CCA CCA Workers Compensation Claims 2

Question 1

Which form is commonly used to report a workers' compensation claim to the insurer in many US states?

Accepted Answer

First Report of Injury (FROI)

Answer

The First Report of Injury (FROI) is the standard form used by employers to notify the workers' compensation insurer and state agency of a workplace injury.

Question 2

A worker injures their back while lifting at work and later develops a psychological condition due to chronic pain. Is the psychological condition likely compensable?

Accepted Answer

Yes, if the psychological condition is a direct consequence of the compensable physical injury

Answer

Secondary psychological conditions that are causally related to a compensable physical work injury are generally covered under workers' compensation.

Question 3

What is a 'scheduled loss of use' award in workers' compensation?

Accepted Answer

A lump sum payment for permanent impairment to a specific body part based on a statutory schedule

Answer

Many states use a statutory schedule assigning a fixed number of weeks' compensation for permanent loss of function to specific body parts.

Question 4

When a third party (not the employer) causes a work injury, the injured worker may:

Accepted Answer

Sue the third party AND receive workers' compensation, with potential subrogation by the insurer

Answer

An injured worker can receive workers' compensation benefits and pursue a third-party tort claim; the workers' comp insurer typically has a subrogation lien on any third-party recovery.

Question 5

What does 'light duty' mean in a workers' compensation context?

Accepted Answer

Modified or restricted work assignments within the injured employee's medical restrictions

Answer

Light duty refers to temporary work assignments modified to accommodate the injured worker's medical restrictions while they recover.

(CCA) Certified Claims Adjuster Practice Test

(CCA) Certified Claims Adjuster Practice Test

CCA CCA Workers Compensation Claims 2