Unit 20: Workers' Compensation Flashcards
Gives employees the right to collect for injury, disability, or death that occurs in the course of employment…
Workers Compensation
Found the employer to not be at fault because the employee knew the risk before employment and assumed all of the risk of injury…
Assumption of risk
A rule of law that stated if there was any fault by the injured party, the injured party is considered to be totally at fault and cannot collect from the party being sued. If the employer could prove fault by the employee, the employer had no responsibility
Contributory Negligence
States that if the injury was caused by a fellow employee, the employer could not be found to be at fault.
Fellow servant rule
Workers compensation benefits
- medical
- disability
- survivor
- burial
- rehabilitation
Compensate employees who are unable to work as a result of work-related injury or disease. Intended to replace a portion of lost income, but not all of it.
Disability/loss of income benefits
Pay for the cost of various types of medical services required because of an employment-related injury/disease.
Payment for basic expenses are generally unlimited and do not contain deductibles.
Medical benefits
Compensate a surviving spouse, children, or other relatives of an employee whose death results from a work -related injury or disease. Survivor benefits include a weekly benefit and a stipulated amount for funeral and burial expenses.
Survivor/death benefits
Include medical rehabilitation, such as physical therapy designed to improve physical functioning and vocational rehabilitation, such as retraining for a different occupation. Benefits pay reasonably justifiable expenses for these purposes
Rehabilitation benefits
- Injury must occur in the course and scope of employment
- disease must be caused by a specific type of employment
Compensable Injuries
What is workers’ compensation?
A form of insurance providing wage replacement and medical benefits to employees injured in the course of employment.
True or False: Workers’ compensation is mandatory in most states in the US.
True
Fill in the blank: Workers’ compensation laws are designed to protect _______.
employees
What are the primary benefits provided by workers’ compensation?
Medical expenses, lost wages, and rehabilitation costs.
Which of the following is NOT typically covered by workers’ compensation? A) On-the-job injuries B) Illness from work conditions C) Injuries caused by employee’s intoxication.
C) Injuries caused by employee’s intoxication.
What is the role of a claims adjuster in workers’ compensation?
To evaluate and process workers’ compensation claims.
True or False: Employees can sue their employer for additional damages if they receive workers’ compensation.
False
What is the purpose of the no-fault system in workers’ compensation?
To provide benefits to injured workers without requiring proof of employer negligence.
What does the term ‘disability benefits’ refer to in workers’ compensation?
Payments made to workers who are unable to work due to a work-related injury or illness.
Which type of injury is typically covered by workers’ compensation?
Injuries occurring during the normal course of employment.
True or False: Workers’ compensation laws vary by state.
True
What is the waiting period for short-term disability benefits in many states?
Usually 3 to 7 days.
Fill in the blank: Workers’ compensation claims must be filed within a certain _______.
timeframe
What does the term ‘temporary total disability’ mean?
A condition where an injured worker is completely unable to work for a limited time.
Name one common type of workplace injury that is covered by workers’ compensation.
Slip and fall injuries.
True or False: Employers have the right to contest a workers’ compensation claim.
True
What is the purpose of a return-to-work program in workers’ compensation?
To help injured employees transition back to work as soon as they are able.
Fill in the blank: Workers’ compensation is intended to provide _______ for employees injured on the job.
financial support
What is a common reason for workers’ compensation claim denial?
Failure to report the injury in a timely manner.
What role do medical providers play in workers’ compensation cases?
They assess and treat injured workers and provide necessary documentation for claims.
True or False: All states require employers to carry workers’ compensation insurance.
False
What does ‘permanent partial disability’ mean?
A condition where an injured worker has a lasting impairment but can still work in some capacity.
What is an independent medical examination (IME)?
An evaluation by a physician who is not involved in the treatment of the injured worker to assess their condition.
Fill in the blank: Workers’ compensation laws are designed to provide _______ for both employers and employees.
protection
What is the significance of the ‘exclusive remedy’ provision in workers’ compensation?
It limits the injured worker’s ability to sue their employer outside of the workers’ compensation system.
Employer must accept and comply with all provisions of the law
Compulsory
Employer may choose not to be subject to the law
Elective
Issued by private insurers. The employer transfers compensation obligations to the insurance company and the required benefits to be paid from the policy.
Workers compensation insurance
Require employers to purchase workers’ compensation insurance from the state. Private insurance companies are not allowed to compete against these funds.
Monopolistic state funds
Gives employers a choice between purchasing workers compensation insurance from a state fund or a private insurance company.
Competitive state funds
