CCMC CCMC - Commission for Case Manager Occupational Health and Disability Management Questions and Answers 2 — Questions and Answers
Question 1: Which classification system is used by US physicians and insurers to document the severity of impairment for disability determination purposes?
- ICD-10-CM coding
- AMA Guides to the Evaluation of Permanent Impairment (Correct answer)
- DSM-5 criteria
- ICF framework
Correct answer: AMA Guides to the Evaluation of Permanent Impairment
The AMA Guides to the Evaluation of Permanent Impairment is the standard reference used by physicians to rate the degree of permanent impairment for disability claims and workers' compensation settlements.
Question 2: Social Security Disability Insurance (SSDI) requires that an applicant's disability must be expected to last at least how long or result in death?
- 3 months
- 6 months
- 12 months (Correct answer)
- 24 months
Correct answer: 12 months
SSDI requires that the disabling condition must have lasted or be expected to last at least 12 continuous months, or be expected to result in death, to meet the program's duration requirement.
Question 3: In occupational case management, what does the term 'maximum medical improvement' (MMI) indicate?
- The claimant has fully recovered with no residual impairment
- The claimant's condition has stabilized and further treatment is unlikely to produce significant improvement (Correct answer)
- The claimant is cleared for full unrestricted work duty
- The insurance carrier has approved all treatment
Correct answer: The claimant's condition has stabilized and further treatment is unlikely to produce significant improvement
Maximum medical improvement (MMI) is the point at which a worker's condition has stabilized and additional medical treatment is not expected to significantly improve function, triggering impairment rating and claim resolution steps.
Question 4: Which case management strategy is used to prevent short-term disability claims from becoming long-term disabilities through early outreach and intervention?
- Retrospective review
- Early intervention and stay-at-work programs (Correct answer)
- Concurrent length-of-stay management
- Discharge planning only
Correct answer: Early intervention and stay-at-work programs
Early intervention and stay-at-work programs contact workers shortly after injury or illness onset to address barriers, coordinate care, and prevent chronic disability before it becomes entrenched.
Question 5: A case manager is assisting an employee with a permanent disability that prevents return to their prior occupation. Which vocational service helps identify alternative career options?
- Functional capacity evaluation
- Vocational rehabilitation counseling and transferable skills analysis (Correct answer)
- Independent medical examination
- Utilization review
Correct answer: Vocational rehabilitation counseling and transferable skills analysis
Vocational rehabilitation counseling including transferable skills analysis identifies occupations the worker can perform given their residual functional capacity, education, and prior work experience.
Question 6: Which SSDI work incentive program allows beneficiaries to test their ability to work for a trial period without losing their disability benefits?
- Ticket to Work program
- Trial Work Period (TWP) (Correct answer)
- Extended Period of Eligibility (EPE)
- Plan for Achieving Self-Support (PASS)
Correct answer: Trial Work Period (TWP)
The Trial Work Period (TWP) allows SSDI recipients to work for up to 9 months (in a rolling 60-month window) without losing benefits, regardless of earnings, to test their ability to sustain employment.
CCMC CCMC - Commission for Case Manager Occupational Health and Disability Management Questions and Answers 2
Which classification system is used by US physicians and insurers to document the severity of impairment for disability determination purposes?