. mines through a variety of activities and programs. Which is an example of such an activity or program?

A) Develops and enforces safety and health rules that apply to all U.S. mines
B) Imprisons any mine operators who experience special compliance problems
C) Mandates and charges for technical, educational, and other types of assistance
D) Works in conflict with industry, labor, and other federal and state agencies

Question 11

Effective July 31, 2001, the Energy Employees Occupational Illness Compensation Program (EEOICP) started providing benefits to eligible employees and former employees of the Department of Energy, its contractors and subcontractors, or to certain survivors of such individuals, and to certain beneficiaries of the Radiation Exposure Compensation Act. Which is responsible for adjudicating and administering claims filed by employees, former employees, or certain qualified survivors?

A) Centers for Medicare and Medicaid Services (CMS)
B) Division of Coal Mine Workers' Compensation
C) State Insurance Fund (or State Compensation Fund)
D) Office of Workers' Compensation Programs (OWCP)

Question 12

Which is a quasi-public agency that provides workers' compensation insurance coverage to private and public employers and acts as an agent in state workers' compensation cases involving state employees?

A) combination program
B) self-insurance plan
C) state insurance fund
D) workers' compensation board

Question 13

To qualify for workers' compensation benefits, an employee must be injured while working within the scope of the job description, be injured while performing a service required by the employer, or develop a disorder that can be directly linked to employment, such as asbestosis or mercury poisoning. The worker does not have to be physically on company property to qualify for workers' compensation. Which is an example of an on-the-job injury that would qualify the employee for workers' compensation benefits?

A) Employee develops pneumonia after working at the medical office all week.
B) Employee faints at the grocery store and believes it is due to stress at work.
C) Employee is injured when picking up reports for the office at the local hospital.
D) Employee is injured in an accident during a trip to the bank to deposit personal checks.

Question 14

The Merchant Marine Act (or Jones Act) provides seamen with the same protection from employer __________ as the Federal Employment Liability Act (FELA) provides railroad workers.

A) assiduousness
B) maintenance
C) negligence
D) oversight

Question 15

Permanent disability refers to an ill or injured employee's __________ capacity to return to work.

A) augmented
B) diminished
C) enhanced
D) heightened

Question 16

The Federal Black Lung Program provides medical treatment and other benefits for __________ conditions related to former employment in the nation's coal mines.

A) cardiovascular
B) integumentary
C) respiratory
D) work injuries and

Question 17

The Longshore and Harbor Workers' Compensation Program, administered by the U.S. Department of Labor, provides medical benefits, compensation for lost wages, and rehabilitation services to longshoremen, harbor workers, and other maritime workers who are __________.

A) injured during employment only
B) injured from or suffer diseases during employment
C) injured and suffer diseases during employment, both of which must occur
D) suffer diseases from employment only

Question 18

The Occupational Safety and Health Act of 1970 created the Occupational Safety and Health Administration (OSHA) to protect employees against injuries from occupational hazards in the workplace. OSHA and its state partners (of approximately 2,100 inspectors) establish protective __________, which are enforced. OSHA also reaches out to employers and employees by providing technical assistance and consultation programs.

A) laws
B) mandates
C) regulations
D) standards

Question 19

The Office of Workers' Compensation Programs (OWCP) administers programs that provide wage-replacement benefits, medical treatment, vocational rehabilitation, and other benefits to federal workers (or eligible dependents) who are injured at work or acquire an occupational disease. In which federal department is the OWCP located?

A) Department of Commerce
B) Department of Health and Human Services
C) Department of Labor
D) Department of Veterans Affairs

Question 20

Vocational rehabilitation claims cover expenses for vocational retraining for both temporary and permanent disability cases. Vocational rehabilitation retrains an ill or injured employee so he or she can return to the workforce. The employee __________ of resuming the position held prior to the illness or injury.

A) may be incapable
B) must be capable