CCA CCA Workers Compensation Claims 1 — Questions and Answers
Question 1: Workers' compensation is considered a 'no-fault' system because:
- Employers never have to pay for workplace injuries
- Employees receive benefits regardless of who caused the accident (Correct answer)
- The government pays all workers' compensation claims
- Only third parties can be held liable for workplace injuries
Correct answer: Employees receive benefits regardless of who caused the accident
Workers' compensation provides benefits to injured employees without requiring them to prove employer negligence, and in exchange, employees generally cannot sue their employer.
Question 2: Which of the following is typically NOT a benefit provided under workers' compensation?
- Medical treatment for work injuries
- Temporary disability payments
- Pain and suffering damages (Correct answer)
- Vocational rehabilitation
Correct answer: Pain and suffering damages
Workers' compensation covers medical expenses, lost wages, and rehabilitation, but does not include non-economic damages such as pain and suffering.
Question 3: A 'maximum medical improvement' (MMI) determination in a workers' comp claim means:
- The worker has fully recovered and has no permanent impairment
- The worker's condition has stabilized and is unlikely to improve further with treatment (Correct answer)
- The employer must pay for all future medical costs indefinitely
- The claim is automatically closed with no further benefits
Correct answer: The worker's condition has stabilized and is unlikely to improve further with treatment
MMI is the point at which the injured worker's medical condition has stabilized and additional treatment is not expected to produce significant improvement.
Question 4: Which type of workers' compensation disability benefit covers a worker who can return to work in a limited capacity at reduced wages?
- Temporary total disability (TTD)
- Permanent total disability (PTD)
- Temporary partial disability (TPD) (Correct answer)
- Permanent partial disability (PPD)
Correct answer: Temporary partial disability (TPD)
Temporary partial disability (TPD) benefits compensate for the wage difference when an injured worker returns to modified or light-duty work at reduced earnings.
Question 5: What is an 'independent medical examination' (IME) in a workers' compensation claim?
- An exam conducted by the treating physician to certify disability
- A medical evaluation by a neutral physician chosen by the insurer or employer to assess the claim (Correct answer)
- A diagnostic test required before any claim can be filed
- An examination performed only in disputed claims before a judge
Correct answer: A medical evaluation by a neutral physician chosen by the insurer or employer to assess the claim
An IME is conducted by a physician selected by the insurer or employer to provide an objective opinion on the nature, extent, and causation of the injury.
Question 6: The 'exclusive remedy' doctrine in workers' compensation means:
- Employees can only file claims under state law, not federal law
- Workers' compensation is the sole remedy for injured employees against their employer (Correct answer)
- Only one type of benefit can be paid per injury
- The employer may only use one insurer for all workers' comp coverage
Correct answer: Workers' compensation is the sole remedy for injured employees against their employer
Exclusive remedy bars employees from suing their employer in tort for work-related injuries; workers' compensation is their only recourse against the employer.
CCA CCA Workers Compensation Claims 1
Workers' compensation is considered a 'no-fault' system because: