Week 1 Flashcards
How long does an injured worker have to alert their employer about a work-related injury to avoid forfeiting worker’s compensation benefits?
30 days
What is the maximum amount employers must provide for medical care until a claim is accepted or rejected?
$10,000
What does AOE and COE stand for when determining if an injury is compensable?
AOE: Arise Out of Employment
COE: Course of Employment
How soon after the initial exam must a Doctor’s First Report (DFR) be filed with the employer or employer’s insurance company?
Within 5 working days
How often must a Primary Treating Physician provide progress reports on the patient’s condition?
Every 45 days, or sooner if conditions change
In the QME process for unrepresented workers, how long does the injured worker have to choose a QME from the panel provided by DWC?
10 days
What is the deadline for a QME to file and serve their Medical/Legal Report to all parties after the examination?
Within 30 days of the exam
What is an AME in the context of workers’ compensation disputes?
Agreed Medical Evaluator - a physician chosen by mutual agreement between the worker’s attorney and the claims administrator when the worker is represented
How long does an employer have to pay all reasonable charges for a Medical/Legal Report from a QME?
Within 60 days
Under which Labor Code section would a dispute about the compensability of a claim fall?
Labor Code 4060
Medical treatment for occupational injury is based on which guidelines?
Medical Treatment Utilization Schedule
When the primary treating physician determines that the employees condition is permanent and stationary, the physician must report within how many days from the date of the initial exam, any findings concerning the existence and extent of permanent impairment and limitations, resulting from the injury?
20 days. The PR4 form.
