CCP Workers' Compensation Claims 2

Question 1

Under most state workers' compensation laws, the 'coming and going' rule generally means that injuries sustained while commuting to or from work are:

Accepted Answer

Covered if the employer provides the transportation

Answer

The coming-and-going rule excludes commuting injuries from coverage, but an exception applies when the employer furnishes transportation.

Question 2

A workers' compensation claim involving a gradual-onset condition like carpal tunnel syndrome is classified as a(n):

Accepted Answer

Occupational disease

Answer

Repetitive-motion conditions that develop over time are classified as occupational diseases rather than sudden traumatic accidents.

Question 3

When an employer disputes compensability, the claims professional should first:

Accepted Answer

Conduct a thorough investigation before making a coverage decision

Answer

A thorough, good-faith investigation is required before any coverage decision, ensuring compliance with prompt-payment statutes.

Question 4

The 'dual-purpose' doctrine in workers' compensation allows coverage when:

Accepted Answer

A trip serves both a personal and a business purpose

Answer

Under the dual-purpose doctrine, a trip is compensable if it simultaneously serves an employment purpose, even if personal errands are also conducted.

Question 5

A Maximum Medical Improvement (MMI) determination is significant in workers' compensation because it:

Accepted Answer

Signals the point at which the claimant's condition is unlikely to improve further with treatment

Answer

MMI marks the transition from temporary disability benefits to evaluation for permanent impairment ratings.

(CCP) Certified Claims Professional Practice Test

(CCP) Certified Claims Professional Practice Test

CCP Workers' Compensation Claims 2