California Self‑Insurance Plans (SIP) Exam

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• The ER has an aggregate excess (stop loss) workers comp policy. Does the ER receive credit against the security deposit?
• When a self-insured certificate has been revoked, the Director retains jurisdiction for what period of time?
• The calcis is the:
• What are the two weight bearing bones of the leg?
• Injury to the trapezius muscle involves which region?
• How many days does the Self-Insurance Plans have to notify you that your application is deficient?
• If a physician did not perform a required exam or prepare the report, what is the proper course of action?
• The purpose of the Self-Insurer's Security Deposit is to secure payment of compensation obligations.
• As an out-of-state self-insurer where must the claims files be kept and maintained?
• The phrase 'Means every person in the service of an employer under any contract of hire or apprenticeship' defines which classification?
• Which statement about Division 5 interpretation is true?
• A chef with average weekly earnings of $1,300 per week is injured on May 16, 2010. After this period of temporary disability he returns to work part time earning $450 per week. What is the correct wage loss TD rate?
• Which action must a physician take in a med-legal report to avoid inadmissibility?
• What standard must an employee demonstrate to establish compensability for a psychiatric injury?
• An experienced examiner or supervisor is defined as someone who has spent how many years handling claims?
• The exclusive remedy described for employee and dependents against the employer implies what about tort actions against the employer?
• What document must every employer except the state secure from the director to self-insure for workers' compensation?
• In the scenario where an employee is temporarily disabled and later incarcerated for an unrelated crime, what is the recommended handling of temporary disability payments?
• The bones of the spinal column are called which of the following?
• Labor Code 3353 defines which classification?
• Once an employer has initiated a self-insurance program, the employer's Certificate to Self-Insure is:
• Which of the following is true about Group Self-Insurance?
• New private self-insurers shall contract with a TPA for how many years?
• Under LC 3351, which of the following is included in the definition of Employee?
• What is the maximum amount a spouse can make in order to qualify for a presumption of total dependency? (Time of death)
• Who issues the certificate of intent to self-insure?
• Nearest the point of attachment, opposite of distal.
• How many cervical vertebrae are there?
• The calcaneus is which bone?
• For master certificate qualification after July 1, 1994, which of the following is a required figure?
• Medical-only claims are included in the Annual Report only for which period?
• Which term denotes the bones of the hand between the wrist and fingers?
• The employer may object to a treating physician's report recommending spinal surgery within how many days of receipt?
• Which description defines slight pain?
• Nerve of the wrist associated with carpal tunnel syndrome is which?
• Which entity determines revocation of a self-insurance certificate when noncompliance occurs?
• The ER provides a wage statement for the employee showing irregular earnings. What is the correct TD rate?
• Which document shows the case is ready for a hearing in WCAB proceedings?
• Injury during a personal errand is generally considered to be:
• A volunteer nurse's aide for a nonprofit hospital injures her back lifting a patient. The injury is:
• What term describes the level of causation required for psychiatric injury when the events of employment must be a substantial cause?
• Which term describes a knee meniscal tear in which a portion is torn and displaced?
• Which term is the tailbone?
• Which condition is commonly described as involving the hand and potential finger contractures?
• For which claim log would the entrance of the fiscal year correspond to the date the injury was reported?
• Which of the following is an acceptable method of payment for disability benefits?
• The term 'Employer' also includes which fund in that scenario?
• Under Labor Code 132A, discrimination may entitle an employee to which remedy?
• An Employer's First Report of Occupational Injury or Illness must be filed within:
• Where is the lacrimal bone located?
• What term describes the joint of a finger farthest from the point of attachment?
• The kneecap; loss of the patella is a 5% absolute in the 1997 PD rating schedule.
• Which bone is the outer forearm bone on the thumb side?
• The navicular joint is located in which part of the body?
• For a victim of a violent act, substantial cause means what percentage?
• Which four conditions are conclusively presumed totally disabled?
• Which bone is located in the thigh?
• An employee arrives at work and is hit by a passerby in the company parking lot. Under the going and coming rule, how is the injury generally classified for workers' compensation?
• An employee forces IWS to accept less money than they are due. The ER faces what civil penalty?
• For an injury in 2007, which filing invokes the jurisdiction of the WCAB?
• Who pays the Labor Code 4850 benefits in the described scenario involving a city police officer who later works for the county?
• Which bone is the shoulder blade?
• After revocation, the Director retains jurisdiction until claim liability exhausted pursuant to the law.
• What is the maximum extension duration for the presumption of public safety officers?
• If there are two or more persons wholly dependent for support upon a deceased employee, how many partial dependents shall receive benefits?
• Administrative Director is the head of which agency?
• When can an injured worker not attend a QME/AME exam?
• How many days does a physician have to submit a Doctor's First Report of Occupational Injury or Illness?
• Which form is required with a denial letter and proof of service?
• An employer forces injured workers to accept less money than they are due. The employer faces:
• Which term describes radiating nerve pain down the limbs?
• What term means pertaining to the heart?
• A greenstick fracture is which description?
• Which form is used in death cases to report to the Administrative Director?
• An employee who does not receive mileage reimbursement for use of his car during an unpaid lunch hour is injured en route to the bank. Which doctrine supports compensation?
• Which finding is described as two inches of thigh atrophy under the 1997 PD Rating Schedule?
• Which statement describes the penalty for delays in payment processes?
• Future Liabilities on the Self-Insurers Annual Report are estimated as follows:
• The largest artery of the body is the:
• If there is no Medical Provider Network, how long may an injured employee wait before treating with a non-network physician?
• An employer desiring a change of employee-selected physician can petition whom?
• Which statement best describes the role of a Third Party Administrator in self-insurance programs?
• Upon receipt of a complete private individual employer application, within how many days will the applicant be notified of the director's decision or deficiency?
• An injury to the trapezius muscle would affect which body region?
• Which term describes surgical repair or replacement of a joint?
• Temporary Disability (TD) rate stands for Temporary Disability; Permanent Disability (PD) rate stands for Permanent Disability. True or False?
• While on scheduled break with the boss and coworkers at their usual place the employee has an injury. You subsequently receive a call from applicant attorney asking why havent paid benefits to the employee. You call the employer and the employer says they did not report it because they did not think it was compensable. A. The employer should have reported it because the employee reported the claim. B. The employer should have repoprted it because any injury us compensable. C. The employer should have reported it because the employee was recieving wages during the break. D. The employer should have reported it becayse the off premises breaks were customary and had the approval of the employer.
• Temporary disability is calculated as which portion of AWE?
• Reapplication for a Certificate of Consent to Self-Insure is required if an employer fails to initiate a self-insurance program within how many months?
• An employer desiring a change of employee-selected physician can petition the:
• Which process resolves objections to medical treatment decisions under Section 4610?
• What remedy applies when an employer forces an injured worker to accept less money than due?
• How many coccygeal vertebrae are there?
• Petition for reconsideration must be filed within how many days after service of findings and award?
• Which term describes a fracture with the bone exposed through the skin?
• You find a doctor's medical-legal bill in a claims file 62 days after the bill was date stamped received. What should you do?
• How many lumbar vertebrae are listed?
• An employee is considered a covered employee in the Medical Provider Network when the employer?
• Who is the head of the Division of Workers' Compensation?
• What are assigned standard ratings in the schedule?
• The scaphoid bone is also known as which bone?
• Outward turning of the eyelid is called?
• An accountant took work home for an annual report. The employee left work at the normally appointed hour and was not reimbursed for mileage. The employee was injured in an auto accident at an intersection one block from home and his supervisor calls to tell you they found paperwork for the end of the year report iin his briefcase in the car. You should:
• A maximum earner in 2010 has 10 weeks of temporary total disability. What is the reserve amount for indemnity?
• Which procedure eliminates motion in a joint to relieve arthritis pain?
• In workers' compensation, the term includes the person injured and any other person to whom a claim accrues by reason of the injury or death of the former.
• Which of the following represents the penalty for failing to obtain workers' compensation coverage?
• What is the SI Application Approval Determination timeframe under old law?
• In rehabilitation, the point where the client's condition is unlikely to improve and no further recovery is expected is called what?
• Orthoscopy is?
• What is the recommended action regarding a late medical-legal bill?
• Fracture extending from side to side.
• For an injury in 2013, resulting in death, reasonable expenses of the ER's burial are allowed up to:
• Which statement best describes volunteer coverage under workers' compensation?
• Which Senate bill, signed into law in 2012, included increased benefits to injured workers and cost-saving efficiencies for employers, with most provisions taking effect January 1, 2013?
• Which statement best describes pronation of the forearm?
• For injuries on or after January 1, 1991 that result in death, burial expenses are payable up to what amount?
• An interim report in a workers’ compensation dispute is due within how many days?
• A Pott's fracture involves:
• Which item is not considered indemnity?
• Under Labor Code 3211, which term describes the entity that includes the State Compensation Insurance Fund and any private insurer authorized to insure employers against compensation liability?
• If an employee has an injury in February 2000 and an aggravation in July 2000, what is the recommended handling?
• Which relationship is explicitly listed as a dependent under the dependent criteria?
• The ER hires an EE with pre-existing arthritis and the ER wants the EE to sign a waiver that they are not responsible for the pre-existing condition. You should tell the ER:
• According to the supplemental job displacement schedule, which PD rating bracket corresponds to a $6,000 benefit?
• An employee is considered covered in a Medical Provider Network when the employer provides what?
• The only forms accepted to pay for the security deposit to be self insured are all of these plus cash except
• Which region is primarily associated with injury to the trapezius muscle?
• Temporary disability rate should be calculated using the rate in effect on which date?
• Is the self-insurance certificate irrevocable in California?
• The employer shall provide the employee with a DWC-1 claim form within how many working days?
• Two weight-bearing bones of the leg are:
• What does the abbreviation IW stand for in workers' compensation terminology?
• For a victim of a violent act, substantial cause means what percent of causation from all sources combined?
• SB 863 is referenced in the material. Which bill is SB 863?
• Which region of the spine contains seven vertebrae?
• An employee has a finger amputation at the proximal joint and his perscription glasses are broken. You shoud pay for:
• Which Labor Code contains the definitions for Appeals Board, Administrative Director, Division, Medical Director, and Qualified Medical Evaluator?
• Fibromyalgia is best described as a syndrome with what characteristics?
• Lordosis refers to which anatomical condition?
• Which option is not an Activity of Daily Living based on the provided material?
• Whenever the right to compensation exists in favor of the employee, the employee shall, upon request of the employer, do which of the following?
• What is the penalty amount when a self-insured employer denies a claim and the denial is not properly documented?
• When can a claim file with future benefits be closed or converted to inactive?
• Which role is responsible for enforcing benefit notices and timeliness of first payments?
• Which statement about Colles fracture is true?
• An injured worker files a claim on September 3, 2007 with the DOI of August 29, 2007, no documentation to support the injury, and the worker was terminated May 30, 2007. You should:
• Which option correctly states a filing deadline for reconsideration after service of an F&A by the WCAB?
• Which form is explicitly mentioned as being completed and returned in the described timeline?
• The sum of the estimate of future compensation as defined by section 3207 plus an estimate for administration of claim and legal costs represents which liability?
• Who issues the Certificate of Consent to Self-Insure?
• What was the burial benefit cap from 1991 to 2013?
• In an injury with two distinct disabilities (grip loss and atrophy), which rating method is used?
• Which statement best describes the relationship between excess coverage and primary coverage?
• The head of the femur fits the:
• The certificate of consent to self-insure shall not be issued to which type of employer?
• Under Labor Code 4062(b), a second medical opinion may be requested in which scenario?
• Which statement is true regarding the effect when death results from serious and willful misconduct?
• Each private group self-insurer shall contract with a TPA for the first ______ full calendar years.
• If an employee has a proximal joint finger amputation and broken prescription glasses, which should be paid?
• For an injury in 2005, what is the maximum WPI?
• When an employee receives salary continuation instead of temporary disability, what must the initial DWC notice include?
• UR filings; which office is the filing location for UR policies and procedures?
• What is the burial expense for the period January 1, 1991 to January 1, 2013?
• The treating physician providing continuing treatment is required to provide a medical report within how many days?
• Loss of natural lens of the eye is called?
• Under Medical Legal Bills, who can delay, modify, or deny medical treatment?
• Which of the following is NOT listed as a prohibited general business practice?
• Which term describes rotation of the forearm so the palm faces downward?
• In the change of physician process, the deadline commonly cited for providing a form is five calendar days. True or False?
• Which statement best describes employer liability for permanent disability (PD)?
• What is the primary purpose of the California Self-Insurer's Security Fund in this context?
• What is the valuation date used for the actuarial submission?
• Claim administrator shall notify the manager in writing within ____ days of a self-insured employer's willful failure to provide __________ funding for the timely payment of WC benefits in accordance with Provisions of the LC.
• Movement away from the body usually from the shoulder or hip is called?
• Which statement is true about Compensation?
• A bucket-handle tear is a tear of which knee structure?
• What is the rating for immobility of the hip where the arc of motion is 0 - 60 degrees?
• What year established burial expenses up to $5,000 for death resulting from work injuries?
• In a UR department, is it permissible for a nurse to approve or deny requests?
• An employee is injured at 3 pm on Friday and is paid for 6 hours. On which day does the waiting period begin?
• Which antibiotic-resistant organism is named in the list?
• You fail to notify the excess carrier of a claim. Who can impose a penalty?
• An employee is injured on Friday, January 10, 1992. The injury is reported to the supervisor by another employee on January 12, 1992. What is the employer's date of knowledge?
• Death benefits are paid in the same manner as which type of disability benefits?
• A twenty year old employee is injured at work but does not report it as required by work procedures. The TPA is told to pay benefits. What should the TPA do?
• What is the term for forward slippage of one vertebra over another?
• Which scenario qualifies as presumed compensable according to the material?
• Inflammation of the middle ear is called?
• Which movement describes bending the wrist toward the palm?
• Which term means fusion of a joint to immobilize it?
• An employee with 11% permanent disability is eligible for SJDB up to which amount?
• Which of the following exactly matches the permanent disability percentage derived in the Colles fracture grip strength problem?
• When both instability and thigh atrophy are present, the overall disability rating should be determined by which of the following?
