2nd class Workers' Compensation

d

A detailed and comprehensive questionnaire that establishes financial need is a/an Select one: a. evaluation questionnaire b. SSDI funding form c. patient/provider interview d. financial means test

d

A maximum benefit amount paid for short-term disability policies is called a _____ cap. Select one: a. short-term b. maximum c. disability d. benefit

false

All business organizations are required to purchase workers' compensation. Select one: True False

c

All of the following are benefits of the workers' compensation program except Select one: a. death benefits b. medical expenses c. food and housing expenses d. disability pay

c

An individual responsible for investigating and resolving workers' complaints against the employer is called a/an Select one: a. investigator b. personal claims representative c. ombudsman d. arbitrator

b

As an alternative to traditional workers' compensation coverage, some employers choose a/an __________________ to provide medical care to injured employees. Select one: a. OSHA-funded plan b. managed care system c. employee-sponsored fund d. health benefit plan

true

Balance billing is not allowed on workers' compensation claims. Select one: True False

false

Because of the extensive information and forms required for workers' compensation claims, it is almost impossible for fraud to occur. Select one: True False

b

Companies pay premiums for workers' compensation insurance; in return, their employees agree to Select one: a. not file claims for on-the-job injuries b. give up the right to sue employers for on-the-job injuries c. pay employers back for their insurance d. split the cost of medical bills for on-the-job injuries

true

Disability income insurance replaces a portion of earned income when an individual is unable to do his or her work resulting from non-employment-related injuries. Select one: True False

c

Disability is normally determined on the basis of the Select one: a. employer's report b. employee's complaints c. attending physician assessment d. workers' compensation insurer's opinion

true

Each state has established rules under which an employee is required to file a claim within a certain time limit. Select one: True False

false

Federal rules and regulations do not allow individual states to change the forms used to report workers' compensation claims. Select one: True False

true

HIPAA permits covered entities to disclose PHI to workers' compensation insurers and/or employers without the individual's written authorization. Select one: True False

c

In which century did workers' compensation get its start? Select one: a. 2000s b. 1700s c. 1800s d. 1900s

true

Most short-term disability policies have a maximum benefit amount that is paid each month. Select one: True False

d

Most state laws exclude coverage for injuries sustained while an employee is commuting to and from work. This is referred to as the _____ rule. Select one: a. in-transit b. to-and-from-work c. commuting d. coming-and-going

b

Some commonly used factors federal programs look at in assessing disability include all of the following except Select one: a. activities of daily living b. earned income c. cognitive/mental impairments d. sensory impairments

false

Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) are identical programs with the same requirements for enrollment. Select one: True False

false

The CMS-1500 is the standard form for billing disability claims. Select one: True False

c

The Federal Employment Compensation Act (FECA) provides workers' compensation for _____ employees. Select one: a. military nonfederal b. military federal c. nonmilitary federal d. nonmilitary nonfederal

false

The Federal Employment Compensation Act (FECA) provides workers' compensation for federal military employees. Select one: True False

true

The Health Insurance Portability and Accountability Act (HIPAA) mandates that if an employer provides insurance to its employees and their dependents, all employees and dependents must be covered regardless of the medical condition. Select one: True False

a

The condition in which the employee has reached a state of maximal medical improvement is called Select one: a. permanent and stationary b. temporary c. chronic d. partial and rehabilitating

false

The health insurance professional has no tangible responsibilities in facilitating disability claims. Select one: True False

b

The major benefit components to workers' compensation include all except Select one: a. medical expenses b. home mortgage payments c. death benefits d. disability pay

c

The national website that provides workers' compensation news and information for employees, employers, insurers, and medical providers is the Select one: a. Disability and Health Team b. Centers for Medicare and Medicaid Services c. Online Workers' Comp Service Center d. Americans with Disabilities

true

The purpose of disability income insurance is to replace a portion of salary or wages lost due to injury or illness that is not work related. Select one: True False

b

The standard form for billing disability claims is Select one: a. UB-04 b. nonexistent c. CMS-1500 d. Form 2129

c

The time limit for filing a workers' compensation claim is established by Select one: a. the employer b. the insurance company that issues the policy c. individual state statutes d. the federal government

a

There are no work requirements for SSI, but the individual must establish Select one: a. financial need b. all of the answers c. inability to perform activities of daily living (ADLs) d. 5 years of legal state residency

true

There are two major types of disability coverage, short term and long term. Select one: True False

true

There is no wage base limit for the Medicare Part A (hospital insurance) payroll tax. Select one: True False

d

To qualify for Social Security benefits, an individual must have worked a specified number of Select one: a. weeks at the same job b. minimum wage hours c. years as a full-time employee d. covered work quarters

false

Vocational rehabilitation is not available for employees who cannot return to their job because of a workers' compensation injury. Select one: True False

d

What is the first step an employee should take for a first report of a nonemergency on-the-job injury? Select one: a. The employee should go or be sent to a medical facility for treatment or diagnosis. b. The employee should have the employer report the incident to a workers' compensation carrier. c. The employee should complete an initial accident report. d. The employee should notify a supervisor of the accident.

c

Which act provides workers' compensation to employees of private maritime employers? Select one: a. Merchant Marine Act (Jones Act) b. Federal Employment Liability Act c. Longshore and Harbor Workers' Compensation Act d. Black Lung Benefits Act

b

Which of the following employers are not required to provide workers' compensation insurance to their employees? Select one: a. employers with fewer than three full-time employees b. all of the answers c. volunteers d. individuals who are business partners

b

Which of the following is not one of the responsibilities of the health insurance professional? Select one: a. maintaining a well-documented health record b. filling out the necessary forms for the patient c. photocopying all forms for the patient's health record d. acquiring the necessary information for claims processing

b

Which program was created to help individuals who receive SSDI or SSI benefits find and keep employment by offering them more options for services and supports? Select one: a. PACE b. Ticket to Work c. Workers' Compensation d. FECA

false

Workers' compensation benefits normally begin immediately after an injury. Select one: True False

c

Workers' compensation insurance is considered to be "no-fault insurance," which means Select one: a. if it is unclear whose fault the injury is, workers' compensation does not have to pay b. benefits are not paid, because the injury is considered to be nobody's fault c. benefits are paid regardless of who is to blame for the injury d. the employee and employer share medical expenses

true

Workers' compensation is an insurance, regulated by state laws, that pays medical expenses for on-the-job injuries. Select one: True False

a

Workers' compensation is considered a/an Select one: a. legally mandated right b. fringe benefit c. employee's responsibility d. optional bonus

true

Workers' compensation is considered no-fault, and benefits are paid regardless of who is to blame for the injury. Select one: True False