Workers Comp Knowledge Quiz – With Hints

Workers Comp Knowledge Quiz – Hints In The Links (Updated)

Dealing with an abscessed tooth is no fun.  I had to miss the NWCDC conference in Vegas this week.   I was going to do a classic-only newsletter this week and write no articles.  Skipping a week did not sound palatable. The answers to the workers comp knowledge quiz will be provided next week.

If you wish to see other quizzes from the past, please check out this search link. 

Piling 10 links in the middle of the questions would ruin the readability of the questions.  The hint links are listed below the questions except for the extra credit question.

1. Which insurance carrier was the first to provide Workers Comp insurance in the US?
2. What is the best method for employers to review current claims?
3. Should a claims adjuster contact an injured worker who is represented by an attorney?  In what instances?
4. Are premium auditors allowed to see all of an employer’s records when performing a workers comp premium audit?
5. Do self-insured employers have an Experience Modification Factor (E-mod, X-Mod)?  If so, what is the term?
6. How many years of Workers Comp records should be available at a moment’s notice? Why?
7.  Define Total Incurred.  Why is the term so important for any insured?
8. What are three of the main differences between self-insured and large deductible programs?
9. Did the Federal Government ever study Workers Comp insurance on a national level?  If so, when and who conducted the study?
10. What is WALSH or PWALSH?  Why are the acronyms so important?
11. Extra credit – Where was the first Workers Comp program published?  What was the name of the publication?

Hints To The Workers Comp Knowledge Quiz Answers

1. First US Workers Comp Insurance Company 
2. Best Method For Claim Reviews 
3. Represented Claimants 
4. Records Allowed 
5. Self-Insured Experience Mod
6. How Many Years of Records
7. Total Incurred Importance 
8. Large Deductible
9. Federal Workers Comp Study 
10. PWALSH or WALSH 
11. You are on your own

Answers to the Workers Comp Knowledge Quiz

The link pages have been left above in case you want to research the answers.

1. Wausau was the first workers comp insurer in the nation.
2. Online access saves time with any type of claim or reserve review.  The employers can answer any of their own questions including reserving by simply logging into the claims system.  Having online access reduces the number of phone calls and emails between the employer and the TPA or insurance carrier.
3. One cardinal sin of workers comp claims adjusting occurs when the adjuster speaks with or emails an injured employee who is represented by an attorney. The employee should contact their attorney who will then speak with the adjuster – even for questions about delayed medical payments or indemnity benefits.
4. A workers comp premium auditor has the right to look at any records that pertain to the policy they are auditing. One main point is the employer does not have to provide ad hoc reports or should only do so at their discretion.
5.  Yes, the self-insured employer has an Experience Mod of sorts referred to as a Loss Development Factor (LDF).  The LDF reflects the performance of a self-insured program.
6. Five at least, if not more.  With predictive analytics becoming so popular, any old claim that is open should be considered as a new one. Underwriters do not stick to just three years as in the past.
7. Total Incurred = Paid + Forecasted Reserves.  The Total Incurred represents what the claims adjuster thinks the claim will cost during its lifetime.  The Total Incurred (less allocated expenses) feeds directly into the Experience Mod system.
8. Large deductible programs still have an Experience Mod while self-insureds do not; large deductible policies are underwritten by a carrier that handles the claims – self-insured programs must hire a Third Party Administrator (TPA) to handle their claims;  Self-insured programs must be approved by the Department of Insurance – Large deductible programs do not need state approval to operate as the policy is underwritten by a carrier.
9. John J. Burton directed the study in 1972 during the Nixon Administration.  The decision was made to not attempt a nationalization of workers comp laws leaving the administration to the states.  OSHA was soon started after the study.
10. WALSH and PWALSH are tests that many claims adjusters and workers comp judges use to consider the correct jurisdiction of a Workers Comp claim which involves multiple jurisdictions.   WALSH acronym = Worked Accident Lived Salaried and Hired in order of importance.   PWALSH adds one and changes another part of the acronym.   PWALSH = Paid from Worked Accident Lived Supervised from and Hired.  The PWALSH test may look more accurate.  However, Paid from is not the most important letter – tends to scramble the order of importance.
11. The original Workers Comp policy was written on stone tablets in ancient Sumeria.  The kingdom even had a Permanent Partial Disability (PPD Chart) for injuries.

Comments

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