Workers' Compensation- Done Flashcards Preview

► Med Misc 57 > Workers' Compensation- Done > Flashcards

Flashcards in Workers' Compensation- Done Deck (27)
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1
Q

Workers compensation is a —– statutory program

A

State

2
Q

Before workers compensation laws were passed employees only recourse to collect damages from work related injury was…

A

To sue the employer

3
Q

Common law prior to workers compensation laws maintained that…

A

An employer was only responsible for injuries or death resulting from a negligent act by the employer

4
Q

Three common law defenses formerly used by employers

A
  1. Assumption risk
  2. Fellow servant rule
  3. Contributory negligence
5
Q

Assumption risk

A

When an individual takes a job, they were assumed to have accepted any hazards associated with the job

6
Q

Fellow servant rule

A

Employers were not liable for injuries caused by fellow employees. Injured workers were required to seek damages from fellow employees that caused or contributed to their injury

7
Q

Contributory negligence

A

Employers were not held liable if an employees negligence contributed to the injury

8
Q

Significant milestones in workers compensation

A
1911- initial act
1940- expansion to include occupational illness and permanent disability
1960- expansion to cumulative trauma 
1973- mandatory rehabilitation act
1992- Americans with disabilities act
9
Q

Provisions under workers compensation

A
  • no fault- limited liability
  • payments are typically 1/2- 2/3 prior wage, non taxable
  • National Council of Compensation Insurance (NCCI) is the licensed advisory organization
10
Q

Federal Workers Compensation Acts

A
  1. The Federal Employees Compensation Act (FECA)
  2. Longshoreman and Harbor Workers Compensation Act
  3. Railroad Workers Act
11
Q

FECA

A

Applies to civilian employees if US government

Does not apply to military personnel

12
Q

State funds

A

Insurance companies owned and operated by the state

13
Q

Types of state funds

A
  1. Monopolistic

2. Competitive

14
Q

Monopolistic state fund

A

The state is the only carrier authorized to write workers compensation insurance

Some state allow self insurance

15
Q

Competitive state funds

A

Compete for business along with private carriers and those who self-insure

16
Q

Purpose of employer self insurance

A
  1. To reduce costs

2. Maximize cash flow

17
Q

Two basic coverages provided

A
  1. Workers compensation

2. Employers liability

18
Q

Benefits under workers compensation

A
  1. Income or cash benefits
  2. Medical benefits
  3. Vocational rehabilitation benefit
  4. Death benefits
19
Q

Impairment

A
  • determined by a physician on the basis if informed medical opinion, based on the results of physical examination and testing
  • anatomical or functional abnormality that persists after appropriate therapy and having no reasonable prospect for improvement
20
Q

Disability

A
  • legal term

- estimate of the extent or effect of impairment upon the life of a patient

21
Q

Other factors considered with disability

A
  1. Age
  2. Education
  3. Economic and social environment
  4. Energy requirements of an individual’s occupation
22
Q

AOE

A

Arising out of employment

23
Q

COE

A

In the course of employment

24
Q

Two conditions that must be met to make an accident, illness or injury compensable

A
  1. It must arise out of employment (AOE)

2. It must occur in the course of employment (COE)

25
Q

Arising out of employment

A

Must be a causal relationship between the employment and the injury

26
Q

Course of employment

A

Time, place and circumstances of an injury must relate to the employment

27
Q

Workers compensation laws are designed to….

A

Protect employees and their families from economic losses due to personal injury caused by accidents and illnesses arising out of and in the course of employment

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