WCCA 10 Knowledge check(s)
Which one of the following best describes advantages of the compulsory California workers compensation laws over the prior common law system?
Employer liability is limited to set amounts, employees do not have to prove employer negligence, and the focus has shifted from indemnification to rehabilitation.
Which one of the following classifications of employers is California's State Compensation Insurance Fund (SCIF) required to insure?
Employers incapable of purchasing workers compensation insurance in the open market
Which one of the following statements about decisions of the California Workers' Compensation Appeals Board is true?
The majority of decisions are panel decisions that are decided by three commissioners selected for a particular case appealed from the trial level.
Which one of the following amendments to the California workers compensation system allowed apportionment of permanent disability to a greater extent than it had ever been before?
2004 Senate Bill 899
Except in certain instances when public hearings are not required, proposed changes to California's workers compensation rules and regulations must be provided to individuals who have requested notice thereof within which one of the following periods of time?
30 days before the hearing about the proposed change
Which one of the following statements best reflects the purpose of the California workers compensation law as described in the California Constitution?
A simple system of justice without formal legal proceedings
The unit of the California Division of Workers' Compensation that focuses on assisting workers and employers in prompt and fair resolution of disputes that sometimes arise from workers compensation claims is the
Claims Adjudication Unit.
Delmond Insurance Company ("Delmond") is preparing to submit a workers compensation insurance quote to the insurance representative for Mellfor Electrical Inc. ("Mellfor") in California. Mellfor is very interested in securing its workers compensation coverage from Delmond.Delmond wants to use an arbitration agreement to resolve any disputes which may arise out of the Mellfor workers compensation policy. The proposed arbitration agreement includes an Illinois choice of law provision.Which one of the following actions is Delmond required to take pursuant to applicable California law?
Delmond must obtain Mellfor's agreement on the Illinois choice of law provision before any dispute arises.
Workers compensation laws are a component of a constitutionally created system that provides for which one of the following?
General welfare of employees
Taunton Indemnity Company ("Taunton") provides workers compensation insurance coverage to Worthley Department Stores, Inc. ("Worthley") in California. For over six months, Taunton and Worthley have been attempting to resolve a claim under Worthley's workers compensation policy. Both companies had hired Martin, a California attorney, to represent them in this claim matter. Last month, Taunton informed Worthley that Taunton had decided to pay any compensation which may become due from Worthley under the open claim. Worthley accepted this arrangement.Shortly thereafter, Worthley's senior managers started asking Martin for advice about the open claim and possible modifications to the applicable claim reserves.Which one of the following actions should Martin take?
He should inform the Worthley senior managers that he is no longer their attorney.
Which one of the following factors leads employers to decide against self-insuring their workers compensation obligations?
Increased self-insurance expenses resulting from ineffective management.
Which one of the following components of the Workers Compensation and Employers Liability Insurance Policy (WC&EL policy) is equivalent to the declarations page of other policies and is divided into four parts, each providing essential information about the insured and the insured's coverage?
Information Page
Which one of the following statements about the structure of the Workers Compensation and Employers Liability Insurance Policy (WC&EL policy) is true?
It is a separate policy that stands on its own.
Which one of the following statements about California Labor Code 3202 is true?
It is binding on the appeals board.
Because the commissioners of the California Workers' Compensation Appeals Board cannot adjudicate every dispute in the state, there are other persons who exercise everyday judicial functions for the board. These persons are
Local judges in district offices.
Which one of the following is a function of the Retraining and Return to Work Unit of the California Division of Workers' Compensation?
Making determinations regarding supplemental job displacement benefits
Maria works in a window manufacturing facility. One day, her employer trained her to use a miter saw to cut wooden frames for the windows. Despite being told not to use the saw in this way, Maria reached under the saw while it was running to retrieve the next piece and severely cut the back of her hand. Maria hired an attorney and attempted to sue her employer for negligence because she felt that the saw was unsafe and that she had received inadequate training in how to use the saw safely. Which one of the following best describes the likely outcome of Maria's efforts?
Maria would receive workers compensation benefits, but would not be able to proceed with the civil suit because of the exclusive remedy rule.
Leila is the CEO of the Millwright Co., a large agribusiness that operates across the United States. Millwright has many types of employees, including farm and casual laborers. Millwright has an unendorsed Workers Compensation and Employers Liability Insurance Policy (WC&EL policy), written by Taunton Insurance, that provides coverage in all states in which Millwright does business. Millwright does no business in any monopolistic fund state. Leila asks Daniel, Millwright's risk manager, whether all of Millwright's workers would receive workers compensation benefits if they sustained a workplace injury or illness. Which one of the following would be Daniel's best response to Leila's question?
