Workers' Compensation Claims Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Workers' Compensation Claims flashcards as text
Under the Defense Base Act (DBA), workers' compensation coverage is extended to:
Answer: Civilian contractors working on U.S. military bases overseas
The DBA extends LHWCA benefits to civilian employees working for U.S. contractors on overseas military or public-works projects.
An 'independent medical examination' (IME) in a workers' compensation claim is typically ordered to:
Answer: Obtain an objective second opinion on diagnosis, causation, or degree of impairment
An IME provides the insurer or employer with an independent physician's assessment to verify or challenge the treating doctor's findings.
Permanent Total Disability (PTD) benefits are appropriate when:
Answer: The worker is completely and permanently unable to engage in any gainful employment
PTD benefits are reserved for workers whose permanent injuries prevent them from engaging in any form of substantial gainful activity.
A 'medical-only' workers' compensation claim is one in which:
Answer: The injured worker receives medical treatment but does not lose more than the statutory waiting period of wages
Medical-only claims involve injuries treated with medical care but where lost time does not exceed the state's waiting period, so no indemnity is paid.
When a workers' compensation claimant returns to work at wages less than pre-injury earnings, the applicable benefit is typically:
Answer: Temporary Partial Disability (TPD)
TPD compensates for the wage differential when the worker is able to return to work but at reduced earnings due to the injury.
Which standard is most commonly used by physicians to rate permanent impairment in U.S. workers' compensation cases?
Answer: AMA Guides to the Evaluation of Permanent Impairment
Most states require or recommend the AMA Guides as the methodology for quantifying permanent impairment in workers' compensation cases.
A workers' compensation insurer's 'reservation of rights' notice serves to:
Answer: Preserve the insurer's right to deny coverage while the claim is being investigated
A reservation of rights letter informs the insured that the insurer is investigating while preserving its ability to deny coverage if grounds are found.