Workers' Compensation and Claims Management Flashcards

Under the US workers' compensation system, which party is primarily responsible for paying medical benefits to an injured employee?

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.

Which of the following best describes a 'temporary total disability' (TTD) in workers' compensation?

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.

What does 'maximum medical improvement' (MMI) mean in disability management?

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.

Which federal law established the framework for state workers' compensation programs in the United States?

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.

In workers' compensation, what is a 'second injury fund' designed to do?

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.

Which type of workers' compensation benefit replaces a portion of the injured worker's lost wages?

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.