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25 terms

15-1 review question.

STUDY
PLAY
Name two kinds of statutes under workers' compensation.
1. Federal compensation
2. State compensation laws
An unexpected, unintended event that occurs at a particular time and place, causing injury to an individual not of his or her own making, is called a/an
Accident
State compensation laws that require each employer to accept its provisions and provide for specialized benefits for employees who are injured at work are called:
Workers' compensation (WC) insurance
Who pays the workers' compensation insurance premiums?
Employer
What is the minimum number of employees per business needed in your state for workers' compensation statutes to become effective?
2
List five types of workers' compensation benefits.
1. Medical treatment
2. Temporary disability indemnity
3. Permanent disability indemnity
4. Death benefits for survivors
5. Rehabilitation benefits
Who can treat an industrial injury?
Licensed physician, osteopath, dentist, or chiropractor
What are 3 types of workers' compensation claims and the differences among them?
1. Nondisability (ND) claim: involves a minor injury in which the patient is seen by the physicians but is able to continue working
2. Temporary disability (TD): occurs when a worker has a work-related injury or illness and is unable to perform the duties of his or her occupation for a specific time or range of time.
3. Permanent disability (PD): is rated according to the sererity of the injury, the age of the injured person, and the patient's occupation at the time of the injury
Weekly temporary disability payments are based on:
percentage of the employee's earning at the time of the injury
After suffering an industrial injury, Mr. Fields is in a treatment program in which he is given real work tasks for building strength and endurance. This form of therapy is called:
Work hardening
When an industrial case reaches the time for rating the disability, this is accomplished by what state agency?
States industrial accident commission or workers' compensation board
1. May an injured person appeal his or her case if he or she is not satisfied with the rating?
2. If so, to whom does he or she appeal?
1. Yes
2. (WCAB) Workers compensation board or the industrial accident commission
When fraud or abuse is suspected in a workers' compensation case, the physician should report the situation to:
Insurance carrier
Explain third-party subrogation
The legal process by which an insurance company seeks from a third-party, who has caused a loss, recovery of the amount paid to the policyholder.
When an individual suffers a work-related injury or illness, the employer must complete and send a form called a/an 1._______________ to the insurance company and workers' compensation state offices, and if the employee is sent to a physician's office for medical care, the employer must complete a form called a/an 2._______________, which authorizes the physician to treat the employee.
1. Employers report of occupational injury or illness
2. Medical service order
Employers are required to meet health and safety standards for their employees under federal and state statutes known as:
Occupational Safety and Health Administration (OSHA) Act of 1970
The process of carrying on a lawsuit is called:
Litigation
A proceeding during which an attorney questions a witness who answers under oath but not in open court is called a/an:
Deposition
The legal promise of a patient to satisfy a debt to the physician from proceeds received from a litigated case is termed a/an:
Lien
When a physician treats an industrial injury, he or she must complete a First report of Occupational Injury or Illness and send it to the following:
Insurance carrier, employer, and state workers' compensation office (All of the above)
TRUE or FALSE

The first thing an employee should do after he or she is injured on the job is to notify his or her employer or immediate supervisor.
True
TRUE or FALSE

A roofer takes his girlfriend to a roofing job and she is injured. She is covered under workers' compensation insurance.
False
TRUE or FALSE

A stamped physician's signature is acceptable on the Doctor's First Report of Occupational Injury or Illness form.
False
TRUE or FALSE

In a workers' compensation case, bills should be submitted monthly or at the time of termination of treatment, and a claim becomes delinquent after a time frame of 45 days.
True
TRUE or FALSE

If an individual seeks medical care for a workers' compensation injury from another state, the state's regulations are followed in which the injured person's a claim was originally field.
True