Workers Comp

Question 0

Who is exempt from compulsory wc?

Answer 0

Farm workers, casual employees, domestic servants

Question 1

What are 3 defenses to wc?

Answer 1

Assumption of risk
Contributory negligence
Fellow servant rule

Question 2

How many years does an entity have to be in business to self insure for wc?

Answer 2

5

Question 3

When an injured employee has lost five days of work how long doses employer have to notify DIA?

Answer 3

7 calendar days

Question 4

Which coverages fall under part I?

Answer 4

Medical expense (no limit)

Income ( 66 2/3 total permanent, 60 partial or temporary)

Dependent/funeral expense ($4000 burial, survivor if fatally injured - children to age
18 or no longer in college)

Rehab/restoration (max 104 weeks)

Question 5

Is there coverage of contributory negligence exists, injury results from another employee or injured employee violated a safety warning?

Answer 5

Yes

Question 6

How long are benefits paid for total incapacity?

Answer 6

156 weeks

Question 7

Is there wc coverage if employee violated the law or injury was self-inflicted?

Answer 7

No

Question 8

What is covered under part II?

Answer 8

Employers liability (3rd party suits against employer by

1) non/employees people not subject to wc law)
2) covered employee dependents

Legal defense expenses in addition to

Question 9

What are basic wc limits?

Answer 9

$100 accident $100 occupational disease $500 aggregate for occupational disease

Question 10

This type of suit occurs when employee sues employer in other capacity. Ex. Suing safety over auto claim.

Answer 10

Dual capacity

Question 11

Suit where employee is injured by faulty machinery sues manufacturer of machinery an manufacturer alleges the employer installed incorrectly.

Answer 11

Third party over

Question 12

Covers injury to family member due to injured employee. Ex. Heart attack finding out about injury, loss of consortium.

Answer 12

Consequential BI

Question 13

Covers employer if an employees family member sues due to loss of consortium, companionship or affection.

Answer 13

Care and loss of services.

Question 14

What is part III of a wc?

Answer 14

Other states insurance … Optional. Must itemize each state.

Question 15

Which states are monopolistic states?

Answer 15

ND, OH, WA, WY

Question 16

What are parts IV V and VI?

Answer 16

IV: duties
V: premiums
VI: conditions

Question 17

When can an employer make a payment?

Answer 17

Can only make at own expense except can pay for emergency medical treatment.

Question 18

When does employer have to report to DIA?

Answer 18

Within 7 days if employee lost 5 days of work.

Question 19

How are wc premiums set?

Answer 19

1) classification of job
2) payroll ($100s of payroll - audit at end)
3) claims experience

Question 20

Wc plan where employer pays claims up to large amount … $100k or $250k. Insurer pays beyond.

Answer 20

Large deductible plan.

Question 21

Used by some wc programs , premium is based on actual loss experience and calculate at end

Answer 21

Retrospective rating plan

Question 22

Which employees are exempt from wc?

Answer 22

1) masters and seamen in interstate commode covered by federal law
2) athletes with contracts providing disability
3) commision paid salespeople (contractors)
4) independent taxi drivers
5) domestic servants less than 16 hours per week.

Question 23

Adds wc coverage for employees normally not eligible.

Answer 23

Voluntary compensation

Question 24

Extends wc to us citizens working in other countries. May cover cost of repatriating for treatment of diseases.

Answer 24

Foreign coverage

Question 25

What are some additional coverages normally not covered by a wc that are afforded when the foreign coverage endorsement is attached?

Answer 25

Repatriating injure employee, treatment of endemic diseases.

Question 26

This fund is set up as an encouragement for employers to hire previously injured persons. It pays all or part of compensation resulting from the prior injury when a partially disabled employee is hired. 1/4% tax on wc on all insurers who write wc insurance.

Answer 26

Subsequent injury fund

Question 27

Law that allowed employee or family to take legal action against (interstate) railroad as result of injury or death. Excl usps

Answer 27

Federal Employers Liability Act

Question 28

Compensation by federal government to employees/family to people working on or around ships. Crew of ship not covered.

Answer 28

Us longshoreman and harbor workers’ comp

Question 29

Extends FELA to crew members of ship. If employer is negligent employee/family may seek damages.

Answer 29

Jones Act