• After revocation of a certificate to self-insure, the director's jurisdiction over work injuries sustained during the period of self-insurance shall continue until all liabilities and all responsibilities have been terminated in accordance with law.
• A finding that the injuries results from the injured employee's serious and willful misconduct means which of the following?
• A petition for reconsideration must be filed within how many days of service of a findings and award by the workers' compensation appeals board?
• Where the injury is caused by Serious and willful misconduct of the EE the compensation otherwise recoverable shall be reduced by ________.
• Which description fits a private self-insurer that participates in the self-insurer’s security fund?
• What is the surgical fixation of a joint called?
• Employer guilty of 132a violation. What does injured worker receive?
• Permanent disability that results in a loss of earning capacity but is not a full 100 percent impairment is called:
• Forward slipping of one vertebra over another is called?
• Which injury is explicitly described as permanently and totally disabling by presumption?
• Overflow of tears is called?
• LC section 4622 requires the ER to pay or object to medical-legal expenses within how many days of receipt?
• In third-party subrogation, how does a lien affect the distribution of the recovery?
• Lacrimation is defined as which condition?
• Which option describes the basis used for disability ratings in this material?
• Fracture of distal end of the radius with outward displacement of the radius.
• The socket of the hip joint is called the
• Which cancer category is included in the list?
• In impairment terminology, what does UE stand for?
• Which is the largest artery in the body?
• In the injury scenario, which items are payable?
• What is the least amount of loss of motion of a finger(s) that is ratable using the 1997 Schedule?
• Which official must approve an MPN plan before it takes effect?
• A cardiac condition precludes heavy lifting. What is the scheduled rating?
• What was the maximum temporary disability rate in 2008?
• A UR department nurse can independently approve, modify, delay, or deny requests?
• The heel bone is also called which term?
• Which percent is the absolute value assigned to loss of the radial head?
• In the context of future liabilities, what is the primary basis for estimation?
• For a victim of a violent act, substantial cause means what percentage of causation?
• Incomplete fracture in which the bone is partly bent and partly broken is called what?
• As of January 1, 2004, which therapies are included in the 24 visits per industrial injury limit?
• When determining the temporary disability rate, the rate used for a payment should be based on which date?
• A settlement by compromise and release is approved; payment is delayed because the order was filed in the wrong file by the insurer. The employee is entitled to which remedy?
• Which Labor Code provision addresses damages in contrast to compensation?
• Private SI Financial Capacity is evaluated over how many months?
• Which broad, flat muscle occupies most of the lower posterior thorax?
• For private applicants seeking to self-insure, in how many days will the applicant be notified after submission of a complete private application?
• What is the maximum add-on for subjective factors for a 2005 injury?
• What is the statute of limitations for subrogation claims?
• Under LC 4660, which document's rating schedule is amended by the Administrative Director?
• A radial head loss is an absolute disability percentage of:
• The process of chewing food prior to swallowing is called which term?
• DOI stands for Date of Injury.
• What benefits should not be considered when calculating average weekly earnings?
• Which Labor Code section is associated with Liberal Construction?
• Do UR policies and procedures and a description of the process have to be filed with the administrative director?
• Which of the following statements describes the remedy when a payment is delayed due to misfiling and late by the carrier?
• Which of the following statements about radial head impairment is true?
• How long does the employer have to give the change of physician form to the employee when asked?
• The _____, after public hearings, shall adopt and revise periodically an official medical fee schedule.
• Which tarsal bone is located in the ankle joint?
• A private self-insurer that participates in the self-insurer's security fund is described as which?
• Enforcement of benefit notices and timeliness of first payments falls under which duties?
• In a case of underfunded trust, how soon must you report to the Manager?
• In the bartender earnings scenario, are tips counted toward earnings for compensation purposes?
• The doctor has 5 days to submit a 5021 form. Choose the correct deadline.
• The navicular bone is categorized as which type of bone within the foot?
• What is the deadline for filing the Self-Insurer's Annual Report for private and public self-insurers?
• Radiating pain, usually down the legs or arms.
• When both Objective and Subjective are used in rating, the index producing which rating is used?
• As an out-of-state self-insurer where must the claims file be kept and maintained?
• For a death case related to a prior award, the filing window is measured from which date?
• Rehabilitation benefits can be settled under which condition?
• The employer is guilty of serious and willful misconduct and as a result of the injury the employee has lost both hands. What percentage should you increase reserves by?
• For psyche claims, if there are no dependents, payments are issued to whom?
• What are the three basic elements of rating for knee disability?
• Which is correct for the totally dependent minor grandchild's eligibility for the special death benefit as when totally dependent minor child?
• If you fail to notify the excess carrier of a claim, the excess carrier may?
• Hip socket.
• Factual determination of dependency can possibly cover all of the following except? (time of the injury)
• If a physician didn't perform a particular exam or prepare the report, you should:
• The thigh bone is called what?
• Under what condition is a totally dependent minor grandchild entitled to the same special death benefit as a totally dependent minor child?
• Which statement about deposits and subsidiaries under the master certificate is true?
• SJDB for permanent partial disability award between 15 and 25% is up to how much?
• If the employer commits serious and willful misconduct resulting in loss of both hands, by what percentage should reserves be increased?
• Under LC 4622, if not paid within 60 days, the amount payable should be increased by what percent together with interest at what percent?
• If the Director determines that a private self-insured employer has failed to pay required benefits, what may he do?
• Are medical-only claims included on the Annual Report?
• The fund that limits payments to employees who have a prior permanent disability and later sustain additional permanent disability is called the
• Fracture in which the fracture is lengthwise on the bone.
• Who supplies the form used for the annual report?
• You are applying for a master certificate after July 1, 1994. What is the amount of net worth and net income needed to qualify for self insurance?
• SJDB for permanent partial disability award between 50 and 99% is up to how much?
• What is a reasonable accommodation for an employee with a latex allergy?
• A worker who is on an errand or special mission for the employer is in the course of employment even though on the way to or from work. What is this exception called?
• Occasional severe back pain takes what standard rating?
• Every self-insurer must file a Self-Insurer's Annual Report on or before:
• If serious and willful misconduct causes loss of both hands, by what percent should reserves be increased?
• What liability applies if a medical provider collects money from an applicant after a claim form is filed?
• If you know an employee will have permanent disability after back surgery but are unsure of the PD amount 14 days after the employee returns to work, you should:
• Which action is proper when an employee unreasonably refuses medical treatment and the employer seeks to suspend benefits?
• The ilium is in which part of the body?
• In 2004 the employee has an injury to the knee. There is no loss of motion, no instability, and no thigh atrophy, but the employee must wear a stretch knee brace. What is the standard rating?
• In a workers' compensation settlement where the employee is later represented, who must pay the attorney fees when the case is settled?
• Forward curvature of the spine is called what?
• Under AMA Guides, apportionment is based on?
• Dorsiflexion refers to which movement?
• Which statement best describes the burial expense change effective after 01/01/2013?
• Under the policy, which scenario would require notifying the Manager?
• Under the 2004 rules, when an employee is P&S for bilateral loss of vision, how is the disability rating determined?
• Which benefit should not be considered when calculating average weekly earnings?
• Which four factors does the administrative Director consider when imposing penalties?
• Penalty for not obtaining workers' compensation coverage is what percentage?
• Fibromyalgia is described as which of the following?
• Under LC 3352, which scenario is explicitly excluded from being an employee due to the arrangement?
• Each group self-insurer shall have and maintain specific ______ insurance coverage.
• Can reserves be reduced based on projected third-party recovery or projected reimbursement from aggregate excess insurance?
• When objecting to a medical determination, the objecting party must notify the other party in writing within a certain period depending on representation. Which statement correctly describes the deadline?
• Identify the term for a surgical procedure that restores joint function.
• The DWC 500-E is which of the following?
• Which body part is associated with ROM as the rating descriptor in the given material?
• Which bone is the longer of the two forearm bones on the side of the little finger?
• Which condition involves an irregular pupil?
• Inflammation of a nerve is medically termed?
• Arthroplast means?
• What is turning outward of the ankle called?
• Which items may the director accept as a deposit to secure incurred liabilities for payment of compensation and the performance of obligations to a self-insured employer?
• Which term denotes visual examination of a joint?
• A large, triangular bone at the base of the spine.
• Which Labor Code section authorizes the Administrative Director to audit insurers, self-insured employers, and third-party administrators to determine if they have met their obligations under the labor code?
• What does the compensable consequence doctrine cover?
• What is the rating for a 30 year old heavy furniture assembler with an 8% impairment standard?
• What is the rating for immobility of the hip with an arc of motion from 0 to 60 degrees?
• NOT a factor considered under Labor Code 129.5?
• Which statement best describes the meaning of preponderance of evidence?
• The suffix -itis indicates inflammation.
• Fibrous tissue that connects the joint ends of bone or cartilage, serving to support and strengthen joints is called what?
• If a claim is not properly notified to the excess carrier, which outcome is possible for the excess carrier?
• The olecranon is located?
• An employee has an injury in February 2000, and in July 2000 suffers an aggravation of that injury. What is the appropriate action for the workers' compensation file?
• Which bone is known as the breast bone?
• Surgical repair of a joint?
• What is the role of the investigator assigned to pursue issues of compensability?
• Misalignment of the jaw is called which term?
• Which term refers to a lung disease caused by asbestos exposure?
• Interim Report for public insurers covers which period?
• For a chemical burn to the upper extremity with 5% WPI, what is the corresponding rating?
• What percentage add-on is used for subjective factors in impairment ratings?
• Which statement best describes the process of utilization review?
• Can an employee bring his personal physician to a medical exam requested by the ER, and who bears the fees?
• Which bone articulates with the acetabulum to form the hip joint?
• The employer is forcing employees to receive workers compensation benefits at a lower rate. what is the employer's liability?
• What is the penalty for discharging or administering compensation obligations in a dishonest manner?
• In the case of an injured employee with dependents who is incarcerated for an unrelated offense, temporary disability is paid to whom?
• CIGA insures which entities?
• Which statement best describes a payment made more than two years from the DOI for a period of disability within the first two years?
• Conjunctivitis affects which part?
• Following revocation, the managers shall determine the need for a special revocation audit of claims and the need for a deposit adjustment to secure future liabilities.
• Which term describes radiating pain into the arms or legs?
• A crack in a bone which does not break the bone to pieces.
• Vocational Rehabilitation may be settled under which condition?
• Where is the latissimus dorsi muscle located?
• If there is a new TPA, who is responsible for filing the report with the Director of Industrial Relations and what is the timeframe?
• Rehabilitation benefits can be settled:
• A 46 year old electric arc furnace operator is limited to light work as a result of silicosis. what is the level of permanent disability?
• Which bone articulates with the humerus at the elbow to form the hinge joint?
• Which entity determines compensability in California workers' compensation disputes?
• In a third-party case with a $100,000 recovery, attorney fees $36,000, costs $4,000, WC lien $40,000, what is the net recovery to the injured worker?
• Which statement correctly describes the reduction of compensation due to serious and willful misconduct?
• What is the purpose of a deposit adjustment in this context?
• An employee is considered a covered employee in the Medical Provider Network when the employer provides what?
• Psychiatric impairments are rated using which scale?
• An injury to the trapezius muscle would affect what body part?
• When temporary disability is mistakenly paid at an incorrect lower rate, what is the proper remedy?
• Which action makes an employee a covered employee in the Medical Provider Network?
• A 20 year old employee with a back injury is evaluated by a middle-of-the-road physician and is deemed to have permanent disability. You are responsible for which benefits?
• In the described scenario, what did the 2001 injury result in?
• Which statement best reflects the independent contractor's control characteristics?
• What is the title of the head of the Division of Workers’ Compensation?
• Which impairment rating schedule is used to rate impairment for finger motion in workers' compensation cases?
• What is the purpose of liberal construction of this division and Division 5?
• The ilium is in what part of your body?
• Which of the following is a component used to rate knee disability?
• There are two distinctive systems used to describe a condition, each yielding its own rating. What are they?
• What is the minimum TD Rate for 2008?
• The two most common fingers involved in Dupuytren's Contracture are?
• In the scenario where John dies and Mary is a dependent spouse with an adopted grandchild, how many dependents are recognized?
• What term describes a lateral curvature of the spine?
• The employer may forward the death notice to the workers' compensation insurer for submission to the Administrative Director. Which party initiates this forwarding?
• Exabersation refers to:
• The penalty for failing to obtain workers' compensation coverage is what percentage of the compensation paid?
• What is the maximum penalty for less serious violations?
• If the employer has not established a Medical Provider Network, the employee is entitled to what regarding physician choice?
• Which are the two types of excess insurance?
• What is administrative agency?
• A Petition for Writ of Review must be filed within ____ days after a Petition for Reconsideration is denied?
• What term describes the five bones of the hand?
• Loss of 92 decibels at 500, 1000, 2000 and 3000 Hz shall be considered total loss. This describes which condition?
• Which deposit is NOT an acceptable form to secure incurred liabilities for self-insurance?
• Under the Personal Comfort Doctrine, is an injury sustained by an employee waiting outside the workplace for it to open compensable?
• The term may indicates which concept?
• What is the target percentage for physicians in the MPN who primarily treat nonoccupational injuries?
• Under LC 3208, which items are included in 'injury'?
• How much can you pay for burial expenses for DOI on or after 1/1/13?
• Apportionment is based on which factor?
• Arthrodesis means?
• What is the meaning of arthroplasty?
• The olecranon is located in which region?
• To whom you apply for a Certificate of Consent to Self-Insure?
• Which nerve is the longest and thickest in the body?
• The right major index finger condition described—failing to clear the mid-palm on active flexion by 3/4 inch and a 25 percent weighted grip loss—what is the percentage of permanent disability?
• Which provision requires considering the nature of the physical injury and the injured employee's diminished ability to compete in an open labor market?
• Under LC 4062(b), a second opinion can be requested by the ER when there is a dispute about the need for spinal surgery.
• Which principle describes compensability without regard to negligence when caused by employment?
• How long do you have to file a petition to terminate liability?
• The ER is forcing EEs to receive WC benefits at a lower rate. What is the ER's liability?
