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Do You Know Your Workers Comp Benefits Info – Quiz 2 – Updated

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10 Questions on Workers Comp Benefits Info – Test Your Knowledge

The great response to the Workers Comp Benefits Info Quiz a few weeks ago made me think – let us do another one cover Workers Comp benefits info.  Remember that certain states may have exceptions.   Each question scores 10 points each – and possibly a bonus to help your score.  Eighty points is a passing grade.

pic of boggle workers comp benefits info
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All these subjects have been covered in the 1800 articles on this website.

  1.  Are Workers Comp benefits taxable?  Why or why not? – The benefits are not taxable.   The one-third reduction from the Average Weekly Wage (AWW *2/3) avoids incentivizing the injured employee by making their Workers Comp weekly benefits the same as what they would have received after taxes if they were currently working.
  2.  An injured employee is balance billed by a medical provider after receiving payment for medical services rendered. Does the employee or the employer have to pay the balance?  The injured employee should not have to pay the balance.  Balance billing is illegal in many states.  Employees should rarely pay for their Workers Comp medical benefits – possibly for their own Independent Medical Exam.
  3. What is the term for medical benefits in a state without a medical fee schedule? Usual & Customary (U&C) is the average medical charge in the area where the medical services are provided.

    Student hand writing workers comp benefits info exam at classroom
    Wikimedia Commons – Alison wood
  4. An employee receives authorized out-of-state treatment.  Will the employer have to pay the bill in full or can the carrier/TPA apply a fee schedule? Most out-of-state treatment cannot be fee scheduled as the medical provider in the other state does not have to acquiesce to the fee schedule in another state.  The bill may be paid in full or at the U&C charges – see #3.
  5.  Do volunteers receive weekly benefits if they are injured while working?  Watch your answer on this one.  Yes, many states have a minimum amount to be paid even to volunteer workers.  I was fined many years ago for not paying a volunteer the state’s minimum Workers’ Comp benefits.  Volunteer Workers Comp benefits was a hard lesson learned by me in the 1980s.
  6. An injured employee is rated with a 10% disability to their back/spine.  The state maximum number of weeks for permanency is 300 weeks? The injured employee’s workers comp rate is $350 per week.  How many weeks of PTD will the employee receive for the 10% rating? I must apologize for this trick question.  The injured employee would receive PPD (Permanent Partial Disability) instead of Permanent Total Disability (PTD) benefits.  The PTD benefits are usually lifetime or a certain state’s maximum benefit payments.  If the question was PPD, then the injured employee would receive 30 weeks at $350 per week (non-taxable).
  7. An employee injures themselves while flying in a plane on a business trip.  Is that injury going to be covered by Workers’ Comp? Yes, if the injured employee was traveling for a work assignment, benefits would be payable.
  8. Are Workers Comp benefits always primary for a compensable claim even if other types of insurance are involved such as automobile insurance or an employee’s short-term disability policy? Yes, Workers’ Comp benefits are almost always the primary payer of benefits for an on-the-job injury or occupational disease.
  9.  A worker is injured while working at an overseas military base.  What is the type of insurance that covers them for this injury? The coverage is called Defense Base Act insurance.  The insurance is specifically designed for workers hurt on foreign military bases.
  10. Is an injured employee owed for mileage driven when attending Workers Comp medical appointments?  Is the rate usually higher or lower than the IRS mileage allowed for medical travel?  Yes, they are owed for roundtrip travel to the medical appointment.   The rate is variable from state to state.  The rate for Workers’ Comp mileage is usually higher than the IRS medical travel allowance.  However, the mileage reimbursement is not taxable.

    Students workers comp benefits info quizes
    Public Domain – Albeiro Rodas

Bonus Question – Workers Comp Benefits Info Quiz

  • Can an employer not file a First Report of injury and pay an injured employee out-of-pocket and file their medical bills under health?  If yes, in what instance? No, a Workers’ Comp claim should always be filed with the insurance carrier or TPA for self-insureds.  Many of the mega claims I have handled started as unreported Workers’ Comp claims.
  • Who is the main supplier of info for employers on their responsibilities when a Workers Comp claim occurs? There could be multiple sources – which ones?  The state Industrial Commissions or Accident Boards always has a section online for information for employers once an accident has occurred.  Carriers and TPAs provide a huge amount of info on what to do when an employee is injured on the job.  Most states provide an employer section on their front page such as the Oklahoma example in the last link.

If you disagree with one of my answers, please include it in the comments.  I did not cover every state exception for my answers due to space and readability.

Give yourself 10 points for every correct question.  If you scored 120, then you are a Workers Comp benefits guru.  A passing grade is 80 points.  The bonus questions count 10 points each.

I will publish the answers next week.  Please remember that J&L is not providing legal or medical advice in this quiz. You can miss four of the questions on the workers comp benefits info quiz and still pass.   Good luck.

©J&L Risk Management Inc Copyright Notice

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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