CDMS Workers' Compensation and Claims Management 2

Question 1

What is the primary purpose of a 'reserve' in a workers' compensation claim?

Accepted Answer

To estimate the total projected cost of the claim for financial reporting

Answer

To fund the injured worker's attorney fees

Answer

To set aside money for future OSHA penalties

Answer

To pay for ergonomic workplace modifications

Question 2

Which term describes a workers' compensation claim that is disputed by the employer or insurer?

Accepted Answer

Controverted or denied claim

Answer

Delayed claim

Answer

Subrogation claim

Answer

Consequential claim

Question 3

What is subrogation in the context of workers' compensation?

Accepted Answer

The insurer's right to recover money paid from a liable third party

Answer

The process of permanently settling a claim for a lump sum

Answer

The transfer of a claim from one insurer to another

Answer

A technique used to reduce fraudulent claims

Question 4

An injured worker's average weekly wage (AWW) is used to calculate which workers' compensation benefit?

Accepted Answer

Indemnity (wage replacement) benefit amount

Answer

Permanent impairment rating

Answer

Medical fee schedule payments

Answer

Vocational rehabilitation stipend

Question 5

Which workers' compensation classification applies when a worker can perform some but not all pre-injury job duties?

Accepted Answer

Temporary partial disability (TPD)

Answer

Temporary total disability (TTD)

Answer

Permanent total disability (PTD)

Answer

Scheduled loss of use

Question 6

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

Accepted Answer

A lump-sum settlement that closes all or part of a claim with finality

Answer

An agreement for the worker to release medical records to the insurer

Answer

A modified-duty return-to-work agreement between employer and employee

Answer

A voluntary agreement to attend vocational rehabilitation