Deck 12: Workers Compensation and Automobiledisability Insurance

Question 1

Who pays the remainder of the medical expenses beyond the allowed charge?

A) patient may not be billed for excess charges
B) employee's private insurance
C) workers' compensation
D) federal funds

Answer 1

patient may not be billed for excess charges

Question 2

If an employee is injured in an automobile while performing work, which policy is going to cover medical expenses?

A) personal injury protection
B) employee's private insurance
C) workers' compensation
D) liability

Answer 2

workers' compensation

Question 3

Who is allowed access to workers' compensation protected health information?

A) only the physician
B) claims adjusters
C) employers
D) physician, claims adjusters, and employers

Answer 3

physician, claims adjusters, and employers

Question 4

How can employees find out if their employer has workers' compensation coverage?

A) ask the office administrator
B) it can be found on the state website
C) information is given upon starting employment
D) it must be posted

Question 5

Which program would an employee be eligible for if they developed cancer from working at a nuclear power plant?

A) Federal Black Lung Program
B) Energy Employees Occupational Illness Compensation Program
C) Longshore and Harbor Workers' Compensation Program
D) personal injury protection

Question 6

Which type of insurance covers damages that the policyholder caused to someone else's body or property?

A) comprehensive
B) collision
C) liability
D) personal injury protection

Question 7

Which notice is sent to an employer and states that the employer is not responsible for the injury?

A) Admission of Liability
B) physician of record
C) independent medical examination
D) Notice of Contest

Question 8

Which notice is sent to an employer and states that the employer is responsible for the injury?

A) Admission of Liability
B) physician of record
C) independent medical examination
D) Notice of Contest

Question 9

What is submitted to determine permanent disability?

A) progress report
B) physician of record
C) independent medical examination
D) final report

Question 10

Which of the following would not qualify for worker's compensation benefits?

A) transcriptionist with carpal tunnel
B) courier that gets into an auto accident on the job while intoxicated
C) landscaper that suffers heat stroke
D) accountant gets hurt in the cafeteria during his lunch break

Question 11

What reimbursement does the physician of record receive when treating a patient that is a federal worker injured on the job?

A) federal employees compensation fee schedule
B) worker's compensation fee schedule
C) Medicaid fee schedule
D) Medicare fee schedule

Question 12

Which compensation program would an employee be eligible for if they were injured on the job building ships?

A) Federal Employees' Compensation Program
B) Energy Employees Occupational Illness Compensation Program
C) Longshore and Harbor Workers' Compensation Program
D) Federal Black Lung Program

Question 13

Which type of coverage covers damages to the policyholder's vehicle that do not involve a collision with another car?

A) comprehensive
B) collision
C) liability
D) personal injury protection

Question 14

Steve worked for 15 years at a receiving department in a warehouse that required lifting of packages 25 pounds and higher. He suffered a back injury and had multiple surgeries. After approximately a year, he was re-hired at the same location, but instead, learned to do administrative work. Which category of worker's compensation was Steve eligible for?

A) injury without disability
B) injury with temporary disability
C) injury with permanent disability
D) injury requiring vocational rehabilitation

Question 15

Which is not considered an occupational illness/disease?

A) lung disorders
B) carpal tunnel syndrome
C) hearing loss
D) amputation

Question 16

Which program provides benefits to individuals working in coal mines?

A) TANF
B) Federal Black Lung Program
C) SSI
D) SSDI

Question 17

Which is not a government disability program that provides partial reimbursement for lost income?

A) TANF
B) worker's compensation
C) SSI
D) SSDI

Question 18

Which is not a source that employers obtain workers' compensation insurance from?

A) state workers' compensation fund
B) self-insured fund
C) federal funds
D) a private plan

Question 19

Workers' compensation insurance covers:

A) lost wages
B) vocational rehabilitation
C) neither lost wages nor vocational rehabilitation
D) both lost wages and vocational rehabilitation

Question 20

In workers' compensation cases, patients' records are kept

A) together with their regular charts
B) in a separate file
C) either together with their regular charts or in a separate file
D) neither together with their regular charts nor in a separate file

Question 21

Workers' compensation programs are administered by

A) state compensation boards
B) state compensation centers
C) city governments
D) both state compensation boards and city governments

Question 22

In workers' compensation cases, what states the employer's name/address, employee's supervisor, date and time of the accident, and the patient's description of events?

A) first report of injury or illness
B) supplemental report
C) final report
D) None of these

Question 23

In workers' compensation cases, what contains the provider's statement that a person is fit to return to work?