• When can an injured worker not attend a QME/AME exam?
• In 2010, a max-earning employee has 10 weeks of TD and the weekly max TD is $986.69. What is the reserve amount?
• A certificate of consent to self-insure must be reapplied for if an employer fails to initiate a self-insurance program within how many months?
• If you find a doctor's medical-legal bill in a claims file 62 days after the bill was date stamped received, you should:
• Under LC 3352, which relationship is explicitly excluded from the Employee category?
• Which nerve is involved in carpal tunnel syndrome?
• If an employee sustains an injury in February and has an aggravation in July, what is the recommended administrative action?
• An employee has a 3/4 inch deficiency in finger clearance and 25% grip loss. What is the permanent disability percentage?
• If a self-insurer's trust account is underfunded, within how many days must you report it to the manager?
• An employee who does not receive mileage reimbursement for use of his car during an unpaid lunch hour is injured while en route to the bank to cash his paycheck. Which doctrine supports compensation?
• In cases where an injury is pursued under exclusive remedy, what is the civil penalty?
• Pronation of the forearm means to?
• Which groups have their AWE determined as max for TTD and TPD?
• Which statement describes how CIGA is funded?
• Dorsiflexion of the foot means:
• An employee traveling on business at the employer’s request is injured while taking a lunch break at a restaurant. The claim would be:
• The EE is guilty of serious & willful misconduct. His PD is 50%. What is the appropriate action?
• A knee injury produces no objective disability or work restrictions but the physician prescribes a long leg brace. What is the standard rating for the knee?
• The ilium is in what part of your body?
• In California workers' compensation, who should be reported suspected fraud to?
• Under Labor Code 132A, the employee shall also be entitled to reinstatement and reimbursement for lost wages and work benefits caused by the acts of the employer. Which is correct?
• Are medical-only claims included on the annual report for the reporting year?
• If injury or death is caused by the intoxication of the other employee, which liability applies?
• Pronation of the forearm means to:
• The two most common fingers involved in Dupuytren's Contracture are?
• What type of coverage is available for risks that select to self-insure most of their workers' compensation losses?
• A 17 year old minor is injured and is minimum for temporary disability. what is the correct permanent disability rate?
• Which statement best describes the use of the MDT table in disability rating?
• Which area is affected by trapezius muscle injury?
• Which bone forms the back of the shoulder girdle and is commonly known as the shoulder blade?
• Which condition is not presumed compensable for a public safety officer?
• Which factor is described as the most common subjective factor in disability ratings?
• An employee is commuting to work in employer-provided carpool vans and suffers an injury. The injury is:
• Reapplication to the director for a certificate of consent to Self-Insure is required if an ER:
• The penalty for failing to obtain worker's compensation coverage is what percentage of the compensation paid?
• A farm laborer age 15 years 9 months is injured and there is serious and willful misconduct by the employee. What is his PD rate?
• What is adjusting location?
• If an employee has a prior 25% permanent disability and later sustains a second injury affecting the other eye, how should you reserve for the second injury?
• If you fail to notify the excess carrier of a claim, the excess carrier may:
• An injury occurs late December but is not reported until January of the next year. In which claim log is the injury reported?
• What are the three basic elements of rating for knee disability?
• Which bone is the outer forearm bone on the thumb side?
• If an injury causes both grip loss and atrophy, which statement is correct regarding rating?
• Which term describes a condition characterized by chronic widespread musculoskeletal pain and fatigue?
• An injury occurs during an off-site break that was customary and approved by the employer. Which statement is correct regarding reporting?
• A volunteer nurse’s aide for a nonprofit hospital injures her back lifting a patient. The injury is:
• Which filing most directly initiates the WCAB's jurisdiction over a new injury claim?
• Under Labor Code 3211, which term is used to describe the insurer that includes the State Compensation Insurance Fund and other private insurers?
• Who may prepare an actuarial study?
• TD Rate 2015 corresponds to which rate?
• Which statement describes the differences in burial expense limits by DOI date?
• In cases of serious and willful misconduct by the employee, when is the 50% reduction in the award not applied?
• If you receive a QME report that shows more permanent disability than anticipated, what is used to determine the PD?
• If an occupation is not listed in the schedule, to which should you relate the basic functions and activities when rating?
• If an employer is guilty of serious and willful misconduct, what is the employee's compensation?
• Pain is disabling when it affects what?
• An experienced examiner or supervisor is defined as having spent how many years handling claims within what time frame?
• Which statement correctly defines an administrative agency in SIP?
• When is an employee considered permanent and stationary?
• Which bone located in the lower leg contributes to the ankle joint with the tibia?
• Damage to the trapezius muscle would most directly affect which area?
• Which is not an ADL?
• If an injury causes both grip loss and atrophy, what does the injured worker receive?
• An employee burns himself in the kitchen after a meeting with coworkers and a supervisor; the injury occurred after drinking with other employees during the meeting. The drinking was condoned by the supervisor. Which is correct?
• Which bone is the weight-bearing bone of the lower leg?
• The employee's treating physician releases him to return to work after removal of his patella and indicates his condition is permanent and stationary. You should:
• Who appoints the Qualified Medical Evaluator, physicians named under Section 139.2?
• Inflammation of the lining of the eye
• Which deadline corresponds to when a physician's report must be received by the employer?
• Which of the following does not produce ratable disability?
• Which bone is the breastbone?
• Multiple finger fracture is known as which term?
• If you know a worker will have permanent disability after a back surgery but you are unsure of the PD amount 14 days after return to work, what should you do?
• In the knee disability options, which is a correct rating for the described case?
• A 40-year-old forester with an elbow injury resulting in loss of motion and 50% upper extremity impairment would produce what whole-person rating?
• What is the correct timeframe for providing written notice to a new employee about workers' compensation information?
• An IW incurred $600 in medical in 2004, $1,200 in 2005 and $800 in 2006. How would you reserve for the medical expense?
• What is the standard rating for moderate to severe pain?
• Which bone is the cheek bone?
• Who bears the expense for routine audits conducted by OSIP?
• The certificate to self-insure shall be valid for __ months after the date of approval by the director.
• The administrator shall adjust estimates immediately based on receipt of what?
• The ER's certificate to self insure is valid until revoked by the director.
• Formal rating determinations shall be deemed to constitute evidence:
• Partial dependents scenario: what do partial dependents receive when there are three wholly dependent for support on a deceased employee and there are additional partial dependents?
• UR or management functions that prospectively, retrospectively, or concurrently review and approve, modify or delay based on medical necessity to cure or relieve treatment recommendations by physicians are known as
• Orthoscopy is?
• If the self insurer has not initiated its self-insurance program within the initial 6 month period what happens?
• If you do not agree with the AME findings, you should?
• Under Labor Code 3300, a private nonprofit organization acting solely as sponsor of a person who, as a condition of sentencing by a court, is performing services for the organization is considered which?
• In anatomical terms, the metacarpus is best described as part of which region?
• A 17-year-old is injured and TD eligibility is at minimum. Which option correctly reflects the PD rate?
• Which bone is the bony projection of the ulna at the elbow?
• Two employees get into an altercation about something they have to do at work. A hits B. Who is entitled to workers comp benefits?
• Which statement about the penalty for failure to file annual report is accurate?
• Reduction of vision to ____/____ or less is considered complete loss of sight in an eye.
• Who shall adopt and revise periodically an official medical fee schedule after public hearings?
• When may an employee treat outside the MPN?
• The metatarsals are located in which part of the body?
• If a petition for reconsideration is granted, the deadline for filing a writ of review begins from the filing of what?
• Which of the following is not one of the three basic knee disability elements?
• The navicular bone belongs to which group of bones?
• Which bone is the uppermost and largest bone of the arm?
• Failure of the tip of a finger to touch the midpalm describes what condition?
• Which of the following is a tarsal bone?
• A Pott's fracture involves which joint?
• Olecranon is the elbow's bony projection
• Which of the following is included as a dependent relationship?
• The penalty for failing to obtain workers compensation coverage is what percentage of the compensation paid
• What bone forms the front of the rib cage and connects the ribs via costal cartilage?
• The calcis refers to which bone?
• LC 4628 requires the physician who signs a med-legal report to take the history, review the medical records, compose/draft the conclusions and disclose any other participants or else the report is?
• Which option best represents the substantial-cause percentage range for psychiatric injury?
• An employee is injured at the place of employment when he burns himself in the kitchen while cleaning up after a meeting with other employees and his supervisor. the injury would not have occurred had the employee not been drinking with other employees during the meeting.
• The injured employee contracts Hepatitis C from a blood transfusion during surgery for a work-related injry. You are responsible for:
• How many bones make up the metacarpus in the hand?
• On the Self-Insurer's Annual Report, future liabilities are estimated as?
• If an employer has an aggregate excess (stop-loss) workers' compensation policy, does the employer receive credit against the security deposit?
• An employer must initiate a self-insurance program within six months to avoid reapplication. Which option matches this requirement?
• Complete immobility of the great toe takes what standard rating?
• What is not considered indemnity?
• An employee is in the break room drinking vodka. A conveyor falls, injuring him; the doctor says the employee was intoxicated. You should:
• Which statement best describes the effect of an aggregate stop loss policy on the security deposit?
• What is the disability number for reduction of vision?
• If an ER is guilty of serious and willful misconduct the EE's compensation is:
• You have assumed the responsibilities of another third party administrator. While auditing the files you discover that there are missing indemnity files. You should:
• Under apportionment, which factor is used to determine allocation among conditions?
• You receive an Employer's First Report of Injury (5020) but accurate weekly wages cannot be determined. How should TD be determined?
• If the employee dies with no dependents, to whom is the money paid?
• Who must send notices indicating workers' compensation coverage or self-insurance status of the employer?
• Which of the following is listed as a temporary disability issue category in the five special TD issues list?
• Specific excess insurance is best described as:
• Proof of service is mandatory with which type of notice?
• Two employees have an altercation at work; A hits B. Who is entitled to workers' compensation benefits?
• What does the Bunkhouse rule pertain to in workers’ compensation context?
• The smaller of the two lower leg bones bears relatively little weight?
• Pertaining to the middle of the body is described by which term?
• Which term means dizziness characterized by spinning sensation?
• Which entity must the Administrative Director consult with to prescribe reasonable rules and regulations relating to benefit notices and related payments?
• What term is used for the requirement that allows a non-state employer to self-insure?
• What is the larger weight-bearing bone in the lower leg?
• What does the CA Self-Insurer's Security Fund provide?
• This division and Division 5 shall be ______ ________ by the _____ (3202).
• Heel bone is anatomically named what?
• What term means visual examination of a joint?
• Multiple finger fractures are referred to as which type of fracture?
• Which term denotes age-related hearing loss?
• What is the disability number for complete immobility of the index finger?
• In the provided example, on what date did the employee file the claim form?
• What is the role of the investigator assigned to pursue issues of compensability?
• An insured has 60 days to report fraud. How many days does an insured have to report fraud?
• You fail to notify the excess carrier of a claim. Who can impose a penalty?
• If temporary disability was paid at an incorrect rate in 2012, what action should be taken?
• For an injury in 2007 what invokes the jurisdiction of the WCAB?
• In handling a third-party case, which outcome is most consistent with protecting the employer's financial interests?
• In calculating benefits, what does 'Max earner at the time of injury' refer to?
• What does AOE/COE stand for in the context of workers' compensation?
• Which bone forms the hip socket?
• A pain described as Moderate is most consistent with which of the following descriptions?
• When can an injured worker not attend a QME/AME exam?
• Under LC 4610, who is authorized to modify, delay, or deny medical treatment requests in a UR setting?
• The hip bone is represented by which bone?
• An employee earns $16 per hour for 40 hours per week and $12 per hour for 20 hours per week from a second job. If he is unable to work both jobs due to an injury in 2008 that occurs on the $16 per hour job, what is the TD rate?
• Which filing invokes the WCAB's jurisdiction for an injury occurring in 2007?
• What is the medical term for an involuntary flexion contracture of the fingers?
• During a break near the workplace, an employee's claim isn’t reported; an applicant’s attorney asks why benefits haven’t been paid. On what basis should the employer have reported the injury?
• Which of the following best describes pronation of the forearm?
• The employee's right major index finger fails to clear the mid-palm on active flexion by 3/4 inch and there is a 25% weighted grip loss. What is the percentage of permanent disability?
• If the PD is 70% or greater, the 50% misconduct reduction does what?
• Pertaining to the lungs.
• Which option best describes how group self-insurance groups operate?
• An injury or death caused by the willful and unprovoked physical act of aggression by another employee falls under which liability?
• How many cervical vertebrae are in the adult spine?
• Formal rating determinations shall be deemed to constitute evidence when?
• Who can set up an MPN?
• Dupuytren's contracture involves
• Which term refers to the back or thoracic region?
• Rehabilitation benefits can be settled under which condition?
• Once the self-insurance program has been initiated in the initial 6 month period, the certificate to self insure shall be valid until __________.
• During stipulation to a permanent disability award, a furniture company claims a $2000 debt; what is proper handling of this lien?
• Which of the following represents a possible civil penalty for wage deductions?
• Which term describes the standard applied to psychiatric injury in California?
• In the PD Rating Schedule, total loss is described as hearing loss. What term describes this condition?
• Which term denotes the largest artery in the body?
• The scaphoid bone is located in the:
• Who is designated as the Manager/Chief in the Self-Insurance Plans?
• Wasting away due to lack of use?
• DOI stands for which of the following?
• The items Dual employment, Public safety officer, Seasonal employee, Earning capacity, and Inmates illustrate which concept in temporary disability administration?
• A 100% upper extremity impairment is what percentage of a whole person impairment?
• Who shall assign three panels of qualified medical evaluators within five working days after receiving a request?
• May and John Doe adopt their 8 year old grandson Joseph. John dies in a work-related accident. Mary is a dependent spouse. How many dependents are there?
• Dorsiflexion involves which movement?
• Which knee injury describes a tear of the meniscus that displaces like a bucket handle?
• Who is responsible for printing or providing the change of physician form?
• Which bone is the hip bone?
• Which term refers to the inflammation of a joint?
• In workers' compensation proceedings, when is proof of service required?