Not all of the workers would receive benefits because in some cases workers compensation laws do not apply to all occupations and no endorsement applies to Millwright's policy.
Gulford Corp. is insured under a Workers Compensation and Employers Liability Insurance Policy (WC&EL policy) written by Pravalt Insurance Co. Item 3.C. of the Information Page of Gulford's policy says: "All states except those listed in item 3.A and ND, OH, WA, and WY." Gulford plans to expand its business operations into Ohio, a monopolistic fund state. Gulford arranges to obtain workers compensation insurance for its Ohio operations through the appropriate state agency. It is concerned, however, because the workers compensation insurance policy provided by the Ohio state agency does not also provide employers liability insurance. Which one of the following explains Gulford's best option to obtain coverage for its employers liability exposure in Ohio?
Obtain stop gap coverage, which is often provided by the insured's general liability insurer
The workers compensation and employers liability (WC&EL) policy primarily covers an employer's obligation to pay benefits required by workers compensation statutes, but also
Protects the employer against claims or suits for bodily injury to an employee when the workers compensation statute does not eliminate the right to sue the employer.
Argot Chemical Company ("Argot") conducts business in the State of California. It has had a workers compensation insurance policy from the same California insurer for the past five years. The anniversary date of this policy is three months from now. Since workers compensation insurance premiums are becoming expensive, Argot's risk management executives have started to consider ways of saving money on insurance costs. They are interested in adding several exclusions to Argot's workers compensation insurance policy upon its anniversary (thereby reducing the policy premium).One of the exclusions under consideration would eliminate coverage for the psychiatric care of Argot's employees.In order to add such an exclusion to its workers compensation insurance policy, Argot is required to
Provide evidence of lawful self-insurance for the psychiatric care of its employees.
If a publishing company in California wants to purchase a workers compensation insurance policy, which one of the following describes a way of obtaining such policy coverage?
Purchasing the coverage from a California-licensed insurer
Which one of the following types of rates will be disallowed by the California Insurance Commissioner?
Rates that do not enable the posting of reserves.
Blythe Corp. is the insured under a Workers Compensation and Employers Liability Insurance Policy (WC&EL policy) written by Taunton Insurance Co. One of Blythe's employees, Samuel, was injured while conducting Blythe's business in Mexico. Samuel was a U.S. citizen based in the United States, but was on a one-week business trip when he was injured in Mexico. Samuel was not eligible for workers compensation benefits in his state of residence due to the nature of his employment, so he made a claim against Blythe under the Employers Liability section of Blythe's policy. Which one of the following statements is true regarding Samuel's claim under Blythe's WC&EL policy?
Samuel has a valid claim under the policy because Samuel was a U.S. citizen temporarily outside of the U.S. when injured
In which one of the following California cities is the Division of Workers' Compensation located?
San Francisco
Which one of the following constitutes an uninsurable risk under a California workers compensation policy?
Some penalties
Aaron worked for Worthley Corp., which was the insured under a Workers Compensation and Employers Liability Insurance Policy (WC&EL policy) provided by the Barnley Insurance Company. Aaron was injured in a workplace accident that was covered under Worthley's WC&EL policy. In addition to Aaron's claim for workers compensation benefits, Aaron's wife Sophie made a claim against Worthley for care and loss of services, which was a valid claim under the law of the state where Aaron and Sophie lived. Which one of the following statements is true regarding a claim by Sophie under Worthley's WC&EL policy?
Sophie has a valid claim under the policy because the law of the state where Aaron and Sophie lived recognizes these claims as valid.
Stulford was insured under a Workers Compensation and Employers Liability Insurance Policy (WC&EL policy). One of its employees, Leah, claimed that she had been sexually harassed by her manager and Leah filed suit against Stulford for sexual harassment. Which one of the following statements is true regarding whether Stulford is covered for Leah's claim under Stulford's WC&EL policy?
Stulford is not covered because employment practices are not covered under the WC&EL policy.
In addition to the California Supreme Court, which other person or courts has the jurisdiction to review awards of the Workers' Compensation Appeals Board?
The Court of Appeal
California state laws and statutes enacted by the legislature with respect to workers compensation are contained in which one of the following?
The Labor Code
Which one of the following is responsible for making available information that describes the overall workers compensation claims process in California, including the rights and obligations of employees?
The administrative director of the Division of Workers' Compensation
Cintriell Corp. is insured under a Workers Compensation and Employers Liability Insurance Policy (WC&EL policy) issued by Richley Insurance Co. A Cintriell employee, Adam, who is an employee not covered by the state workers compensation law, is injured in an accident in the course of his employment with Cintriell. Adam makes a claim for his injury under Cintriell's WC&EL policy. Which one of the following will determine the maximum amount of compensation that Adam may receive?
