DC Workers' Compensation Insurance Flashcards

Under DC workers' compensation, medical benefits provided to an injured employee:

Answer: Cover reasonable and necessary medical treatment with no dollar cap

DC workers' compensation medical benefits cover all reasonable and necessary medical treatment related to a work injury without a statutory dollar limit.

In DC, a workers' compensation insurer must provide notice of acceptance or denial of a claim within how many days of receiving the claim?

Answer: 30 days

DC workers' compensation regulations generally require insurers to accept or deny claims within 30 days of receiving formal notice.

A DC worker suffers a permanent partial disability (PPD) as a result of a work injury. Benefits are calculated based on:

Answer: The degree of impairment and the worker's pre-injury average weekly wage

PPD benefits in DC consider the percentage of permanent impairment and the worker's average weekly wage to determine the compensation amount.

Which of the following is true about a DC workers' compensation policy's 'experience modification factor' (e-mod)?

Answer: It adjusts the employer's premium based on their actual loss history compared to expected losses for their industry

The experience modification factor compares an employer's actual claims experience to the average for their industry, adjusting premiums up for worse-than-average experience and down for better-than-average.

Under DC workers' compensation law, vocational rehabilitation benefits are designed to:

Answer: Help injured workers who cannot return to their previous job retrain for suitable alternative employment

Vocational rehabilitation services help injured workers who cannot return to their previous occupation gain skills for alternative employment.

If a DC employee's death is caused by a work-related injury or illness, workers' compensation death benefits are payable to:

Answer: The employee's surviving dependents

Death benefits under DC workers' compensation are paid to the deceased worker's surviving dependents, such as a spouse or minor children.