• The latissimus dorsi muscle is primarily located in which region?
• To whom do you apply for a Certificate of Consent to Self-Insure?
• Who controls medical in the first 30 days?
• Subsequent injury fund rule: The fund will apply if the combined injuries are opposite and total more than 70%.
• Which statement is true regarding notices for salary continuation plans?
• An Interim Report covers a six-month period. For private insurers, which period is covered?
• What term describes flexion of the ankle toward the sole of the foot?
• Who can impose a penalty for failing to notify the excess carrier of a claim?
• For many employees, such as traveling salespeople, which rule describes that the time and place for performing work duties may be at the employer's discretion?
• A fracture in which the bone breaks and bone extends through the skin is called what?
• When is a document considered filed at the WCAB?
• Colles fracture involves which bone?
• Which percentage represents the permanent disability rating for the 46-year-old electric arc furnace operator with silicosis?
• Under SIP, who has authority to modify, delay, or deny treatment, given specialization requirements?
• If a doctor’s medical-legal bill is received 62 days after the date stamp, which action is appropriate?
• An employee is seriously injured due to his own serious and willful misconduct. The compensation is reduced by 50% unless which conditions apply?
• What is the role of the master certificate of consent to self-insure in relation to deposits?
• What is the standard rating for slight to moderate pain?
• What record is used to track work comp claims maintained by a self-insurer?
• DIA-510 is a notice form used to report death when the employee left no surviving minor child. Within how many days must it be filed?
• Which of the following does not involve the lungs?
• Fracture in which one bone fragment is wedged into the interior of another fragment.
• Which document is filed with the Workers' Compensation Appeals Board when an applicant proceeds with adjudication of a claim without counsel?
• Which description best defines a comminuted fracture?
• A moderate pain could be tolerated, but would cause a marked handicap in the performance of the activity precipitating the pain.
• Which rule states that injuries sustained while commuting are not compensable unless exceptions apply?
• Two employees get into an altercation about something they have to do at work. A hits B. Who is entitled to workers' compensation benefits?
• Two inches of calf atrophy is equivalent to a disability due to moderate ankle instability; which term is described?
• For private individual employer applicants seeking a master certificate, how many calendar years must the business have been in operation?
• Which statement describes Voc Rehab settlement conditions?
• If an employee has two injuries that reach MMI at the same time, does Williamson apply?
• What is the primary function of the Workers' Compensation Appeals Board in California?
• The weight-bearing and larger bone of the lower leg?
• Labor code 138.4 deals with which of the following?
• Which TD Rate year had the largest range width?
• Disability from moderate instability of the ankle joint is most closely associated with which condition?
• When requested by an employee or employer, the medical Director appointed shall assign three panels of qualified medical evaluators within _____ days after receiving a request for a panel.
• Smallest and most fragile bone of the face, near the eye is the?
• Should you notify the chief of a change in minority shareholders?
• During off-season, the temporary disability rate for a seasonal worker is based on two-thirds of what?
• Every self insured shall file an SI annual report on forms supplied by the Manager or Chief.
• Which term describes abnormal sensations such as burning or tickling in response to touch?
• MMI stands for what term in workers' compensation?
• For aggregate disability payments after an injury, temporary disability cannot exceed how many weeks, counted from the start of temporary disability?
• Who is described as enforcing benefit notices and timely payments?
• Which item is the penalty for a serious misconduct reference?
• Absence of the lens of the eye is called?
• When a third-party creditor asserts a lien during a workers’ compensation case, what is the typical proper course of action?
• How many days do you have to respond to a request for medical treatment?
• Voc Rehab may be settled where:
• Incurred liabilities for the payment of compensation include which components?
• The employee is receiving salary continuation from the employer in lieu of TD. Is DWC notice required?
• For an injury on or after January 1, 2005, the maximum whole person impairment under AMA guides is:
• Out-of-state audits apply to former self-insurers under what condition?
• Under LC 4702, in the case of minor children, payment of death benefits should continue until which event?
• Which term describes an injury that results from a single incident or exposure?
• Who can revoke a certificate of consent to self-insure?
• The DWC-1 claim form must be provided to the employee within 3 calendar days.
• Which item is explicitly listed as an exception to compensation for off-duty activities unless reasonably expected by employment?
• Taking work home when done for the employer's benefit falls under which concept?
• In the MPN, the goal shall be at least what percent of physicians primarily engaged in the treatment of nonoccupational injuries?
• The rules indicate that a letter to the AME should be used to request clarification with a copy to the attorney.
• Hearing loss due to aging is called?
• What is the purpose of the security deposit held by the self-insurer?
• A medical-only claim is one in which which statement is true?
• Which term refers to the bone on the thumb side of the forearm?
• A high school teacher leaves school after the end of the day. The school, located in a bad neighborhood, provides parking for her in a district owned lot at the school. The teacher pulls out of the school lot onto the city street and approximately two blocks from the school while stopped at a red light a man forces his way into her car, assaults her and steals her purse.
• As of January 1, 2020, which condition is included as an injury under the mental health provisions?
• Which nerve is described as the longest and thickest in the body?
• Loss of an eye is called what?
• What is the smallest and most fragile bone of the face near the eye?
• LC 4660 requires the Administrative Director to amend the PD rating schedule once every ___ years.
• Which statement best describes the definition of first aid from the provided material?
• Which form is used to file an employee workers' compensation claim?
• In the medical cost example, which years are cited for costs?
• Which document is not typically filed with the board when pursuing adjudication?
• Apportionment of PD shall be based on what?
• What is the maximum burial expense for 2007-2012 as described?
• A foreman and coworkers are drinking on the loading dock after work ends at 5 pm. A coworker is injured when he backs his truck into something while leaving because he was intoxicated. Is the injury compensable?
• Dependents have how long from the date of death to file a claim?
• An employee is at home for a workers' compensation injury receiving TD. He contracts measles from one of his children. What are you liable for?
• Which item should be included on the Self-Insurers Annual Report?
• In handling a third party case, your primary concern should be to?
• A notice of Employee Death shall be filed with the Administrative Director within *** days, where the employee left no surviving minor child.
• A bartender with earnings of $600 per week, averages tips of $250, and also receives one free meal per day from the employer. The employer's cost of the meal is $15. If the employee paid for the meal it would cost $125 per week. What is the employee's TTD rate?
• A self-insured employer has denied a claim but the file does not properly document the reason for the denial. What is the amount of the penalty?
• When a co-employee is intoxicated or proximate cause by the willful and unprovoked physical act of a co-employee, when can an IW proceed with a civil suit and collect workers’ compensation?
• For a victim of a violent act, substantial cause means?
• Which vertebral region contains seven vertebrae?
• Which change does not require notifying the chief?
• What must occur for a Compromise and Release (C&R) to be valid?
• In the third-party example, what is the gross recovery from the negligent third-party defendant before deductions?
• Permanent disability with a rating of 100% is referred to as which type of disability?
• Which term denotes the turning inward (inversion) of the eyelid?
• For a TD payment made for a 2006 injury in 2008, which rate applies?
• An employer calls and tells you they fired an employee for reporting an industrial injury. You should:
• Which description best defines affiliate certificate?
• Other than earnings, what controls the rate at which temporary disability is paid?
• In the dependents framework, a child incapacitated from earning is considered:
• Which of the following statements best describes the going-and-coming rule for injuries?
• The employer has an aggregate stop loss excess insurance policy. It is:
• A decision or award may be increased by up to what amount or percentage, whichever is less?
• Fracture in which a bone is broken completely through crosswise.
• What term describes the fusion of two or more bones in a joint?
• Which bone is the longer of the two forearm bones, on the side of the little finger?
• What does UR stand for in the context of utilization management?
• Which scenario is an exception to the coming and going rule?
• The shin bone is called the:
• Which scenario is an example of a valid exception to the coming-and-going rule?
• Under the Two Year Rule (4661.5), what happens to permanent disability payments when there is a good faith issue?
• In practice, can a nurse modify, delay, or deny a medical treatment request under CA workers' comp rules?
• Which option best identifies the body charged with adjudicating workers' compensation claims in this context?
• The employee earns $2000 per week, works six months per year and collects EDD benefits the rest of the year. He returns to work and is injured on his first day back. The correct total TD rate is?
• Which term refers to the surgical repair of a joint?
• Which option lists the three basic elements of rating for knee disability?
• What is a document considered filed with the Worker's compensation Appeals Board?
• An employer calls and tells you they fired an employee for reporting an industrial injury. You should:
• An employer and employee file third party actions and obtain a recovery. Who has first right of recovery—the Employee? or the Employer?
• Which type of insurance coverage must a group self-insurer maintain beyond primary to meet the requirement?
• In impairment terminology, what does LE stand for?
• How are death benefits paid?
• Loss of a natural lens of the eye?
• If a physician didn't perform a particular exam or prepare the report you should:
• Which muscle is located in the lower back?
• What is the term for the largest nerve in the body, originating in the spine and extending to the foot?
• Which bone is the large, triangular bone at the base of the spine?
• The impairment standard is adjusted to account for which factors?
• How many thoracic vertebrae are listed?
• What is the most common type of arthritis?
• In the 1997 PD Rating Schedule, failure of the tip of the finger to touch the mid-palm on action flexion by 3 inches or more indicates which condition?
• If the average weekly earnings are $600, what is the two-thirds temporary disability rate before applying any cap?
• Which statement correctly describes the implementation notice in the Medical Provider Network program?
• Which item is not required to be included in the Claim Log?
• Gelatinous center of an intervertebral disc
• Which statement best defines an experienced claims adjuster, according to the material?
• The end of the radius near the elbow is which structure?
• Which principle best describes SI Reserves?
• In the nursing student scenario, what sequence of temporary disability rates is described?
• The zygoma (zygomatic bone) involves which area of the body?
• Re-application to the Director for a certificate of consent to self-insure is required if an employer fails to initiate a self-insurance program within what timeframe?
• Osteoarthritis is the most common type of arthritis
• For a baker earning $1,400 per week, the TD rate (May 1, 2010) is which amount?
• If an employer or insurer is penalized with 132A, what may the employee file?
• Which term refers to the fluid found in a joint?
• If a self-insured license is revoked, the Director maintains jurisdiction until what condition is met?
• Which statement about credit toward the security deposit is correct?
• Which bone forms the shoulder blade?
• In the example involving a 2004 injury, what is the reserve percentage assigned to that injury?
• The annual report should include the number of medical only cases reported.
• Which movement describes turning the palm so the face of the hand is downward?
• Which term denotes the act of bending or being bent?
• Private individual employer applicants for a master certificate should meet what minimum requirements?
• Which bone is the longer of the two forearm bones and lies on the outside of the little finger?
• An employer desiring a change of employee selected physician can petition the:
• Private Self-Insurance coverage year runs from January 1 to December 31. Which option reflects this period?
• Which term describes the lining that produces joint fluid?
• The heel bone is known as what?
• What is required in order to prove serious and willful misconduct?
• To petition for a change of employee selected physician, the petition is filed with which office?
• How many thoracic vertebrae are there?
• Which description defines a compound fracture?
• For a master certificate issued after July 1, 1994, what is the required net worth and average net income over the past five years to qualify for self-insurance?
• Administrative Director is the head of which agency?
• If you assume the responsibilities of another TPA and discover missing indemnity files, what should you do?
• Which entity is responsible for enforcing benefit notices and timeliness of payments in workers' compensation?
• Which of the following is an obligation of former self-insurers?
• Which disease is explicitly listed as included in the cancer presumption in the material?
• If an employee has more than one injury, which statement describes how disability should be calculated?
• Inward turning of the eyelid is called?
• In the grip strength-based disability calculation for the Colles fracture case, which percentage is used as the permanent disability value?
• Which term corresponds to double vision?
• Where must claims files be kept for out-of-state self-insurers unless the Manager approves in writing to administer from a location outside California?
• Which bone is the upper arm bone?
• A finding that the injuries resulted from the injured EE's serious and willful misconduct means which of the following?
• If a QME notice is sent to the injured worker and no response is received, within how many days should it be sent to the DWC?
• The MPN includes physicians primarily engaged in the treatment of which injuries?
• All claims files shall be kept and maintained for how long?
• In a self-insured setting, which option describes paying benefits in accordance with the Labor Code?
• When both instability and thigh atrophy are present, how is the rating determined?
• No rateable pain indicates which level of pain?
• If the Manager has granted written approval to administer from a location outside California, where may the claims files be maintained?
• In the two-job scenarios, how is the temporary disability rate determined?
• If an IW unreasonably fails or refuses to obtain medical treatment, what is one potential remedy?
• Under the Personal Convenience Doctrine, is an injury sustained while the employee is changing the car’s oil and waiting for work to start compensable?
• What is not an Activity of Daily Living?
• Which statement about waivers of pre-existing conditions is correct?
• The security deposit of a private self-insurer shall not apply to all subsidiaries and affiliates included under the master certificate of consent to self-insure.
• Into which region of the spine do the cervical vertebrae belong?
• Inflammation of the bone and joint is called what condition?
• Under AMA Guides apportionment is based on?
• An employee is injured March 2, 2011, but doesn't tell the employer until March 4, 2011. The employee goes to the doctor that day and is taken off work. The claim form is returned March 7, 2011. When does disability begin?
• A DIA form 510 in a death case must be filed unless the employer has actual knowledge that:
• Entropion is defined as the inward turning of which structure?
• Which PD range yields the $6,000 PD benefit?
• Which artery carries blood from the heart to the lungs?
• What is the deadline to file a petition to terminate liability?
• Trapezius muscle injury is most likely to involve which region?
• An insurer issues indemnity payments on a CA WC claim using an Ohio bank. This is:
• If a review indicates serious and willful misconduct by the employer, the reserves should be increased by what amount?
• A Doheny fracture refers to a fracture of which bone with outward displacement?
• If the Director determines that a private self-insured employer has failed to pay required workers' compensation benefits, he/she may:
• What is the maximum burial expense payment for DOI between January 1, 1991 and December 31, 2012?
• If a claim is not denied within 90 days, the claim is presumed to be denied unless rebutted by later evidence.
• What is the penalty for failure to file a complete or timely annual report?
• Which figure represents the maximum burial expense referenced for a 2007 death caused by injury?
