CDMS Workers' Compensation and Claims Management 1 — Questions and Answers
Question 1: Under the US workers' compensation system, which party is primarily responsible for paying medical benefits to an injured employee?
- The employee's health insurance carrier
- The employer or its insurer (Correct answer)
- The federal government through SSDI
- The state's general fund
Correct answer: The employer or its insurer
Workers' compensation is an employer-funded system where the employer or its insurer pays for work-related injury medical benefits.
Question 2: Which of the following best describes a 'temporary total disability' (TTD) in workers' compensation?
- The worker has a permanent impairment but can work part-time
- The worker is completely unable to work but is expected to recover (Correct answer)
- The worker has reached maximum medical improvement with residual limitations
- The worker can perform modified duty immediately after injury
Correct answer: The worker is completely unable to work but is expected to recover
TTD means the injured worker is temporarily unable to perform any work and is expected to eventually recover.
Question 3: What does 'maximum medical improvement' (MMI) mean in disability management?
- The claimant has received all available treatments
- The claimant's condition has stabilized and further recovery is unlikely (Correct answer)
- The claimant has recovered completely and can return to full duty
- The claimant qualifies for permanent total disability benefits
Correct answer: The claimant's condition has stabilized and further recovery is unlikely
MMI is the point at which the injured worker's medical condition has stabilized and significant further improvement is not expected with treatment.
Question 4: Which federal law established the framework for state workers' compensation programs in the United States?
- The Workers' Compensation Act of 1908 (Federal Employees) (Correct answer)
- The Social Security Act of 1935
- The Occupational Safety and Health Act of 1970
- The Americans with Disabilities Act of 1990
Correct answer: The Workers' Compensation Act of 1908 (Federal Employees)
The Federal Employees' Compensation Act of 1908 was the first major US workers' compensation law, though each state administers its own separate program.
Question 5: In workers' compensation, what is a 'second injury fund' designed to do?
- Pay benefits to workers injured a second time on the same job
- Encourage employers to hire workers with pre-existing disabilities by limiting their liability (Correct answer)
- Provide supplemental income to permanently disabled workers
- Fund rehabilitation programs for injured workers
Correct answer: Encourage employers to hire workers with pre-existing disabilities by limiting their liability
Second injury funds limit an employer's financial liability for a combined disability so employers are more willing to hire workers with pre-existing conditions.
Question 6: Which type of workers' compensation benefit replaces a portion of the injured worker's lost wages?
- Medical indemnity benefit
- Vocational rehabilitation benefit
- Indemnity (wage replacement) benefit (Correct answer)
- Permanent partial disability lump sum
Correct answer: Indemnity (wage replacement) benefit
Indemnity benefits replace a portion (typically two-thirds) of the worker's pre-injury wages during the period of disability.
CDMS Workers' Compensation and Claims Management 1
Under the US workers' compensation system, which party is primarily responsible for paying medical benefits to an injured employee?