CH 15 Workers' Compensation

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A physician who is incorporated is considered an employee under workers' compensation laws.

True

Progress reports subsequent to the initial report for workers' compensation patients may be narrative and are not necessarily completed on the special forms available in most states.

True

The OSHA Act provides that if a state submits an OSHA plan and it is approved by the government, then the state may assume responsibility for carrying out OSHA policies and procedures and is excluded from federal jurisdiction.

True

The statutes for workers' compensation laws fall under

federal and state compensation laws.

The First Treatment Medical Report or Physician's First Report of Occupational Injury or Illness form should be signed

in ink by the physician.

An individualized program of therapy using simulated or real work tasks to build strength and improve the worker's endurance toward a full day's work is known as

work hardening.

In an industrial case, the physician's office may collect all amounts not covered by the workers' compensation fee schedule.

False

It is believed that the longer the injured person remains out of work, the better the chance of recovery and return to the workplace.

False

Minors are not covered by workers' compensation.

False

The injured worker does not have the right to be evaluated by a physician who is not assigned by the employer.

False

Waiting periods affect workers' compensation medical and hospital benefits.

False

When coding for the office visit, patient injury, or illness evaluation and creating a report, use CPT code 99945, 99966, or 99980.

False

Workers' compensation benefits are subject to income tax.

False

Workers' compensation benefits include

1. medical care. 2.disability income. 3.death benefits.

The reason for workers' compensation laws is

1. to ensure a prompt return to work of any injured or ill employee. 2. to provide income to the injured or ill worker. 3. to encourage maximum employer interest in safety.

A narrative industrial medical report should include only objective findings and not subjective factors.

False

All state workers' compensation laws are compulsory.

False

The form that contains authorization for the physician to treat the injured employee is the

Medical service order.

OSHA stands for

Occupational Safety and Health Administration.

Which is the correct procedure for keeping an industrial patient's financial and health records when the same physician is also seeing the patient as a private patient?

Separate financial and health records must be used.

A date of injury is a requirement for all workers' compensation insurance claims.

True

Authorization to treat a patient with an industrial injury may be obtained over the telephone.

True

Beginning in the 1990s, increases in fraudulent workers' compensation claims have been noted throughout many large metropolitan cities.

True

Chiropractic care is a medical benefit offered with state workers' compensation.

True

In many states, workers' compensation laws have exemptions for certain occupations such as

domestic employees, babysitters, and gardeners.

Final determination involving settlement of an industrial accident is known as

adjudication.

Supplemental report(s) for patients on temporary disability should be sent to the insurance carrier

after every office visit.

When a case is rated for permanent disability and settled, this is called

compromise and release

State compensation laws that require each employer to accept its provisions and provide for specified benefits are

compulsory laws.

A proceeding in which an attorney asks a witness questions regarding a case and the witness answers under oath but not in open court is known as a/an

deposition.

Premiums for workers' compensation insurance are paid by the

employer

The simplest type of workers' compensation claim is

nondisability

An abnormal condition caused by exposure to environmental factors associated with employment is termed a/an

occupational illness.

In a PD claim, the physician's final report must include the words

permanent and stationary.

In a workers' compensation case, the contract and financial responsibility exists between the

physician and the insurance company.

In an industrial case, if the patient is experiencing pain that can be tolerated but will cause some handicap in the performance of the activity precipitating the pain, it is classified as

slight pain.

Videotapes made of the patient without his or her knowledge to document the extent of the patient's permanent disability are called

sub rosa films.

If a worker has a work-related injury or illness and is unable to perform the duties of his or her occupation for 2 months and then returns to modified work for 1 month before returning to full work, the claim is referred to as a

temporary disability claim.


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