• Under the AMA Guides, apportionment is based on what primary factor?
• Which item does not have to be included in the Claim log?
• What is the stated purpose of liberally construcing Division Four in Division Five of the Labor Code?
• A metacarpus is:
• Which of the following are included in 100% permanent disability (PD) assumptions?
• Eversion or outward turning of the eyelid is called?
• Raising the foot, pulling the toes toward the shin
• Under the 2018 Date of Injury framework, the 30-day authorization without prior utilization review applies when the body part is accepted as compensable and addressed by which of the following?
• Which entity has authority to approve location outside of CA for the claims file?
• What action is allowed when a private self-insured employer fails to pay benefits?
• Which item is NOT an obligation of former self-insurers?
• Fracture of the distal end of the radius with outward displacement of the radius is called what?
• Which bone is on the thumb side of the forearm?
• In calculating the PD rate for a 17-year-old minor, which rate is used?
• Abnormal anterior curvature of the spine is called?
• Which scenario best illustrates the Special Mission Exception?
• What is the formula for TPD?
• Removal of a spinal disk is called?
• If a 17-year-old is injured and the minimum for temporary disability applies, which statement about the permanent disability rate is correct?
• Inability to express, write, or understand once familiar terms or objects?
• A 39 year old auto mechanic has a slight instability of the knee, no atrophy and a preclusion from heavy lifting. What is the level of permanent disability?
• If an employee has a permanent disability of 72% and is guilty of serious and willful misconduct, what should the Board award?
• In California workers' compensation, a 10% penalty may be assessed for unreasonable delay.
• Examination of the eye with a scope
• Which hand bone is navicular bone?
• MMI stands for which of the following?
• If you fail to notify the excess carrier of a claim, which entity can impose a penalty?
• Which term means inflammation of the eye's lining?
• Which term describes misalignment of the jaw?
• A Safeway employee breaks his leg in 2010 and has 10 weeks of TD. He is a max earner, recovers fully and has no permanent impairment. How should this claim be reserved for indemnity?
• The Administrative Director plays a governing role in the California workers' compensation system. True or False?
• The smaller of the two lower leg bones is called what?
• What does a notice of denial require?
• In cases where an employee under a certain age is injured and illegally employed at the time of injury, the entire compensation otherwise recoverable shall be increased by what percent?
• Which term refers to a carpal bone of the wrist in the material?
• An EE, not paid for mileage, going to the bank on his lunch break to cash his paycheck, had an injury, the injury is:
• Penalty for offering or receiving compensation to refer clients or patients?
• How is reduction of vision rated in 2004?
• If the applicant has received a prior award of PD, it shall be conclusively presumed that ...
• Which official is empowered to prepare, adopt, and amend impairment schedules under LC 4660?
• How many cervical vertebrae are listed?
• Involuntary flexion contracture of the fingers usually the ring and little fingers (Dupuytren's contracture) is?
• Which statement is true regarding credit toward the security deposit in SIP?
• Tuberculosis is listed as an injury under CHP presumption when it develops during service. Which term corresponds to this injury category?
• The treating physician providing continuing treatment is required to provide medical reports within how many days?
• Which percentage corresponds to Slight in the spine disability schedule?
• Which term means chewing?
• In a two-impairment scenario, the rating for the impairment combining method is:
• TD Rate 2016 corresponds to which rate?
• When is the employer required to provide a claim form?
• The calcaneus bone is the heel bone.
• An employee is terminated following an industrial injury because he filed a claim for compensation benefits. The EE is entitled to which of the following?
• If a physician didn't perform a particular exam or prepare the report you should:
• Who assumes payment of workers' compensation obligations when a self-insurer becomes insolvent?
• What is the penalty for discharging or administering compensation obligations in a manner that injures the public or those dealing with the employer or insurer?
• Formal rating determinations are evidence only as to which aspect?
• In evaluating evidence under the preponderance standard, which factor is key?
• Which of the following is NOT listed as an exception to the condition of compensation?
• When can an injured worker not attend an AME/QME exam?
• Which outcome is described as a penalty for failure to secure workers' compensation?
• Which bone is located in the cheek area?
• Reduction in vision to 20/200 or less using the 1997 PD schedule is called?
• What is the maximum per 30-day period for the late filing penalty?
• What is the summary of penalties on an employer for failure to secure workers' compensation?
• The employee has the right to a second opinion from a participating physician on which topic?
• Which term refers to the costs and losses recovered in a civil action?
• What percentage penalty applies for failing to obtain workers' compensation coverage?
• What is the impairment qualification amount for the 26-49 age range?
• In addition to the annual report, what other type of report may a manager require?
• What does PD stand for in this context?
• Otitis media is inflammation of the middle ear.
• Which term describes a long-lasting condition commonly used in disability ratings?
• Which bone is located in the hand and is also called navicular?
• To whom do you apply for a Certificate of Consent to Self-Insure?
• Which bone is the knee cap?
• What best describes the nucleus pulposus?
• Which type of case is not required to be reported on the annual report?
• What document authorizes an employer to self-insure under the SIP?
• Using an out-of-state bank to issue California workers' compensation indemnity payments is:
• If two impairments are 10% and 5%, what is the combined rating using the greatest plus half of the lesser?
• When an injured employee's attorney requests that payments be sent to the attorney's office, what is the proper action?
• A self-insured employer is not responsible for an audit fee in which case?
• What is the penalty for failing to obtain workers' compensation coverage?
• Permanent and stationary, in impairment terms, means there is no expectation of further improvement.
• Who bears the responsibility to ensure the employer's subrogation lien does not exceed the net recovery amount?
• What should be included on the Annual Report?
• Upon receipt of a complete public entity application, within how many days will the applicant be notified?
• True or False: All self-insurers shall provide the manager with information on standard workers' compensation policies, specific access coverage, and any aggregate excess workers' compensation coverage carried.
• For master certificate eligibility, which credit rating is required?
• What term describes benefits that assist a disabled employee with job displacement?
• What is the temporary disability rate for a baker earning $1,400 per week for an injury May 1, 2010?
• An employee has an admitted injury resulting in PD of 72%. The employee is also guilty of serious & willful misconduct. What should the Board award?
• If you send a QME panel and you don't get a response, how long do you have to wait?
• Who reports potential fraud claims?
• What is alternative composite deposit?
• How many vertebrae are there?
• The treating physician providing continuing treatment is required to provide you with a medical report within how many days?
• If the denial is based on new evidence discovered after 90 days, which statement is true?
• In workers' compensation, what does PD stand for?
• Numbness, weakness, and pain in the hand due to compression of the median nerve at the wrist
• What is the term for rotation of the forearm so that the palm faces posteriorly?
• In respect to excess carrier involvement in a second injury, which action may be appropriate?
• Which document serves as proof that service has been properly completed?
• The head of the femur fits into which structure?
• In California SIP, if the injury involves an employee under 16 who was illegally employed at the time of injury, by what percent is the compensation otherwise recoverable increased?
• What is the knee cap?
• Which bone forms the kneecap?
• When an attorney for the injured worker requests that payments be sent to his office, which of the following is the correct practice?
• A knee injury produces no objective disability or work restrictions but the physician prescribes a stretch leg brace. What is the standard rating for the knee?
• Pronation of the forearm means to?
• Under the AMA Guides apportionment, which factor is used to determine apportionment?
• A 39-year-old baker with knee injury causing slight instability and a restriction from heavy lifting has what level of permanent disability?
• Which bone is the thigh bone?
• Which of the following is an obligation of former self-insurers?
• In salary continuation cases, the DWC notice should include:
• In impairment notation, LE stands for which body part?
• If a self-insured employer has not adequately funded their trust account for over a week, what action is required?
• Exabersation refers to:
• What is the maximum TD Rate for 2007?
• Penalties for violating LC 3215 include which of the following?
• The disability evaluation bureau can prepare what kinds of ratings?
• When can you close a claims file?
• What is the standard rating for moderate vertigo?
• Which date applies for private self-insurers to file the Self-Insurer's Annual Report?
• A lump filled with fluid at a joint, commonly the hand or wrist, is called what?
• Which bone is a tarsal bone near the ankle?
• Death benefits are specified for which dependent counts?
• If, just before the one-year anniversary, the employee's claim under submission, what is the status of the statute of limitations?
• Chronic overflow of tears is called what?
• Which of the following is an Activity of Daily Living?
• How long does Self-Insurance Plans have to notify you that your application for self-insurance is deficient?
• A Friday injury with six hours paid triggers the waiting period to begin on which day?
• How long does Self-Insurance Plans have to notify you that your application for self insurance is deficient?
• In a scenario where an employee previously had 25% PD and later injures another eye, how should you reserve for the new injury?
• Which of the following best defines the term 'substantial cause' in the context of violent acts?
• Complete immobility of the great toe yields what standard rating?
• What is the impairment qualification amount for the 15-25 age range?
• What is the medical term for lateral movement of the wrist toward the little finger side?
• Can an employee bring his personal physician to a medical exam requested by the employer?
• An employee works 40 hours a week and earns $16 per hour. He has a second job working 20 hours per week and earning $12 per hour. If he is unable to work both jobs what is the temporary disability rate for an injury in 2008 that occurs on the $16 per hour job?
• Following revocation of a certificate, the manager may determine the need for which action to secure future liabilities?
• In the medical costs example, what currency is used to express the figures?
• The large muscle of the back is which?
• When is a self-insurer not responsible for an audit fee?
• What penalty applies to late PD payments?
• What is the maximum temporary disability rate for an injury in 2010?
• The scaphoid bone is located in which region?
• Which description best describes a fracture where the bone protrudes through the skin?
• If the employer desires a change of physicians or chiropractor, whom may he petition?
• The self-insurer's security fund is governed by whom?
• You are applying for a master certificate after July 1, 1994. what is the amount of net worth and net income needed to qualify for self-insurance
• If an injured employee's injury results from serious and willful misconduct, what is the effect on indemnity benefits?
• Which list accurately describes the four conditions conclusively presumed totally disabled?
• Do UR Policies and Procedures and a description of the process have to be filed with the Administrative Director?
• Which term describes the legal concept that a worker's remedy is limited to workers' compensation rather than the civil court?
• Which form is used to report a work injury by the employer?
• TD Rate 2012 corresponds to which rate?
• Proof of service is necessary for which notices?
• Which carpal bone is commonly called the navicular bone?
• What does excess insurance coverage provide for group self-insurers?
• When both objective/subjective index and work capacity index are used and yield different disability ratings, which rating is used?
• In a case of a 39 year old auto mechanic with slight knee instability, no atrophy and a preclusion from heavy lifting, what is the permanent disability level?
• Which state agency is responsible for enforcing benefit notices and timeliness of payments?
• Employers with similar workers' compensation exposure that form a reciprocal for self-funding are known as what?
• Which bone is commonly known as the heel bone?
• What rating is assigned to occasional back pain, such as described in the guidelines?
• Which term denotes the backward bending of the foot upward?
• According to Benson, how should multiple injuries be settled?
• What is affiliate certificate?
• In a third-party case with the described figures, what is the net recovery to the injured worker after attorney fees, costs, and WC lien?
• Which of the following does not produce rateable disability?
• In the city police officer scenario, who pays the Labor Code 4850 benefits?
• When can you proceed with a civil action against a coworker for an injury while receiving workers' compensation benefits?
• Which of the following is an obligation of former self-insurers?
• How many sacral vertebrae are listed?
• Regarding pre-existing arthritis waivers, which statement is correct?
• The hip bone is represented by which bone?
• In Death Benefit Rates 2006-2015, which option corresponds to $320,000?
• Is an insurance company allowed to keep claim files out of state? If so, when is it okay?
• A finding that the injuries resulted from the injured EE's serious and willful misconduct means:
• Which muscle forms the large superficial muscle mass of the upper back and neck?
• In the bartender earnings scenario, what are the EE's weekly earnings used for compensation (wages plus tips plus value of the meal if provided)?
• Which term refers to an irregular pupil?
• When an injured worker dies of a industrial injury; Who is automatically presumed dependent? (at the time of injury)
• How many days does a physician have to submit a Doctor's First Report of Occupational Injury or Illness?
• Which term denotes degeneration of the joints of the vertebrae?
• How many days do you have to dispute a medical bill?
• In a third-party subrogation, which lien is limited to the net recovery amount?
• What are the filing deadlines for the self-insurer's annual report for private and public entities?
• When must a Self-Insurer's Annual Report be filed for private versus public self-insurers?
• Under what condition will eyeglasses and hearing aids be replaced?
• Which statement about the reduction in indemnity when the employee's own serious and willful misconduct caused the injury is true?
• A back injury with a preclusion for heavy lifting takes what standard rating?
• Degenerative arthritis of the joints is known as which condition?
• Middle of the body
• LC4601 addresses which employee right in workers compensation?
• The 5814 Penalty provides which of the following?
• Who is responsible for adopting and revising the official medical fee schedule?
• Reapplication to the Director for a Certificate of consent to Self Insure is required if an employer:
• A finding that the injures resulted from the injured employee's serious and willful misconduct means?
• Which remedy includes a 10% penalty for unreasonable delay in payment of an award?
• Which term describes rotation of the forearm so the palm faces downward?
• After January 1, 2013, how much is the SJDB voucher worth?
• What is the per-violation penalty for the most serious violations?
• To whom do you apply for a Certificate of Consent to Self-Insurance?
• The employee is guilty of serious and willful misconduct. His permanent disability is 50%. You should:
• May and John Doe adopt their eight-year-old grandson Joseph. John dies in a work-related accident. Mary is a dependent spouse. How many dependents are there?
• What is the term for the rule that workers' compensation provides the exclusive remedy?
• An injured employee with dependents is incarcerated for an unrelated offense. Temporary disability otherwise due is:
• If a physician bills an injured worker, what action should be taken?
• The employer shall provide a claim form in how many days?
• For impairment assessment, what does WPI stand for?
• Which of the following would be considered indemnity?
• What is the name of the rule that generally holds injuries during a commute to be noncompensable?
• What acronym is used for physicians appointed by the Administrative Director to evaluate medical conditions?
• Which statement best describes the effect of serious misconduct by the employee on compensation?
