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workers comp ch 15
| Question | Answer |
|---|---|
| Any abnormal condition or disorder caused by exposure to environmental factors associated with employment including acute or chronic illnesses or disease that may be caused by inhalation, absorption, ingestion, or direct contact is known as | occupational illness or disease |
| The days that must elapse before workers compensation weekly benefits become payable is called | waiting period |
| A special fund that assumes all or part of the liability for benefits provided to a worker because of the combined effect of a work-related impairment and a preexisting condition is known as | second-injury fund or subsequent-injury fund |
| A claim for an on-the-job injury that requires medical care but does not result in loss of working time or income is known as | nondisability claim |
| What benefit includes hospital, medical and surgical services, medications, and prosthetic devices that may be rendered by a medical doc, osteopath, dentist, or chiropractor | medical treatment |
| What benefit is in the form of weekly cash payments made directly to the injured or ill person | temporary disability indemnity |
| What benefit may consist of either weekly or monthly cash payments based on a rating system that determines the percentage of permanent disability that is determened separately by the bureau in San Francisco | permanent disability indemnity |
| What benefit consist of cash payments to dependents of employees who are fatally injured with a burial allowance is given in some states | death benefits for survivors |
| What benefit can be medical or vocational rehabilitation in cases of sever disabilities | rehabilitation benefits |
| When a worker has a work-related injury or illness and is unable to perform the duties of his job for a specific time or range of time | temporary disability |
| In many states a form if retraining, education, job guidance, and placement is reffered to as | vocational rehabilitation |
| An individualized program using simulated or real work task to build up strength and improve the workers endurance toward a full days work is known as | work hardening |
| Science and technology that seek to the anatomic and physical needs of the worker to the workplace is known as | ergonomic |
| C and R | compromise and release |
| An agreement between the injured party and insurance company on a total sum in which the case can be closed is called | compromis and release (C and R) |
| P and S | permanent and stationary |
| Phrase meaning that damage from the injury of illness is permant is known as | permant and stationary (P and S) |
| The final determination of the issues involving settlement of an industrial accident also known as rating os a case is | adjudication |
| A proceeding in which an attorney asks a witness queations about a case, and the witness answers under oath but not in open court is known as | deposition |
| A legal promise to satisfy a debt owed by the patient to the physician out of any proceeds received on the case | lien |
| The legal process by which an insurance company seeks from a third party, who has caused a loss, recovery of the amount paid to the policyholder is known as | third-party subrogation |
| When an employee is injured the employer should submit what kind of form to the insurance company | employer's report of occupational injury or illness |
| When an employee is sent to a physicians office for medical care an employer should complet a form called | medical service order |
| A representative of the insurer who authorizes treatment and investigates, evaluates, and negotiates the patients insurance claim and acts for the company in the settlement of claims is known as | claims examiner |
| A report must be submitted with the claim when the notation BR follows the procedure code description is called | by report |
| WP | waiting period |
| WC | workers compensation |
| FECA | federal employees compensation act |
| SIF | subsequent injury act |
| benefits under the state law that applys to a compensable injury of an employee hired in one state but injured outside that state is known as | extraterritorial |
| ND | nondisability claim |
| TD | temporary disability |
| WCAB | workers compensation appeals board |
| Videotapes made without the knowledge of the subject used to investigate suspicious claims is called | sub rosa films |
| OSHA | occupational safety and health administration |
| What is designed to set fees at a percentile of the providers usual and customary fee | percentile of charge schedule |
| This takes into account the time, skill, and extent of the service provided by the physician which each procedure is rated on how difficult it is, how long it takes, the training a physician must have to perform it, and expenses the physician incurs | relative value schedule |
| When a specific dollar amount is used for each of the sections of the fee schedule is known as | conversion factor |
| AME | agreed medical evaluator |
| IME | independent medical evaluator |
| QME | qualified medical evaluator |
| A person hired by the insuance company or appointed by the referee or appeals board to examine an individual, independent from the attending physician, and renders an unbiased opion about the degree of disability of an injured worker is called | medical evaluator |
Created by:
maryce
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