CCA Workers Compensation Claims Flashcards
6 cards from real CCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CCA Workers Compensation Claims flashcards as text
What is a 'compromise and release' (C&R) settlement in workers' compensation?
Answer: A lump sum settlement that closes out all future workers' comp benefits
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.
Under OSHA, which injuries must be recorded on the OSHA 300 log?
Answer: Work-related injuries requiring more than first aid treatment
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.
A claimant is filmed performing heavy physical activities at home while claiming total disability. This evidence is most useful for:
Answer: Investigating potential workers' compensation fraud
Surveillance footage showing physical activities inconsistent with claimed disability is key evidence in workers' compensation fraud investigations.
What is the purpose of a vocational rehabilitation benefit in workers' compensation?
Answer: To train injured workers for new employment when they cannot return to their previous job
Vocational rehabilitation helps injured workers who cannot return to their former position acquire new skills or education to re-enter the workforce.
Which metric is commonly used to evaluate an employer's workers' compensation loss experience for insurance rating purposes?
Answer: Experience modification factor (e-mod)
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.
A workers' compensation adjuster receives a claim for a cumulative trauma disorder. What is the key question to establish compensability?
Answer: Whether the condition arose out of and in the course of employment due to work activities
For cumulative trauma claims, the adjuster must determine whether repetitive work activities were a contributing cause of the condition, satisfying the 'arising out of employment' standard.