AIC AIC Workers Compensation & Liability Claims

Question 1

Under workers' compensation law, what is the 'exclusive remedy' doctrine?

Accepted Answer

Workers' compensation benefits are the sole remedy an injured employee has against the employer for work-related injuries

Answer

The claimant must use only one doctor

Answer

The insurer must settle claims exclusively through mediation

Answer

Only one adjuster may handle each claim

Question 2

What is a 'compensable injury' under workers' compensation?

Accepted Answer

A work-related injury or illness arising out of and in the course of employment that qualifies for workers' compensation benefits

Answer

Any injury that occurs at home while working remotely

Answer

An injury requiring surgery costing more than $5,000

Answer

An occupational disease not covered by health insurance

Question 3

What does 'temporary total disability' (TTD) mean in workers' compensation?

Accepted Answer

A condition where the injured worker is completely unable to work for a limited period while recovering

Answer

A permanent impairment preventing any work

Answer

A disability affecting only part of the workday

Answer

A disability caused by a pre-existing condition

Question 4

What is 'maximum medical improvement' (MMI) in workers' compensation claims?

Accepted Answer

The point at which the injured worker's medical condition has stabilized and further recovery is unlikely

Answer

The point at which the insurer stops paying medical bills

Answer

The maximum amount of medical benefits the insurer will pay

Answer

The date the worker must return to full duty

Question 5

In workers' compensation, what is an 'independent medical examination' (IME)?

Accepted Answer

An examination by a physician selected by the insurer or employer to provide an objective opinion on the injury

Answer

A medical exam required before any claim is accepted

Answer

An exam required by the treating physician

Answer

A mandatory annual health screening for all employees

Question 6

What is the purpose of a 'light duty' offer in managing workers' compensation claims?

Accepted Answer

To offer modified or restricted work within the injured employee's medical restrictions, reducing wage loss benefits

Answer

To reduce the employer's OSHA obligations

Answer

To avoid paying medical bills during recovery

Answer

To transfer the claim to a different insurer