Question 1

The CMS-1500 and UB-04 universal claim forms are used to file workers' compensation claims for medical and hospital services.

Accepted Answer

The answer of The CMS-1500 and UB-04 universal claim forms...

Question 2

Vocational rehabilitation involves the __________ of an injured employee to enable him or her to return to the workforce.

Accepted Answer

The answer of Vocational rehabilitation involves the __________ of an...

Question 3

The workers' compensation insurance carrier must pay for services if an independent review organization decides that the care was medically necessary.

Accepted Answer

If an independent review organization determines that the care was medically necessary, the workers' compensation insurance carrier is obligated to pay for the services.

Question 4

The provider from whom an injured worker receives medical care is referred to as the __________ doctor or __________ of record.

Accepted Answer

The answer of The provider from whom an injured worker...

Question 5

Medical benefits replace a portion of any wages a worker loses because of a work-related injury or illness.

Accepted Answer

Medical benefits cover the cost of medical care for a work-related injury or illness, but do not replace lost wages. Wage replacement benefits are typically covered under a separate component of workers' compensation, often referred to as disability benefits or lost wages benefits.

Question 6

The __________ rating describes the degree of permanent damage done to the worker's body as a whole.

Accepted Answer

The answer of The __________ rating describes the degree of...

Question 7

Eligible children can receive death benefits until age 18, or age 25 if they are a full-time college student.

Accepted Answer

This statement is true. Children who are eligible for Social Security survivor benefits can receive them until age 18 (or 19 if they are still in high school) and can continue receiving benefits until age 25 if they are a full-time college student.

Question 8

The earliest workers' compensation programs were opposed by organized labor because they did not encourage a(n) __________ work environment.

Accepted Answer

The answer of The earliest workers' compensation programs were opposed...

Question 9

Medical benefits for a workers' compensation claim begin __________ .

Accepted Answer

The answer of Medical benefits for a workers' compensation claim...

Question 10

Temporary income benefits are paid if the injury or illness causes the worker to lose income for more than 7 days.

Accepted Answer

This statement is true. Temporary income benefits are paid to workers who are unable to work for more than 7 days due to a work-related injury or illness.

Question 11

In regard to workers' compensation cases, patient health information and claim data are subject to the same confidentiality rules as regular medical records.

Accepted Answer

Workers' compensation cases often involve the sharing of patient health information and claim data with employers, insurance carriers, and others involved in the case, which is not typically allowed under the standard confidentiality rules for regular medical records.

Question 12

A workers' compensation claim will be paid by the carrier even if no case number is assigned.

Accepted Answer

A workers' compensation claim cannot be paid by the carrier without a case number being assigned. The case number serves as the unique identifier for the claim and is necessary for processing and tracking its progress.

Question 13

What is occupational disease?

Accepted Answer

The answer of What is occupational disease?...

Question 14

If the workers' compensation insurance requires preauthorization for certain services, the preauthorization must be obtained before services are rendered; this does NOT apply if the services were provided in an emergency situation.

Accepted Answer

Preauthorization is required for certain services in workers' compensation insurance, but this requirement does not apply in emergency situations.

Question 15

are Workers' Compensation Department employees who can help the worker with his or her claim once a proceeding has been scheduled.

Accepted Answer

The answer of are Workers' Compensation Department employees who can...

Question 16

Medical records for workers' compensation cases are to be kept separate from a patient's regular medical records.

Accepted Answer

This is true as per HIPAA regulations. Medical records for workers' compensation cases are considered a separate category of protected health information and must be kept confidentially and separately from a patient's regular medical records. This is to prevent any potential discrimination or retaliation against the employee based on the information revealed in their workers' compensation case.

Question 17

A spouse is eligible to receive death benefits for life unless he or she remarries.

Accepted Answer

In most cases, a spouse who is eligible to receive death benefits from a deceased spouse's pension plan or life insurance policy will receive those benefits for life unless he or she remarries. However, the specific terms and conditions of the plan or policy may vary, so it is important to review the documentation carefully.

Question 18

Up to $6,000 of a deceased worker's funeral expenses can be paid as __________ benefits.

Accepted Answer

The answer of Up to $6,000 of a deceased worker's...

Question 19

Eligibility to receive supplemental income benefits ends 365 days from the date of injury.

Accepted Answer

Eligibility for supplemental income benefits typically extends beyond 365 days from the date of injury, depending on the specific circumstances and regulations of the jurisdiction.

Question 20

Each __________ regulates and administers its own workers' compensation program.

Accepted Answer

The answer of Each __________ regulates and administers its own...

Quiz 18: Workers Compensation