Chapter 14: Workers Comp

Question 1

Who is not covered by OSHA?

Answer 1

-Self-employed
-immediate family members of farm employers that do not employ outside workers
- injuries covered by another federal agency

Question 2

Federal employees are covered under one of the federal workers comp programs. What are the 4 programs?

Answer 2

1. Energy employees occupational illness compensatoin program (EEIOP)
2. Federal employees compensation program
3. Longshore and Harbor workers comp program (LHWCP)
4. Federal black lung program

Question 3

According to OSHA, who has the highest rate of work related musculoskeletal disorders?

Answer 3

Nurses’ aides, orderlies, and attendants

Question 4

A patient presents to be seen with chronic beryllium disease that he incurred while under government employment. What coverage would apply to him?

Answer 4

Part B Energy Employees Occupational illness compensation program

Question 5

Can an employer require an employee to pay a portion of the insurance premiums for the compensation coverage? Why or why not?

Answer 5

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

Question 6

Which program covers postal workers for employment related injuries?

Answer 6

Federal Employees compensation program

Question 7

Which program is an act providing compensation and medical coverage for treatment to coal miners who are totally disabled by pneumoconiosis?

Answer 7

Federal Black Lung Program

Question 8

Which program provider workers comp to most waterfront workers and contractors working overseas for the US Government?

Answer 8

Longshore and Harbor Workers’ Compensation Program (LHWCP)

Question 9

Longshore and Harbor Workers’ Compensation Program (LHWCP) is a federal law that provides for the payment of compensation, medical care and vocational rehab services for workers disabled from injuries on the job on navigable waters of the US or adjoining areas used customarily in the?

Answer 9

Loading, unloading, repairing, and building of vessels

Question 10

LHWCA covers which workers in traditional maritime occupations such as?

Answer 10

-Longshore workers
- ship repairers
- harbor construction workers
- employees at overseas military bases or contractors working outside the US
- Employees on the Outer Continental Shelf of the US
- civilian employees of the Armed forces

Question 11

Who does the LHWCA specifically exclude?

Answer 11

seamen, employees of the US or any state or foreign government, employees with injuries were caused by intoxication or their own willful intention to harm themselves or others

Question 12

What are the 2 types of Pneumoconiosis/Black Lung?

Answer 12

Simple and complicated

Question 13

The Energy employees occupational illness compensation program consists of 2 parts. Which part is an employee eligible for if the employee sustained a radiogenic cancer, chronic silicosis, beryllium sensitivity, or chronic beryllium disease while working at a covered location?

Answer 13

Part B

Question 14

The Energy employees occupational illness compensation program consists of 2 parts. Which part is an employee eligible for if the employee developed a covered illness because of exposure to any toxic substance at a dept of energy facility or RECA section 5 mine or mill?

Answer 14

Part E

Question 14

Under the Federal Employees Compensation Program, what federal division adjudicates new claims, pays medical expenses and compensation benefits, and helps injured employees return to work?

Answer 14

Division of Federal Employees Compensation Act (DFEC)

Question 15

State workers compensation law includes what 4 types of coverage?

Answer 15

1. State insurance fund
2. Self-insurance plans
3. commercial workers comp insurance
4. combination programs

Question 16

what is an agency that provides workers comp insurance coverage to private and public employers and acts was an agent in state workers comp cases involving state employees?

Answer 16

State Insurance Fund

Question 17

What do Self Insurance Plans require?

Answer 17

requires the employer to set aside a state mandated percentage of capital funds to cover medical expenses, & wage compensation

Question 18

What type of insurance can offer policies for employers to purchase if they meet state mandates for workers comp coverage?

Answer 18

Commercial Workers Comp Insurance

Question 19

What Program describes when an employer can choose a combination of any of the other workers comp coverage requirements?

Answer 19

Combination Programs

Question 20

What is needed to submit a workers comp claim?

Answer 20

• patient name, DOB, SS, address and ph #
• employers name, address and ph #
• workers comp carrier address, ph# and claim #
• injury information

Question 21

How is a workers comp claim submitted and what is included?

Answer 21

Paper copies of:
- CMS 1500
- First Report of Injury form
- progress note

Question 22

4 copies of the First Report of Injury are needed for distribution to ?

Answer 22

1. state workers comp board
2. compensation payer
3. employer
4. patients chart

Question 23

what is the filing deadline for the first report of injury? and the claim?

Answer 23

First report of injury - determined by state law
Claim submission - determined by payer