A) first report of injury or illness
B) supplemental report
C) final report
D) none of these

Question 24

In workers' compensation cases, what should the physician file to explain changes in the patient's status?

A) first report of injury or illness
B) progress report
C) final report
D) final statement

Question 25

Which government program are veterans covered by?

A) Veteran's Compensation Program
B) FECA
C) Veteran's Pension Program
D) both Veteran's Compensation Program and Veteran's Pension Program

Question 26

The report for a disability claim should include which of the following?

A) pain scale
B) expected duration of disability
C) treatment
D) statistical information

Question 27

An injury caused by the work environment over a long period of time is an

A) occupational disease/illness
B) non-traumatic injury
C) traumatic injury
D) both occupational disease/illness and non-traumatic injury

Question 28

Compensation for work-related illnesses and injuries may come from which of these occurrences?

A) tax expenses
B) time and travel
C) vocational rehabilitation
D) tax expenses, time, and travel

Question 29

Work-related illnesses or injuries suffered by civilian employees of federal agencies are covered under

A) FECA
B) TRICARE
C) OSHA
D) None of these

Question 30

The Office of Worker's Compensation Programs (OWCP) is a part of the U.S. Department of

A) Defense
B) Labor
C) Health
D) Commerce

Question 31

What entity administers workers' compensation laws for employees eligible under state laws?

A) a federal compensation board/commission
B) FECA
C) a state compensation board/commission
D) OSHA

Question 32

A physician's first report of injury or illness would not include information about

A) the dates of examination and treatment
B) clinical treatment
C) the diagnosis
D) all of these must be included

Question 33

Compensation for work-related illnesses and injuries does not cover which of these occurrences?

A) medical treatment
B) permanent disability payments
C) vocational rehabilitation
D) time and travel

Question 34

Workers' compensation insurance covers

A) medical costs
B) lost wages
C) disability benefits
D) all of these

Question 35

When the medical office treats patients injured in a motor vehicle accident (MVA), who often covers the cost of the treatment?

A) the patient
B) worker's compensation
C) health insurance policy
D) automobile insurance policy

Question 36

Who funds the worker's compensation insurance?

A) a federal compensation board/commission
B) the state funds
C) the employer only
D) the employer and the employee share the cost

Question 37

What is different from worker's compensation claims as opposed to regular claims?

A) nothing is different
B) must be on a paper claim
C) must be sent electronically
D) not required to use HIPAA transactions and code sets

Question 38

If an employee does not see a physician requested by the managed care organization, what may occur?

A) the patient may be terminated from employment
B) lost wages reimbursement will need to be paid back
C) the private insurance plan must grant benefits
D) benefits may not be granted

Question 39

What are written, legal claims on property to secure the payment of a debt?

A) lien
B) liability
C) health insurance policy
D) automobile insurance policy

Question 40

The Energy Employees Occupational Illness Compensation Program is part of which program?

A) OWCP
B) Federal Employee's Compensation Program
C) SSI
D) Federal Black Lung Program

Question 41

How do states determine wage loss benefits?

A) an average of salary for a certain amount of time
B) two-thirds of their salary
C) different methods
D) it is the same as their salary

Question 42

What is different from worker's compensation claims as opposed to regular claims?

A) nothing is different
B) must be on a paper claim
C) must be sent electronically
D) not required to use ICD-10-CM

Question 43

Which is true regarding compensation for lost wages?

A) it is sent to the employer to disburse to employee
B) lost wages need to be paid back
C) checks are sent directly to employee
D) income taxes are withheld from the payments

Question 44

What is PIP referred to as?

A) no-fault
B) all-fault
C) liability
D) comprehensive

Question 45

Which program covers an employee at a military base, whose primary responsibility was to construct atomic bombs?

A) LongShore and Harbor Workers' Compensation Program
B) Energy Employees Occupational Illness Compensation Program
C) Federal Employee's Compensation Program
D) Federal Black Lung Program

Question 46

Which of the following demonstrates a repetitive stress injury?

A) carpal tunnel
B) heat exhaustion
C) slip and fall
D) one that results in death

Question 47

Which of the following is true regarding workers' compensation claims and HIPAA?

A) nothing is different
B) the patient's authorization is needed to exchange health information
C) must use HIPAA transactions and code sets
D) it does not adhere to HIPAA code sets regulation

Question 48

What is required on the billing forms?

A) patient's signature
B) injury case record number
C) claim number
D) progress notes

Question 49

Which is not a typical form of additional coverage available on automobile insurance?

A) aftermarket parts reimbursement
B) uninsured motorist
C) property damage
D) rental reimbursement