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Chapter 17
insurance
| Question | Answer |
|---|---|
| Worker's Compensation is the same program as | Workman's Compensation |
| Worker's Compensation laws protect employers and fellow workers by | LIMITING the award that an injured employee can recover from an employer |
| Federal and State laws require | employers to maintain worker's compensation coverage for employees for work-related illness and injuries |
| The employer must by notified | IMMEDIATELY when an injured worker presents for the first visit without a written or personal referral from the employer |
| The first report of injury form is completed in | QUADRUPLICATE when the patient first seeks treatment |
| The worker does not have to be | ON COMPANY PROPERTY to qualify for worker's compensation |
| Providers are required to accept worker's compensation reimbursement as | PAYMENT IN FULL |
| Medical treatment claims are the | EASIEST TO PROCESS because they are filed for minor illness or injuries |
| Comprehensive records of all vaccinations administered and any accidental exposure incidences must be retained for | 20 years |
| Permanent disability refers to an employee's | DIMINISHED CAPACITY to return to work |
| OSHA was created to protect | employees against injuries from occupational hazards in the workplace |
| Schedule loss of use (eyesight, hearing, or body part) compensation is limited to | a certain number of weeks according to a schedule set by law |
| The first report of injury form does not contain a | signature line |
| A physician should | personally sign the original and all photocopies of progress reports before they are filed |
| If the employer disputes the | LEGITIMACY of the claim, a first report of injury must be filed anyway |
| A detailed NARRATIVE PROGRESS/SUPPLEMENTAL report is | filed to document any significant change in the worker's medical or disability status |
| MONTHLY benefit checks are | sent to coal miners who are totally disabled by pneumoconiosis. |
| Office of Worker's Compensation Programs (OWCP) provides: | Wage replacement benefits, Vocation rehabilitation, Medical treatment |
| The Energy Employees Occupational Illness Compensation Program provides benefits to employees of the | Department of Energy |
| OWCP programs include both Energy Occupational Illness Compensation Program and | Federal Black Lung Program |
| The Department of Labor manages programs designed to prevent work-related injuries and illness which include: | Mine Safety and Health Administration, Occupational Safety and Health Administration, Jones Act |
| The Division of Federal Employee's Compensation Act (FECA) processes medical expenses and | compensation benefits to injured workers and survivors |
| Survivor benefits are calculated according to the employee's earning capacity | at the time of illness or injury |
| The Longshore and Harbor Worker's Compensation Program covers workers under contract with the | U.S. GOVERNMENT FOR DEFENSE PROJECTS outside the continental United States |
| The employee's HEALTH CARE PROVIDER is | responsible for determining the extent of disability of the employee |
| The State Insurance Fund is a quasi-public agency that provides | workers' compensation insurance coverage to private and public employers. It can also acts as an agent in state workers' compensation cases involving state employees |
| The following are examples of on-the-job injuries: | Employee is injured while dropping off lab samples to the local laboratory, Employee attending an out-of-state conference is involved in a car crash, Worker slips on ice when leaving the hospital after delivering something for the doctor |
| Worker's 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 |
| Self-insurance plans are required to set aside a | percentage of funds to cover medical expenses and have sufficient capital (money) to qualify. |
| Office of Workers' Compensation Programs administers programs that provide | wage replacement benefits to federal workers |
| Survivor Benefits are | death benefits that are calculated at the time of the employee's injury or illness |
| Adjudication is a | dispute resolution process in which appeals board makes a final determination |
| Deposition is a legal proceeding during which a party answers questions | under oath |
| MSDS (Material Safety Data Sheets) are documented containing information about | chemical and hazardous substances used on site. |
| First Report of Injury form is filed with the | State Workers' Compensation Board/Commission |
| The Energy Employees Occupational Illness Compensation Program is a | federal program |
| Workers' Compensation Board of Commission is the state agency responsible for providing payments to | dependents of the deceased covered worker |
| Budget chargeback process is the | transfer of funds from responsible federal agency's budget to the DFEC |
| Compensation file is created by providers for | established patients injured on the job |
| Federal Employment Liability Act is a statute that provides | railroad employees with protection from negligence |
| Employer Fraud is committed by an employer who | misrepresents payroll amounts |
| Arbitration | is a dispute resolution process made by an impartial person with no judicial powers |
| State Insurance or Compensation Fund is the | fiscal agent designated by state law and the corporation involved |
| Federal Black Lung Program provides | monthly benefits to coal miners |
| Workers' Compensation does not pay benefits when the employee was | negligent in performing assigned duties |
| Two benefits for the employer who incorporates managed care into the Workers' Compensation Program is that managed care | protects human resources and reduces workers' compensation costs |
| The Department of Labor manages both the | Mine Safety and Health Administration as well as OSHA (Occupational Safety and Health Administration) which exist to prevent work-related injuries and illness |
| Employees qualify for workers' compensation if they are injured while working within the | scope of their job description or doing something the employer requested or developed a disease the can be directly to their work environment |
| Medical treatment claims are the easiest to process because they are filed for | minor illness or injuries |
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