• In a third-party recovery scenario, the employer has the first right if the lien does not exceed the recovery amount.
• A Notice of Employee Death shall be filed within how many days if the employee leaves no surviving minor children?
• In a scenario where an ER and EE file third-party actions and obtain a recovery, who has the first right of recovery?
• Who holds the title of Manager/Chief in the Self-Insurance Plans?
• What is the maximum penalty per violation for a physician who lies on a medical-legal report?
• The total number of vertebrae in the adult vertebral column is:
• TD for an injury in 2012 was paid at an incorrect rate (too low). What should you do?
• What is the impairment qualification amount for the 0-14 age range?
• Which change in a self-insurer's status does not require notification to the Manager?
• Trapezius muscle injury most commonly involves which region?
• Volunteers are not covered unless _____.
• Penalty for referring clients includes incarceration for not more than how long, a fine, and a felony?
• Which of the following is an obligation of former self-insurers?
• Which statement accurately describes how the temporary disability rate is determined?
• What is the standard rating for an injury involving amputation of the major thumb at the metacarpal joint?
• Within how many days must the employer provide a list of physicians?
• TD Rate 2014 corresponds to which rate?
• Labored or difficult breathing is termed?
• Which permanent disability is presumed to be total in character?
• If an employer is guilty of serious and willful misconduct the employee's compensation is:
• If a permanent disability award is exactly 15%, the applicable SJDB cap is up to how much?
• What does the acronym GAF stand for?
• What is the time frame for reporting fraud?
• Which description defines severe pain?
• SJDB for permanent partial disability award between 26 and 49% is up to how much?
• How many days does an EE have to return the QME form before a panel is selected for them?
• When can the Administrative Director assess civil penalties up to $100,000?
• If there are three persons wholly dependent for support on a deceased employee and additional partial dependents the partial dependents would receive:
• An injured worker incurred medical costs of $600 in 2004, $1,200 in 2005, and $800 in 2006. What is the recommended annual medical expense reserve?
• Under which rule is a traveling employee injured while away from home on business considered compensable?
• Which pair correctly describes the interim report due dates for private and public cases?
• Fracture that is commonly described as a fracture above the ankle, involving the distal tibia and fibula.
• Wasting away due to disuse?
• In handling a third-party case as an examiner, what is your primary concern?
• When an employer is self-insured for workers' compensation, who is responsible for claims adjustment?
• What does synovial mean?
• Which bone is the smallest and most fragile bone of the face near the eye?
• The best description for a comminuted fracture is
• Who is responsible for enforcing benefit notices and timeliness of payments?
• According to the material, how many visits are allowed per industrial injury?
• Which bone is commonly known as the cheekbone?
• A special audit has the power to take away which credential?
• Under LC 3351, which of the following describes an elected or appointed paid public officer?
• For an injured employee 38 years of age, how would the rating be affected?
• Which statement about temporary disability rates is true?
• The Administrative Director may also assess civil penalties of up to $100,000 for certain prohibited general business practices. Which option describes the maximum?
• The turning outward (eversion) of the eyelid is called?
• An estimate that represents an expected value over the range of reasonably possible outcomes is called what?
• How many vertebrae are typically in the adult spine?
• In 2006, what are the death benefits for 1, 2, and 3 or more total dependents?
• Which form is used to initiate a California workers' compensation claim?
• Dupuytren's contracture affects which anatomical region?
• What is the term for the lateral movement of the hand toward the radius?
• Which condition is described as a chronic disorder causing widespread pain and sleep problems?
• Which term denotes impairment of speech, language, or communication?
• Which item does not have to be included in the Claim Log?
• What is the TD rate for an injury in 2005?
• For private self-insurers, the Self-Insurer's Annual Report is due by which date?
• Should you notify the chief of a change in status when the self-insurer proposes to cease doing business in California?
• To whom must a disability evaluation unit rater send the report when the worker is unrepresented?
• A compound fracture is?
• How much does an illegally employed person under 16 receive?
• Which statement about the daily change-of-physician timeline is true?
• Which of the following is NOT considered an Employer under LC 3300?
• Dorsiflexion of the foot means:
• Under the dependent criteria, which individual is conclusively wholly dependent on a deceased employee if the surviving spouse earned $30,000 or less in the year before death?
• Which option correctly states the duration to maintain the claims file for a self-insured administrator?
• In the context of excess coverage, after what threshold does excess insurance provide coverage?
• Because the employer does not have a plant nurse, the employee is sent to a physician for removal of a foreign object from the eye. Which action best applies?
• Securities issued by the self-insurer or its subsidiaries, or its affiliate companies or parent companies, shall not be included in the security deposit except for particular self-insured deposits.
• An employer calls and directs you to deny a claim you know is compensable. You should:
• Dorsiflexion of the foot refers to which movement?
• Spouse includes registered domestic partner under which Labor Code section?
• A man goes to his wife's work upset over a custody issue and shoots her. Is this compensable?
• The employer wants to comprise and release the claim for $12,500 if the employee resigns. Which statement best describes the propriety of this approach?
• Fill in: every ER except the state should secure the payment of comp by being ________ ________ liability.
• A Doheny fracture is a fracture of which bone with outward displacement?
• Decompression of the median nerve at the wrist is a treatment for which condition?
• Which date marks the start of disability in the example where the injury occurs March 2 and the worker is removed from work on March 4?
• Fracture of distal end of the radius with outward displacement?
• After SI approval, within how many days must you notify the Administrative Director of changes (such as ownership or articles)?
• What is the Self-Insurers Security Fund?
• How many days do you have to respond to a request for medical treatment?
• What is the primary purpose of the DWC-1 form?
• An employee works 40 hrs a week and earns $16 per hour. He has a second job working 20 hrs per week and earning $12 per hour. If he is unable to work both jobs what is the temporary disability rate for an injury in 2008 that occurs on the $16 per hour job?
• Which document is filed with the board when an applicant proceeds without representation?
• What is the minimum group net worth specified for the plan?
• Which is accurate about annual reports due dates?
• Palmarflexion of the wrist means moving the wrist:
• Fatigue fracture is best described as what?
• To remove surgically is to which term?
• The SI interim reporting due for public plans is due within how many days?
• A 17-year-old minor is injured and is minimum for PD. What is the correct PD rate?
• An IW with dependents is incarcerated for an unrelated offense. TD otherwise due is:
• For an out-of-state self-insurer, who determines whether claims files can be maintained outside California?
• Which bone forms the shoulder blade?
• What does the acronym TPA stand for in this context?
• Which term describes a risk that is personal when an employee is assaulted by a third party with a purely personal grievance?
• To request an audit when indemnity records are missing, which party should you contact?
• Can an employee bring his personal physician to a medical examination requested by his employer?
• When is a document considered filed at the WCAB? A. Date it is received? B. Date it is postmarked? C. Date of Express Mail pickup? D. Date of cover letter filing it?
• Under the Order of Credit rules, estimates of future liability may:
• Any person rendering service for another, other than as an independent contractor is ______ to be a(n) _______.
• From the date of request, how many days must an ER or insurer provide an employee with a change of physician form?
• In 2006, death benefits for 1, 2 and 3 or more total dependents are described as how many distinct numbers?
• Which entity administers changes to an employee-selected physician?
• Which statement best describes the requirement for self-insureds to provide information to the manager about workers' compensation coverage?
• An employee is in the break room drinking vodka. A conveyor falls seriously injuring him and the doctor at the hospital says the employee was intoxicated. You should:
• The dominant hand is 10% stronger than the non-dominant hand. The dominant hand is what percent stronger than the non-dominant hand?
• By what date must private self-insurers file the annual report?
• Annual actuarial studies for private insured employers are due by which date?
• Which party has the authority to impose penalties for failure to notify the excess carrier of a claim?
• Who can modify, delay and deny requests for treatment?
• Fracture described as a fracture that is not open to the outside environment.
• Proof of service is mandatory with what type of notice?
• What was the 2010 maximum temporary disability (TTD) rate?
• A closed fracture is best described by which term?
• An employee took work home for an annual report. The employee injured in an auto accident near home; paperwork found in his briefcase in the car. You should:
• When earnings are irregular and there is data showing actual weekly earnings, the TD rate is calculated as what?
• Which bone forms the hip socket?
• Which statement about the MPN is most consistent with its establishment?
• A 39 year old baker, group 420, has a knee injury with slight instability precluding heavy lifting. What is the level of permanent disability?
• Which code section prohibits an employer from extracting or receiving from an employee any contribution to cover the cost of workers' compensation coverage?
• You have assumed the responsibilities of another TPA. While auditing the files you discover that there are missing indemnity files. You should:
• When mileage isn't paid in advance, what is the typical treatment for mileage reimbursement?
• If an employer provides a wage statement showing irregular earnings, what is the correct basis for the disability rate?
• The zygomatic bone forms part of which region?
• What happens if a payment is made two years after the date of injury?
• How many vertebrae are in the human spine?
• For burial expenses, what is the payment option for a DOI prior to 1/1/91?
• Which term denotes extreme or abnormal extension?
• Which term root means vertebra?
• A nurse obtains Findings & Award in April 2002. She dies in May 2007. A death case may be filed within how many years from the Date of Disability (DOD)?
• Which is the weight-bearing and larger bone of the lower leg?
• What is not an activity of daily living
• Zygoma involves what part of the body?
• Which benefit should not be considered when calculating average weekly earnings?
• What is the form called to report occupational injuries or illness by physicians?
• When a routine audit is performed, how often does it occur?
• The 14-day timeline for SI application approval determination is described as part of which law?
• What is associated with carpal tunnel syndrome?
• Flexion (bending) of the wrist toward the palm
• You are applying for a master certificate after July 1, 1994. What is the amount of net worth and net income needed to qualify for self-insurance
• What is the max allowance for pain resulting from a single injury?
• A man shoots his wife at the wife's workplace due to a custody dispute. Is this compensable under workers' compensation?
• Hoarseness takes what standard rating?
• Which term refers to the intervertebral disk?
• Which statement best describes a comminuted fracture?
• What term describes a fracture where the bone breaks the skin?
• A fracture of the lower fibula and the malleolus of the tibia with outward displacement of the foot is called?
• A child under the age of 18, or a child of any age found by any trier of fact to be physically or mentally incapacitated from earning shall be ______ to be wholly dependent for support upon a deceased employee.
• What is the rating for immobility of the hip when the arc of motion is 0-60 degrees?
• Which of the following is not a potential dependent under dependency determinations?
• If the insurer delays denial after 90 days but later presents new evidence discovered after 90 days, what can the denial be based on?
• If no objection is filed within the required period, the claim becomes compensable after how many days?
• What is prima facie evidence attributed to each injury?
• A worker earns $2000 per week for six months and collects unemployment benefits the rest of the year. He returns to work and is injured on his first day back. What is the correct total TD rate?
• What is the standard rating for someone with moderate vertigo?
• There are _____ cervical vertebra.
• A self-insured employer has denied a claim but the file does not properly document the reason for the denial. What is the amount of the penalty?
• What is the term for the lateral movement of the wrist toward the little finger side?
• Arthrodesis means which of the following?
• What are the correct supplemental job displacement benefit amounts by PD rating?
• The nucleus pulposus is
• Within how many days must a petition for reconsideration be filed?
• Which statement about liability for permanent disability is correct?
• What standard rating corresponds to constant moderate pain?
• You do not agree with the Agreed Medical Examiner's findings. You should:
• Which statement best describes how impairment is typically expressed in SIP ratings?
• What is the SJDB voucher amount for category 50+ before 2013?
• How is the penalty described for unreasonable delay or refusal to pay an award?
• What is the purpose of an interim report in workers' compensation?
• When a self-insured certificate has been revoked, the Director retains jurisdiction for what period of time:
• Tear of the medial meniscus of the knee.
• Which of the following is true about the ability of the manager to require an additional self-insured annual report?
• A bucket-handle tear refers to a tear of which structure?
• Dupuytren's contracture involves which body part?
• Under the regulations, you have to respond to a request for medical treatment within how many days?
• Which entity must contract with a TPA for the first five full calendar years?
• A bartender with earnings of $600 per week, averages tips of $250, and also receives one free meal per day from the employer. The employer's cost of the meal is $15. If the employee paid for the meal it would cost $125 per week. What are the employee's earnings for compensation purposes?
• Which is the largest artery in the body?
• The artery which carries the blood from the heart to the lungs?
• What is the penalty for failure to file a complete or timely annual report?
• Must UR Policies and Procedures be filed with the Administrative Director?
• If a claim is not denied within 90 days, it can only be denied later based on what?
• After January 2008, how long can Temporary Total Disability (TTD) benefits be paid before expiration?
• Fibromyalgia is best described as chronic pain in which tissues?
• Which term describes the anterior curvature of the spine?
• Forward curvature of the spine is referred to as which term?
• In a knee injury scenario without motion loss but with a brace, what is the standard rating?
• Tailbone
• A patient described as having no rateable pain would be classified as which level?
• In that third-party case, what is the attorney fees amount?
• In a scenario where an employee is injured at work, off work the next day, sees a doctor two days after the injury, and is hospitalized three days after the injury, when does the waiting period start?
• What does the California Insurance Guarantee Association (CIGA) primarily insure?
• TD stands for which term in workers' compensation context?
• In the context of a 132a violation, which outcome is described for the injured worker?
• Which section specifically defines ‘Employer’ to include state agencies and public entities?
• A 27 year old chemist has a chemical burn to the eyes in 2010 producing a 14% whole person impairment. What is the rating?
• An applicant's attorney files an application for adjudication of Claim. You choose not to be represented. What documents do you file with the WCAB?
• A DIA form 510 in a death case must be filed unless the employer has actual knowledge that:
• Under the 4850 Public Safety Officers provision, how many days are provided if there are no dependents?
• Which elements are involved in the suspension of physician, practitioner; or provider from participation in the Worker's Compensation system for cause, including notice and hearing; adjudication of liens?
• What is the weight-bearing and larger bone of the lower leg?
• Who do you report fraud to?
• Which statement is true about burial expenses after 2013?
• The calcis (calcaneus) is which bone in the body?
• What was the maximum burial expense for the year 2013?
• Which large muscle runs along the side of the neck and upper back?
