CCA CCA Workers Compensation Claims 3

Question 1

What is a 'compromise and release' (C&R) settlement in workers' compensation?

Accepted Answer

A lump sum settlement that closes out all future workers' comp benefits

Answer

A partial payment plan for medical bills

Answer

An agreement to return to work at reduced pay

Answer

A court order requiring the employer to provide treatment

Question 2

Under OSHA, which injuries must be recorded on the OSHA 300 log?

Accepted Answer

Work-related injuries requiring more than first aid treatment

Answer

All minor first aid injuries

Answer

Only fatalities and hospitalizations

Answer

Injuries reported more than 30 days after they occur

Question 3

A claimant is filmed performing heavy physical activities at home while claiming total disability. This evidence is most useful for:

Accepted Answer

Investigating potential workers' compensation fraud

Answer

Increasing the claimant's permanent disability rating

Answer

Establishing that the employer violated safety regulations

Answer

Proving the injury was pre-existing

Question 4

What is the purpose of a vocational rehabilitation benefit in workers' compensation?

Accepted Answer

To train injured workers for new employment when they cannot return to their previous job

Answer

To compensate the employer for retraining costs

Answer

To pay for college education unrelated to the injury

Answer

To permanently replace lost wage benefits

Question 5

Which metric is commonly used to evaluate an employer's workers' compensation loss experience for insurance rating purposes?

Accepted Answer

Experience modification factor (e-mod)

Answer

Expense ratio

Answer

Combined ratio

Answer

Loss ratio

Question 6

A workers' compensation adjuster receives a claim for a cumulative trauma disorder. What is the key question to establish compensability?

Accepted Answer

Whether the condition arose out of and in the course of employment due to work activities

Answer

Whether the injury was reported within 24 hours

Answer

Whether the employer had prior notice of the employee's medical history

Answer

Whether a doctor treated the employee before the claim was filed