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 compromise and release is a final lump sum settlement that extinguishes all or most future workers' compensation obligations in exchange for a one-time payment.

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

OSHA requires recording of work-related injuries and illnesses that result in more than first aid treatment, days away from work, restricted work, medical treatment beyond first aid, or diagnosis by a healthcare professional.

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

Surveillance footage showing physical activities inconsistent with claimed disability is key evidence in workers' compensation fraud investigations.

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

Vocational rehabilitation helps injured workers who cannot return to their former position acquire new skills or education to re-enter the workforce.

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

The experience modification factor (e-mod or EMR) compares an employer's actual loss history to the expected losses for their industry, adjusting premium up or down.

(CCA) Certified Claims Adjuster Practice Test

(CCA) Certified Claims Adjuster Practice Test

CCA CCA Workers Compensation Claims 3