The bodily injury by accident limits of Cintriell's policy
Prior to the workers compensation system, injured workers sought to recover damages through the courts and employers used common law defenses to avoid liability. Which one of the following describes an assumption of risk defense that would have been used in these cases?
The employer was not liable for the injury because the worker willingly took the job knowing the dangers.
Cromley Exterminators, Inc. ("Cromley") recently purchased a new workers compensation insurance policy from Richley Insurance Company. The policy was issued in California and includes several legally permissible exclusions. Cromley's risk manager has been asked to explain the main sections of the workers compensation insurance policy to several of his fellow executives at the company. While discussing the policy exclusions, the risk manager needs to stress the fact that
The exclusions do not change Cromley's statutory obligation to secure workers compensation payments.
Which one of the following statements about decisions of local workers compensation judges in California is true?
They become decisions of the Workers Compensation Appeals Board, unless reconsideration is granted
Which one of the following describes a change in the workforce that came about as a result of the Industrial Revolution?
Unskilled workers and machinery predominated.
Which one of the following options is available to a manufacturing company for securing payment of workers compensation in California?
Using a joint exercise of powers agreement to self-insure workers compensation claims and benefits.
Worthley Department Stores, Inc. ("Worthley") has had a workers compensation insurance policy with Delmond Insurance Company ("Delmond') for the past five years. This policy covered Worthley's main location in California. In early January, Delmond sent Worthley an additional premium billing resulting from a payroll audit of Worthley's main location. Worthley's risk managers lost this bill and it was never paid. Delmond sent Worthley a notice of cancellation, indicating that the insurance policy was to be cancelled in ten days for failure to pay the audit premium. For the next three months, Worthley attempted to find a new insurance carrier to provide replacement workers compensation coverage. During that time period, Worthley also received monthly premium billings from Delmond under its original policy covering the Worthley location. Worthley timely paid all these premium bills, notwithstanding the cancellation notice which it had received. If Delmond argued that the original workers compensation policy provided no coverage for Worthley during February, March and April, such argument
Would fail because of the doctrine of estoppel.
Jancy Supermarkets, Inc. ("Jancy") is insured under a workers compensation insurance policy issued in California by Gulford Insurance Company ("Gulford"). One of the insured locations under the policy is Jancy's large supermarket in Anaheim, California. For this location, Gulford's designated loss control representative issued a written recommendation concerning Jancy's electric meat cutters. The recommendation clearly specified that all electric meat cutters at Jancy's Anaheim location should be inspected and certified in good working order by a qualified third-party mechanic. Gulford requested that all of these inspections be completed by the close of business on September 30. Jancy agreed to comply with that request.On the morning of September 30, Jancy submitted written documentation to Gulford regarding the required inspections. The documentation indicated that all but one of the meat cutters at the Anaheim supermarket had been inspected as required and found to be working properly. The only meat cutter at the supermarket that was not inspected by September 30 was an old model that was kept in a locked storage room and was not being used. That meat cutter was inspected by another independent mechanic on October 1, and was also found to be in proper working condition. Jancy informed Gulford of this separate inspection via fax on October 1.If Gulford attempted to cancel Jancy's workers compensation policy because all of the inspections were not completed by September 30, such cancellation
Would not be enforced because there was no material failure to comply with Gulford's loss control recommendations.
Jack works as a painter and inventory manager for Richley Home Improvements, Inc. ("Richley"). Having started with Richley seven years ago, Jack has been a careful employee with a good performance record. However, for the past year Jack has been drinking heavily while at home on weekends. Last Wednesday, Jack fell off a ladder while working in Richley's main storage room. He sustained a broken wrist as a result of the accident, and promptly filed a claim for this injury under Richley's workers compensation insurance policy.Jack's doctors advised him to stay home for two weeks after the accident. While recuperating at home, Jack engaged in his usual weekend habits and became quite intoxicated on a Saturday evening. As he stood up from his reclining chair that evening, he felt very dizzy from all the alcohol, lost his balance and fell backwards into a closet door. Jack hit the back of his head on a doorknob and required two stitches near the tip of his right ear. Soon after this, Jack contended that Richley's workers compensation insurance policy should also cover his head injury. He alleged that his broken wrist contributed to his inability to hold himself up, maintain his balance, and thereby avoid falling into the door at home. He further alleged that if he had not fallen while at work, he would never have had a broken wrist and would never have fallen into the door. Under these circumstances, Richley's workers compensation insurer
Would not have a duty to defend relative to a workers compensation claim made by Jack for his head injury.
