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Mod 5A UHI Ch. 17

Worker's Compensation

QuestionAnswer
OWCP Office of Worker's Compensation Program
OWCP definition Administers programs that provide wage-replacement benefits, medical treatment, vocational rehabilitation, and other benefits to federal workers and their eligible dependants.
Federal Black Lung Program Provides medical treatment and other benefits for respirator conditions related to former employment in the nations coal mines.
Federal Employees' Compensation Act Program Administered by the OWCP and provides workers compensation coverage to all federal and postal workers throughout the worlds for employment related injuries and occupational diseases.
Longshore and Harbor Workers' Compensation Program Administered by the U.S Dept of Labor, provides medical benefits, compensation for lost wages and rehabilitation services to longshoremen, harbor workers, and other maritime workers injured during employment or suffer from diseases caused by employment.
OSHA Occupational Safety and Health Act of 1970
OSHA definition Protects employees against injuries from occupational hazards in the workplace.
FELA Federal Employment Liability Act
FELA definition Provides railroad employees with protection from employer negligence.
Comprehensive records of all vaccinations administered and any accidental exposure incidences. Must be retained for 20 years.
Merchant Marine Act Jones Act-Provides seamen with protection from employer negligence.
Worker's Compensation Board/Commission State agency responsible for administering workers' compensation laws and handling appeals for denied claims or cases.
Workers' Compensation eligibility Injured while working within the scope of the job, injured while performing a service required by the employer or develops a disorder that can be directly linked to employment.
Classification of Workerss Compensation cases Medical treatment, temporary disability, permanent disability, vocational rehabilitation, survivor benefits.
Survivor Benefits Provide death benefits to eligible dependants and are calculated according to the employee's earning capacity at the time of illness of injury.
Providers are required to accept the... Workers' compensation allowable fees as payment in full for covered services rendered on cases involving on-the-job illnesses or injuries.
First report of injury Completed by the provider, when the patient first seeks treatment for a work-related illness or injury.
Patient signature on first report of injury Not required as when the patient requests treatment for a work-related injury or disorder the patient has given consent for filing of compensation claims and reports.
First report of injury filing deadline 24 hours to 14 calender days depending on state requirements.
Progress report A detailed narrative progress/supplemental report documenting any significant change in the worker's medical or disability status.
Adjudication Judicial dispute resolution process in which an appeals board makes a final determination.
Deposition A legal proceeding during which a party answers questions under oath but not in open court
Arbitration Dispute resolution process in which a final determination is made by an impartial person who may not have judicial powers.
Fraud Knowlingly obtaining benefits for which they are not eligible.
Abuse When worker's compensation system is used in a way contrary to its intended purpose or to the law.
Difference between fraud and abuse Intent
Created by: ROSSMIBOA
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