• True or False: A self-insured who elects to purchase an aggregate excess policy shall not be given any credit towards the security deposit to be posted due to aggregate insurance coverage.
• Which statement about TTD expiration is true after January 2008?
• Which statement describes keeping claim files out of state?
• Which term is used for a heart attack?
• Which penalty amount is stated in the material?
• A pain could be tolerated but would cause a marked handicap in the activity precipitating the pain is best described as which level?
• Fracture of the lower part of the fibula and tibia just above the ankle. The most commonly encountered fracture above the ankle.
• The act of bending or being bent, opposite of extension is called what?
• When is settlement of vocational rehabilitation permitted?
• Backward flexion or bending of the foot or hand upward is called?
• Which fingers are most commonly involved in Dupuytren's Contracture?
• The director may revoke a certificate of consent to self-insure for what reason?
• If an employee is represented and the employer objects to the treating physician's recommendation for spinal surgery, how many days are allowed to reach agreement on a second opinion and what professional is involved?
• If temporary disability is payable more than two years from the date of injury, this is governed by which rule?
• Which data field is not required in the claim log?
• Which of the following is an obligation of former self-insurers?
• In Medical Provider Network planning, who approves the plan?
• What is the standard rating for someone with moderate vertigo?
• What is the difference between the maximum and minimum TD Rate for 2007?
• An experienced indemnity examiner must have how many years of handling claims within the past eight years?
• What is the cap for partial dependents under the four-times support rule?
• Labor Code 4850 provides paid leave of absence for which group?
• In excess insurance, which term describes insurance that provides coverage after a self-insured retention or underlying policy layer?
• A Colles fracture most directly involves which bone?
• Which term describes injuries resulting from repetitive mental or physical trauma over time that cause disability or require medical treatment?
• The back of the elbow is formed by which structure?
• The fibula is the smaller bone and bears relatively little weight. Which option best states this truth?
• An employee sustains an injury entirely off duty while running personal errands. Is this compensable?
• What are future liabilities on the annual report estimated as?
• An employee at home for a workers' compensation injury contracts measles from a child. What are you liable for?
• Proof of service is mandatory with what type of notice?
• What is the temporary disability (TD) rate for an injury in 2005?
• Bucket-Handle Tear(Meniscus) describes tear of the medial meniscus.
• An examiner cut off TD after the treating doctor released the employee to return to work on June 3, but the employee does not return until June 14. What should you do?
• Which item is not required to be included in the Claim Log?
• Fraud involving workers' compensation cases is reported to?
• Which status applies to a child under 18 or a child of any age who is physically or mentally incapacitated from earning when considering support for a deceased employee?
• In the medical expenses example, how much was incurred in 2005?
• Who is responsible for enforcing benefit notices and timeliness of first payments?
• Which term denotes total hearing loss defined by a decibel criterion?
• What recourse does an employee have if an employer fires them for reporting an industrial claim?
• Which permanent disability is presumed to be total in character?
• An upper extremity impairment rated as 100% corresponds to what percentage of whole person impairment?
• Which statement reflects the standard rating for complete immobility of the great toe?
• What is the TD Rate minimum across 2006-2008?
• Which condition is explicitly associated with the duty belt in the listed occupational conditions?
• The director may not accept as a deposit to secure incurred liabilities for the payment of compensation and the performance of obligations of a self-insured employer;
• Which statement is true about the filing deadlines for private and public self-insurers?
• What does the acronym TTD stand for in workers' compensation?
• What is the current burial benefit cap (2013-present)?
• What is the maximum amount a person can make in order to qualify for total dependency?
• When is the document considered filed with the WCAB?
• The interim reporting due for private SI plans is due within how many days?
• Which statement about interim report due dates is correct?
• Which statement best describes the valuation of securities by the manager?
• Which type of audit requires written permission?
• As a self-insured administrator how long do you have to maintain the claims file?
• A DEU rater with a report that apportions PD for an unrepresented worker must send the report to which body for review?
• For injuries on or after January 1, 2005, maximum WPI is 100%. If necessary, it may be increased based on pain-related impairment assessment.
• To protect your right to recover workers' compensation payments from a negligent third party you should file?
• An injured worker unreasonably fails or refuses to get medical treatment for his injuries. You should?
• Injury includes items?
• The Administrative Director shall prescribe reasonable rules and regulations for serving on the employee, notices dealing with the payment, nonpayment, or delay in payment of temporary disability, permanent disability, and death benefits. Which provision governs these notices?
• How many days does an employer have to provide a change of physician form?
• If the applicant has received a prior award of permanent disability, what is conclusively presumed at the time of any subsequent industrial injury?
• Enacted by the legislator and signed by Governor Arnold Schwarzenegger, April 19, 2004, made comprehensive change in California's Worker's Compensation system. Most changes took effect on urgency basis causing turmoil at the agencies responsible for overseeing workers compensation. Which Senate bill is this?
• Which of the following best describes the employer's obligation to medical care under workers' compensation rules?
• The Director may not accept as a deposit to secure incurred liabilities for the payment of compensation and the performance of obligations of a self-insured ER.
• The zygomatic bone forms the prominence of the cheek. Which option best describes this bone's location?
• What is the act of bending a joint called?
• Who established the MPN?
• What are the annual report dates for private and public insurers?
• The director may only accept certain forms as payment for self-insurance obligations. Which of the following is NOT an accepted form?
• For public self-insurers, the annual report is due by which date?
• For injuries on or after January 1, 2013 that result in death, burial expenses are payable up to what amount?
• Annual report for private and public self-insurers is due when?
• Which application types have a 21-day notification period after receipt?
• Otitis media involves which part of the ear?
• When may an EE treat outside of the MPN?
• The fibrous tissue that stabilizes joints by connecting bones is called what?
• Occasional severe back pain takes what standard rating?
• The bones of the foot between the ankle and the toes are called which term?
• Coming to or returning to work at an odd hour at the request of the employer falls under which concept?
• The self-insurer's 'expected level' is commonly referred to as the undiscounted ________ ________ _____________.
• Under this division, 'compensation' means compensation and includes benefits conferred by this division upon an injured worker or, in the event of his death, upon his dependents.
• Which PD range has an SJDB cap of $8000?
• Under Labor Code 3212.1, cancer presumption applies to which group?
• Rateable permanent disability shall not be increased if the subjective disability is described as:
• What is the maximum amount of the increase in compensation when reinstatement occurs after injury?
• Which document must the employer provide to explain access to the MPN and how to access care?
• If the maximum temporary disability rate for 2010 is $986.69, and the calculated two-thirds rate would be $1,200, what is the actual TD rate?
• Which of the following is a tarsal bone?
• Absence of the eye's natural lens is called?
• Who appoints the Medical Director, the physician named under Section 122?
• Which term refers to the heel bone?
• Which statement best describes LC 3301 ‘Specified Sponsors Not Employers’?
• Once an employer has initiated a self-insurance program, the employer's certificate to self-insure is valid until when?
• In a 1992 injury case where the permanent disability award was $69,782 and the board found the injury resulted from serious and willful misconduct, by how much may the compensation otherwise recoverable be reduced?
• If you fail to notify the excess carrier of a claim, the excess carrier may:
• Which entity is associated with three types of audits?
• Inflammation of bone and joint is termed which condition?
• When an employee sustains a second injury or aggravation, what is a valid approach to disability ratings?
• In the scenario with three wholly dependent for support on a deceased employee and additional partial dependents, the partial dependents would receive: (cap question)
• For a temporary disability payment, which TD rate should be used when the payment is issued?
• If an employee files a workers' compensation claim and experiences retaliation, what claim may they file?
• Under Labor Code 3300, the state in every state agency is listed as an example of what?
• The heel bone is called what?
• Which section states that offering or delivering any rebate or other consideration is a felony?
• Which muscle is the large muscle of the neck and upper back?
• Means fire fighting member and member of a fire department
• An ER has established a UR department under LC 4610 and hired a nurse to approve or deny requests. This is:
• Which scenario illustrates a valid exception to the coming-and-going rule due to a special risk?
• The employee is receiving salary continuation from the employer in lieu of TD. Is DWC notice required?
• TD payments are issued according to which schedule?
• What term means difficulty breathing?
• What is the statute of limitations for subrogation claims?
• A death case may be filed within how long?
• A Colles fracture involves which forearm bone?
• Movement of the hip toward the body?
• In assessing permanent impairment of the index finger, which factors are typically considered?
• A petition for Writ of Review must be filed within 45 days after a denial of the Petition for Reconsideration. Which deadline is correct?
• Carpal tunnel syndrome is associated with which nerve?
• Hoarseness takes what standard rating?
• Which statement best describes subjective factors in disability assessment?
• Which option correctly describes the master certificate qualification after July 1, 1994?
• In order to qualify for self-insurance after July 1, 1994, which net worth and average net income profile would meet the standard?
• Under the Hofmeister Two Year Rule, what is the PD payment status when there is a good faith issue?
• A knee injury produces no objective disability or work restrictions but the physician prescribes a local knee brace. What is the standard rating for the knee?
• UR Review Policies and Procedures shall be filed with which entity?
• Arthrodesis means:
• Which statement is true about the 50% misconduct reduction when the employee is a minor?
• Which scenario demonstrates an exception to the Labor Code 3600 special risk concept?
• Which entity is responsible for paying indemnity benefits for a work-related injury?
• Which bone is the collarbone?
• If an employer directs you to deny a compensable claim and you know it is compensable, what should you do?
• What is aggregate excess insurance?
• Which statement best describes aggregate excess insurance?
• Within how many days must the death notice be filed?
• By what factor is upper extremity impairment converted to WPI?
• The 90-day period in which a claim denial must be issued begins from which date?
• Under the going and coming rule, injuries occurring while traveling to or from work are generally:
• In the Hepatitis C scenario, which benefit is typically provided under workers' compensation?
• Which bone is the collarbone?
• Which Labor Code addresses objection to medical determination when an employer objects to a treating physician’s recommendations?
• Conjunctivitis involves the:
• A seasonal employee works six months a year and is a max earner; while not working he is a min earner. What is his TD rate out of season?
• Under California Labor Code 4610, who may modify, delay, or deny a request for medical treatment?
• For public self-insurers, the annual report must be filed by what date?
• Division Four in Division Five of the Labor Code should be ______. _____ by the courts with the purposes of extending benefits for the protections of persons injured in the course of employment.
• Unless there is an Order of Credit estimates of future liability may:
• PD rates can involve considering average weekly earnings in its computation. True or False?
• The scaphoid bone is part of which area?
• Where is the lacrimal bone located?
• Who may revoke a self-insurer's Certificate to Self-Insure?
• If nothing is done within 60 days, what is added?
• The employer must provide the employee with a DWC-1 claim form within how many days?
• In the example where combined weekly earnings equal 880, dividing by 1.5 yields the TTD rate. What divisor is used in that calculation?
• Which statement is true about misconduct by the employer increasing the employee's compensation?
• If the Director of Industrial Relations determines that a private self-insured ER has failed to pay required benefits, he/she may:
• Which describes a compound fracture?
• The statement 'After revocation, the director's jurisdiction over work injuries sustained during the period of self-insurance shall not continue until all liabilities and all responsibilities have been terminated in accordance with law.' is:
• Formal rating determinations shall be deemed to constitute evidence:
• Utilization Review (UR) in the California workers' compensation context stands for Utilization Review. True or False?
• What term means the surgical repair or replacement of a joint?
• Which is the smaller of the two lower leg bones?
• Otitis media involves which part of the body?
• If a physician lunch arrangement is considered a prohibited benefit, which of the following is the most appropriate action for the employee?
• What must you do to initiate a subrogation claim?
• What is the manual or electronic listing of work comp claims maintained by the self-insurer called?
• If the injury occurs to an employee under 16 years of age and illegally employed at the time of injury, the entire compensation otherwise recoverable shall be increased by
• In the nursing student scenario, what is the temporary disability rate after graduation but before receiving the nursing certificate?
• Formal rating determinations shall be deemed to constitute evidence in which manner?
• The lacrimal bone is located near which anatomical feature?
• Which of the following cannot be commuted except for first aid claims?
• Which option lists the three basic elements of rating for knee disability?
• A petition for Reconsideration must be filed within how many days of service of a findings and award by the WCAB?
• How many distinct SJDB voucher category ranges existed before 2013?
• What is the anatomical term for the cheek bone?
• An employee, whose diabetes is out of control, punches out at 3 pm. Before leaving the company parking lot, he faints and falls fracturing his elbow. You should:
• If an employer is guilty of serious and willful misconduct employees compensation is...
• The ER shall notify the administrative director of each employee death, except when ...
• Which term means pertaining to the heart?
• Under the 2018 DOI rules, if the treatment is rendered by a physician or facility selected by the ER, the EE is eligible for treatment within how many days following the DOI?
• Which PD range yields the highest Permanent Disability benefit?
• If a self-insured purchases an aggregate excess policy, shall they receive any credit toward the security deposit?
• To rotate the forearm so the palm faces downward.
• An injured employee who is temporarily disabled is incarcerated for an unrelated crime. You should:
• Are vocational rehabilitation cases required to be reported on the annual report?
• Which of the following is not accepted as a deposit to secure incurred liabilities for a self-insured employer?
• In a third-party recovery with a WC lien, does the lien reduce the net recovery payable to the employee?
• What is the bony projection of the ulna at the elbow?
• If accurate weekly wages cannot be determined, how should TD be determined?
• Who can modify, delay and deny requests for treatment?
• Which per-violation amount is specified for the most serious violations?
• A stipulation in a workers' compensation proceeding means what?
• Inflammation of bone and cartilage is described by which term?
• An employee's injury is aggravated by the employer's fraudulent concealment of the injury and its connection with the employment. Which liability applies?
• Which guidelines govern the evaluation protocols and rating procedures for impairment mentioned in the material?
• Permanent disability with a rating less than 100% is called:
• Which bone in the hand is also known as the navicular bone?
• In the knee rating scenario where a brace is prescribed but there is no objective disability, what is the standard rating?
• Which socket houses the head of the femur?
• An self-insured ER has not adequately funded their trust account for over a week, preventing payments on claims. What action is required?
