CPB Chapter 14: Workers' Compensation

QUIZ

QUIZ

TEST

TEST

Which program provides lump-sum compensation and health benefits for eligible Department of Energy nuclear weapons workers injured on the job? a. Energy Employees Occupational Illness Compensation Program b. Federal Employees' Compensation Program c. Longshore and Harbor Workers' Compensation Program d. Federal Black Lung Program

a. Energy Employees Occupational Illness Compensation Program

What is essential to ensure the non-work related issues are not sent to workers' compensation? a. Maintain separate charts b. Have a provider that only sees workers' compensation patients c. Have release of information from signed d. None of the above

a. Maintain separate charts

A patient presents to be seen with chronic beryllium disease that he incurred while under government employment. What coverage would apply to him? a. Part B Energy Employees Occupational Illness Compensation Program b. Federal Black Lung Benefit c. Part E Energy Employees Occupational Illness Compensation Program d. Longshore and Harbor Workers' Compensation Program

a. Part B Energy Employees Occupational Illness Compensation Program

What type of plan covers private and public employers and acts as an agent in state workers' compensation cases involving state employees? a. State Insurance Fund b. Self-Insurance Plans c. Commercial Workers' Compensation Insurance d. Combination Programs

a. State Insurance Fund

For an employer to have a self-funded plan, the employer must: a. set aside a state mandated percentage of capital funds. b. set aside a federally mandated percentage of capital funds. c. payout at least one Workers' Compensation claim per year. d. require employees to sign a waiver so they cannot be sued for additional damages.

a. set aside a state mandated percentage of capital funds.

OSHA has developed what standards to protect against transmission of infectious agents? a. Bloodborne Pathogens standards, Specimen Testing standards, CLIA standards b. Bloodborne Pathogens standards, Personal Protective Equipment standards, Respiratory Protection standards, TB compliance directive c. Respiratory Protection standards, Personal Protective Equipment standards, Coding standards d. TB compliance directive, Specimen Testing standards, Medical Record standards

b. Bloodborne Pathogens standards, Personal Protective Equipment standards, Respiratory Protection standards, TB compliance directive

Which form is used to submit claims to workers' compensation insurance? a. Remittance advice b. CMS-1500 c. Encounter form d. Healthcare claim form

b. CMS-1500

Which program covers postal workers for employment related injuries? a. Energy Employees Occupational Illness Compensation Program b. Federal Employees' Compensation Program c. Longshore and Harbor Workers' Compensation d. Federal Black Lung Benefits

b. Federal Employees' Compensation Program

Which statement is TRUE regarding Workers' Compensation? a. The carrier must find fault with the employer for Workers' Compensation to apply. b. In exchange for Workers' Compensation benefits, the employee cannot bring civil action against the employer for pain and suffering. c. In exchange for Worker's Compensation benefits, employees lose the seniority they have acquired at their job. d. Independent contractors are covered under Workers' Compensation.

b. In exchange for Workers' Compensation benefits, the employee cannot bring civil action against the employer for pain and suffering.

Workers' compensation is a(n) ______________ insurance program. a. Catastrophic b. No fault c. At fault d. Personal injury

b. No fault

What type of state worker's compensation coverage allows an employer to set aside money to cover medical expenses and other related benefits for its employees? a. State insurance fund b. Self-insurance plans c. Commercial workers' compensation insurance d. Combination program

b. Self-insurance plans

Which entity governs workers' compensation law? a. Federal b. State c. Department of Labor d. OSHA

b. State

What does no-fault insurance mean? a. The insurance will pay only if no one was found to be at fault. b. The insurance will pay regardless of who was at fault. c. Both insurances pay evenly when no one is found to be at fault. d. No payments or benefits are paid.

b. The insurance will pay regardless of who was at fault.

Why must a provider keep a separate chart for documentation of the work-related injury for workers' compensation cases? a. To protect the patient's privacy b. To prevent documentation of the patient's non-work-related issues from being disclosed to the workers' compensation insurance c. To protect the patient's commercial insurance from knowing what injuries were sustained in a work-related incident d. To prevent duplicate payment for similar services

b. To prevent documentation of the patient's non-work-related issues from being disclosed to the workers' compensation insurance

What is the timely filing limit for claims for workers' compensation services? a. 60 days b. Will vary by payer c. 120 days d. 90 days

b. Will vary by payer

Which of the following allows employers in some states to choose coverage options (state, commercial, or self) to comply with workers' compensation coverage requirements? a. Federal Employees' Compensation Program b. State Insurance Fund c. Combination Programs d. There is no type of coverage that allows this.

