Disability Benefits, Workers' Compensation & Return-to-Work Flashcards

An injured worker's employer requests a medical evaluation by a physician who is not the treating provider to assess causation and restrictions. This is called:

Answer: Independent medical examination

An IME is performed by a non-treating physician, often at the insurer's request, to provide an opinion on diagnosis, causation, MMI or restrictions.

Which statement best distinguishes SSI from SSDI?

Answer: SSI is needs-based; SSDI is based on insured work history

SSI is a means-tested program funded by general revenues, while SSDI requires insured status from FICA-covered work.

A private long-term disability policy pays benefits for 24 months if the claimant cannot perform their own occupation. After 24 months, the definition typically shifts to:

Answer: Inability to perform any occupation for which they are reasonably suited

Many LTD policies shift from an 'own occupation' to an 'any occupation' definition after an initial period, often 24 months.

A worker covered by the Longshore and Harbor Workers' Compensation Act is most likely employed as:

Answer: A dock worker loading ships

The LHWCA covers maritime workers such as longshore and shipyard workers, while seamen fall under the Jones Act.

An SSI recipient under age 22 who regularly attends school earns wages. Which work incentive excludes some of these earnings when calculating SSI?

Answer: Student Earned Income Exclusion

The Student Earned Income Exclusion excludes a portion of earned income for SSI recipients under 22 who regularly attend school.

A rehabilitation counselor contacts local employers to confirm whether jobs suited to a client's restrictions exist and what they pay. This activity is a:

Answer: Labor market survey

A labor market survey verifies the availability, requirements and wages of suitable jobs in the client's geographic area.

Which program provides intensive, work-simulated conditioning designed to restore an injured worker's physical and behavioral readiness for a specific job?

Answer: Work hardening

Work hardening is an interdisciplinary, job-specific program using real or simulated work tasks to build tolerance for return to work.