c. Combination Programs

OSHA is an agency of _______________? a. Department of Health and Human Services b. Department of Veterans Affairs c. Department of Labor d. Department of Inspector General

c. Department of Labor

What kind of workers are covered under the Longshore and Harbor Workers' Compensation Program? I. Shipbuilders II. Seamen III. Government worker IV. Longshore worker a. I, II, III, and IV b. I and III c. I and IV d. I, II, and IV

c. I and IV

Healthcare workers must be provided specific training including the use of Standard Precautions if they might come into contact with ____________. a. Lifting and repetitive tasks b. Workplace violence c. Infectious materials d. None of the above

c. Infectious materials

Which program provides workers' compensation benefits to most waterfront workers and contractors working overseas for the U.S. government? a. Energy Employees Occupational Illness Compensation Program b. Federal Employees' Compensation Program c. Longshore and Harbor Workers' Compensation Program d. Federal Black Lung Program

c. Longshore and Harbor Workers' Compensation Program

A 70-year-old patient with complex pneumoconiosis presents after a fall. X-rays are taken and are negative for fracture. The patient gives both a Medicare card and a Federal Black Lung ID card. How should this claim be billed? a. Federal Black Lung first, then Medicare b. Medicare first, then Federal Black Lung c. Medicare only d. Federal Black Lung only

c. Medicare only

According to OSHA, who has the highest rate of work-related musculoskeletal disorders? a. Movers b. Welders c. Nurses aids d. Manufacturers

c. Nurses aids

Which statement is TRUE regarding Workers' Compensation reimbursement for providers? a. Providers can balance bill the patient for any amounts Workers' Compensation does not pay. b. Providers are paid 100% of the providers charge for the services provided in the Workers' Compensation case. c. Providers are required to accept reimbursement from Workers' Compensation payers in full. d. Providers can determine whether or not to accept payment from the Workers' Compensation payer or from the patient's commercial insurance.

c. Providers are required to accept reimbursement from Workers' Compensation payers in full.

Under Workers' Compensation, when is a worker covered for an injury that occurred on-the-job? a. Only if the employer was negligent b. Only if the employee is not to blame c. They are covered regardless of who is at fault d. If there is a witness to the injury

c. They are covered regardless of who is at fault

The Occupational Safety and Health Act (OSHA) was created to assure safe and healthy work conditions by setting and enforcing standards and provide _____________________. a. Training b. Outreach c. Education d. All of the above

d. All of the above

Which of the following may be benefits included as part of workers' compensation? a. Wage-loss benefits b. Medical rehabilitation c. Career rehabilitation d. All of the above

d. All of the above

Which program provides compensation and medical coverage for treatment to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment and to the survivors of coal miners whose deaths are attributable to the disease? a. Energy Employees Occupational Illness Compensation Program b. Federal Employees' Compensation Program c. Longshore and Harbor Workers' Compensation Program d. Federal Black Lung Program

d. Federal Black Lung Program

Which federal program provides coverage to three million federal and postal workers around the world for employment-related injuries and occupational diseases? a. Longshore and Harbor Workers' Compensation Program b. Federal Black Lung Program c. Energy Employees Occupational Illness Compensation Program d. Federal Employees' Compensation Program

d. Federal Employees' Compensation Program

What must be submitted to the workers' compensation payer after an initial employee injury visit? a. CMS-1500 claim form, office encounter note and a letter from the provider documenting the case b. CMS-1500 claim form and First Report of Injury form c. First Report of Injury form and office encounter note d. First Report of Injury form, CMS-1500 claim form, and office encounter note

d. First Report of Injury form, CMS-1500 claim form, and office encounter note

What information is needed to file a Worker's Compensation claim? I. Patient name, address, and phone number II. Patient Social Security number III. Employer's name, address, and phone number IV. Patient's employment position V. Injury details VI. Workers' Compensation carrier address and phone number VII. Workers' Compensation claim number VIII. Patient's insurance carrier and subscriber ID a. I, III, V, VI b. I, II, III, V c. I, III, IV, V, VI, VIII d. I, II, III, V, VI, VII

d. I, II, III, V, VI, VII

For OSHA, which employees are included as healthcare workers? I. medical staff II. maintenance staff III . housekeeping IV. food service staff V. administrative staff a. I only b. I and V c. I, III, and V d. I-V

d. I-V

Who is NOT entitled to Workers' Compensation Benefits? a. Part-time employee b. Full-time employee c. The President of a company d. Independent contractor with the company

d. Independent contractor with the company

Can an employer require an employee to pay a portion of the insurance premiums for the workers' compensation coverage? Why or why not? a. Yes, if the employee only works part-time b. No, if the employee only works part-time c. Yes, if the employee also pays a portion of the commercial insurance premium d. No, the employer is required by law to pay the premiums for coverage

d. No, the employer is required by law to pay the premiums for coverage

Which option is NOT a covered entity under HIPAA? a. Blue Cross Blue Shield HMO b. Physicians c. Aetna PPO d. Workers' Compensation

d. Workers' Compensation

According to OSHA, which industries have the more work related injuries and illnesses than any other sector? a. healthcare and railroads b. shipyards and railroads c. healthcare and pipeline transportation d. healthcare and social assistance

d. healthcare and social assistance