• If an employee is terminated following an industrial injury after filing a workers' compensation claim, which benefit package applies?
• Which of the following best describes when a claims file is considered closed?
• Which nerve is the largest in the body and runs from the spine to the foot?
• Which term refers to the arteries supplying the heart muscle?
• In a CA workers' compensation context, which day was used for indemnity payments via an Ohio bank?
• What connective tissue connects bone to bone?
• How can a person demonstrate individual competence as an administrator for a self-administered self-insurer or agency-administered self-insurance program?
• Occasional severe back pain takes what standard rating?
• When determining a TD payment for a late payment, which rate should be used?
• In a knee injury scenario with a brace and no objective disability, which rating applies?
• What is the most common type of arthritis?
• Utilization Review is primarily concerned with which aspect of medical treatment in workers' compensation?
• For a seriously and willfully misconduct case, with 50% PD, what is the proper procedure before reducing benefits?
• The six-month interim period covered by public self-insurers is which dates?
• How many days do you have to dispute a medical bill?
• Synovial describes a substance found where?
• A public or individual private self-insured employer shall notify the chief in writing within how many days of a change in status?
• Who is responsible for enforcing benefit notices and timeliness of first payments?
• If PD is 50%, what portion of compensation should be paid to the employee?
• Which statement lists the four types of ratings issued by the DEU?
• When a private self-insured employer fails to pay required benefits, the Director may
• Which bone is the shoulder blade?
• Which artery carries blood from the heart to the lungs?
• If the Director of Industrial Relations determines that a private self-insured ER has failed to pay required benefits, what may the Director do?
• What are the weight-bearing bones of the leg?
• If an employer fails to initiate a self-insurance program within six months, what action is required?
• Which is considered first aid in the context of an industrial injury?
• An examiner cut off temporary disability based on a doctor's return-to-work date but the employee returns later. What is the proper action to verify the return-to-work date?
• Which describes a compound fracture?
• Leg braces when prescribed may be used:
• Which statement is a possible civil penalty enforcement action?
• Which term refers to the carpal bone of the wrist (as listed in the material)?
• A Colles fracture involves which bone?
• What percentage conversion is used to convert upper extremity rating to whole person?
• The UR process is governed by which type of written documents?
• The manager for good cause may require any self-insured to submit a self-insurer's annual report covering which period in addition to the annual report?
• A greenstick fracture is a?
• For a public safety officer who contracts tuberculosis it is?
• Which statement is true regarding disclosures to the manager by self-insurers?
• An injured worker with dependents is incarcerated for an unrelated offense. Temporary disability otherwise due is:
• In the Colles fracture case, the permanent disability was 13 percent.
• Bucket handle tear is a term used to describe a knee meniscal tear; what is its exact name?
• Fracture in which the fracture lines slants across the bone.
• Which of the following is not a valid interim period for self-insurers?
• What is the term for a fracture in which the bone has been twisted apart?
• Which definition best describes a medical only claim?
• What is the maximum temporary disability rate for an injury in 2010?
• Which condition is included under the Total Permanent Disability Presumption?
• A fluid-filled lump near a joint, often on the wrist or hand, is known as which?
• If the director revokes a self-insured license, who retains jurisdiction over ongoing claims?
• What is the maximum TD Rate for 2006?
• Otitis media is inflammation of which part?
• What does Date It Is Received determine in WCAB filing?
• An accountant took work home for an annual report. The employee left work at the normal appointed hour and was not reimbursed for mileage. The employee was injured in an automobile accident at an intersection one block from home and his supervisor calls to tell you they found paperwork for the end-of-the-year report in his briefcase in the car. You should:
• Which statement about the death notice filing deadline is true?
• What best describes the deductible amount paid by the insured before coverage applies?
• If the employee would have paid for the meal, how much would the weekly cost be?
• Which statement best reflects the action to take if there is a valid claim of employer serious and willful misconduct?
• When a self-insured license has been revoked, the Director retains jurisdiction for what period?
• Which of the following is NOT a type of arthritis listed in the material?
• The navicular bone referenced in wrist injuries is located in which region?
• Loss of the radial head is a ____% absolute.
• What are the three basic elements of rating for knee disability?
• The five metacarpals are collectively known as which singular term?
• Which entity electronically files the actuarial summary?
• MRSA stands for which organism?
• The interim report for public self-insurers is due on which date?
• When a file review indicates a valid claim for serious and willful misconduct by the employer, you should?
• Are medical-only claims included on the Annual Report?
• Under LC 4062(b), when can the ER request a second opinion?
• When may an EE treat outside of the MPN?
• Should excess carrier claims be reported on the annual report?
• Which statement is true about the compensable consequences doctrine?
• Chronic widespread pain in muscles, soft tissue and joints with fatigue is known as what?
• A fracture that involves multiple fingers is called what?
• Where an injury causes both grip loss and atrophy what does the injured worker get?
• Which code section governs the Administrative Director's penalties for less serious violations?
• Under Labor Code 3300, the legal representative of any deceased employer is categorized as which?
• Under workers' compensation, a person rendering service for another, other than as an independent contractor, is presumed to be what?
• Which Labor Code section defines the date of knowledge used to determine when an employer is aware of the injury?
• Which presumption applies to public safety officers?
• Under LC 3208, which statement is accurate about replacement of eyeglasses and hearing aids?
• A knee injury with no objective disability or work restrictions but a long leg brace is prescribed. What is the standard rating for the knee?
• In a PD calculation scenario with serious misconduct, what is the Board's likely award?
• The first payment of temporary disability is due no later than how many days after knowledge of the injury and disability?
• Under LC 3208, 'injury' includes which of the following items arising out of employment?
• In the event of trapezius muscle injury, which body area is affected?
• The employer's personal liability is described as which of the following?
• The largest artery of the body is the:
• Under the law, which entities are included in the term 'Insurer'?
• The six-month interim period covered by private self-insurers is which dates?
• You do not have to notify the Manager of a change of status where:
• The bony projection of the ulna at the elbow
• When the employee's attorney requests payments be sent to the attorney's office, what is the correct recipient for disability benefit payments according to the scenario?
• In workers' compensation, what term describes the sole remedy available?
• What happens when a physically or mentally incapacitated dependent turns 18?
• Which condition would most likely allow a Vocational Rehabilitation settlement?
• What does MTS stand for in the context of medical treatment regulation?
• What is the penalty for failure to file a complete or timely annual report?
• Who provides the Self-Insurers Annual Report form?
• What is the standard rating for an injury in 1997 involving an amputation of the major thumb at the carpal joint?
• Dupuytren's contracture involves which part of the body?
• The specific excess policy shall not have a retention level above ______ nor an upper limit of less than ______________.
• The injured employee contracts Hepatitis C from a blood transfusion during surgery for a work related injury. You are responsible for:
• Is an insurance company allowed to keep claim files out of state? If so, when is it okay?
• SJDB for permanent partial disability award less than 15% is up to how much?
• Are meals provided by the employer considered part of an employee's earnings for workers' compensation purposes?
• Which entity is the appropriate authority to petition when changing an employee-selected physician?
• The employee arrived at work early. WHile in the company parking lot the employee is hit by a passerby. The injury is:
• If an injury occurs after 2005, what is the maximum permissible add-on for subjective symptoms?
• Which bone is commonly referred to as the cheekbone?
• The report apportions permanent disability and must be sent to which entity?
• Which formula is sometimes used for bilateral vision impairment when calculating disability?
• The administrative Director’s duties under Labor Code 138.4 include appointment, qualification, suspension, termination of QME's; time frames, guidelines, procedures, and immiscibility of medical evaluation. Which is the missing element in that list?
• A pain that could be tolerated, but would cause a marked handicap in the activity is described as which level of pain?
• If you accept any rebate, refund, commission, preference, patronage, dividend, discount or other consideration, the fine will be up to
• 60% of a whole person impairment equals what decimal value?
• DWC-1 500E is used to communicate what action?
• The Disability Evaluation Unit Rater who apportions permanent disability must send the report to which entity?
• A medical clinic physician that you refer all your patients to calls and says he wants to take you out to lunch every week to thank you for your referrals. What should you tell the doctor?
• Which statement best explains the concept of 'special risk' in workers' compensation?
• To whom do you apply for a certificate of consent to self-insure?
• Under AMA Guides apportionment is based on?
• The presumption is rebuttable only by evidence discovered after which period?
• Which rule best describes the basis for apportioning PD when a subsequent injury occurs?
• What is the TD Rate maximum across 2006-2008?
• When a self-insured license has been revoked, the Director retains jurisdiction for what period of time?
• Which bone is the shoulder blade?
• A 47 year old electrician has a knee injury with certain impairments. Permanent disability is what percentage?
• To protect your right to recover workers' compensation payments from a negligent third party you should file:
• Under the 'Preponderance of the evidence' standard, which statement is true?
• Which statement best describes compensability of injuries arising out of or in the course of employment when negligence does not matter?
• After public hearings, who shall adopt and periodically revise the official medical fee schedule?
• A 5020-employer’s report of occupational injury must be filed within how many days?
• If you receive an Employer's First Report of Injury (5020) but accurate weekly wages cannot be determined, how should TD be determined?
• A Colles fracture involves the radius.
• Nucleus pulposus is the gelatinous core of the intervertebral disc
• The employer hires an employee with pre-existing arthritis and the employer wants the employee to sign a waiver that they are not responsible for the pre-existing condition. You should tell the employer:
• The spousal definition including registered domestic partner is codified in which Labor Code section?
• What term describes the farthest joint of the finger?
• For therapy visits, how many visits are allowed per category for an industrial injury?
• Which disease is listed specifically for Park Rangers?
• Under Labor code 129, the Administrative Director must do what regarding payment schedules and penalties?
• Which term is used to describe a myocardial infarction?
• "Shall" when used in the LC means?
• What type of fluid is present at synovial joints?
• A soft tissue lesion of the neck is rated under which impairment descriptor?
• In a seasonal, out-of-season TD rate calculation, the rate is two-thirds of average annual earnings from all employment.
• If there is no MPN, after how many days does the employer choose a physician of choice?
• Trapezius muscle damage would impact which part of the body?
• Absence of the lens of the eye is called?
• If an injury occurs in late December but is not reported until January of the next year, in which claim log is the injury reported?
• Apportionment is based on which factor?
• Once a self-insurer has initiated a self-insurance program, the Certificate to Self-Insure is valid until revoked by whom?
• Apportionment in workers' compensation is based on what factor?
• Which statement about independent contractor status is correct?
• If a self-insured employer has not adequately funded their trust account, within how many days must you report to the Manager?
• Labor code 4610 is associated with which regulatory process?
• Which statement best describes the concept of liberal construction as applied to this division?
• To which body may the Director refer a nonpayment issue related to benefits?
• Which civil penalty amount is possible for wage-related violations under SIP enforcement?
• Which condition describes hearing loss associated with aging?
• Which bone is located in the lower leg?
• How much can you pay for burial expenses for DOI prior to 1/1/91?
• A medical only claim is:
• In 2006, the death benefit for one dependent was how much?
• Once an employer has initiated a self insurance program, the ER's certificate to self insure is:
• Which date is used to determine the filing date for a document submitted to the WCAB?
• In that third-party case, what is the costs amount?
• Who is responsible for enforcing benefit notices and timeliness of payments?
• An employee seriously injured due to his own serious and willful misconduct. The compensation is reduced by 50% unless
• A presumption for certain public safety officers that a hernia, pneumonia, or heart trouble arising during service is in the course of employment is codified in which Labor Code section?
• Which forearm bone lies on the little finger side?
• Loss of the radial head is a ____% absolute.
• If an employee is terminated after filing a claim and is entitled to compensation adjustments, which option correctly describes the entitlement?
• An employer tells you they fired an employee for reporting an industrial injury. Which action should you advise the employee may pursue?
• Which Labor Code provision requires the employer to provide a claim form and notice of potential eligibility within one working day after an injury resulting in lost time beyond the shift or medical treatment beyond first aid?
• When is the due date for the private interim report?
• Pain radiating along a nerve path is most consistent with which condition?
• In a scenario where an injured employee contracts Hepatitis C from a blood transfusion during surgery for a work-related injury, which of the following is the employer's responsibility?
• What does P&S stand for in impairment rating terminology?
• When earnings are irregular and shown on a wage statement, what is the correct TD rate?
• A trapezius muscle injury would primarily involve which anatomical region?
• Which bone is located in the thigh?
• Injury to the trapezius muscle is most likely to affect which body part?
• In the bartender earnings scenario, what are the employee's earnings?
• Which term refers to the thigh bone?
• For a 17-year-old who is injured and qualifies for temporary disability (TD), which option best describes the permanent disability (PD) rate?
• The Colles fracture case yielded a permanent disability of 13%. This percentage is derived from grip strength comparisons between the injured and uninjured hands.
• An employee who does not receive mileage reimbursement for use of his car, while on an unpaid lunch hour, is injured while on his way to the bank to cash his paycheck. You should:
• What is the role of the investigator assigned to pursue issues of compensability?
• By what date must a qualified actuary submit an actuarial study and summary to OSIP?
• A self-insured employer has not adequately funded their trust account, preventing you from making payments on claims. You are required to report it to the manager within:
• When an occupation occurs which is not listed in the schedule you should?
• The employer has an aggregate excess Worker's Compensation policy. Does the employer receive credit against the security deposit?
• Which muscle located on the back and involved in extending and adducting the arm?
• In the scenario of a February injury with a July aggravation, what is the recommended file action?
• Administrative Director is
• Which condition involves pain in muscles and soft tissues rather than joints?
• Should you notify the chief of a change in status when the self-insurer changes ownership?
• The five bones of the palm of the hand are called which term?
• What is the end of the radius at the elbow called?
• What happens to death benefits after the employee dies?
• Which bone is located in the face?
• The self-insurer's penalty is covered by the Self-Insurers Security Fund. Which option best expresses this?
• You are applying for a master certificate after July 1, 1994. what is the amount of net worth and net income needed to qualify for self-insurance
• Which term describes an injury that occurs as the result of a single incident or exposure?
• How much is added if you make a late payment?
• If the employee's permanent disability is determined to be 15 percent, which option represents a typical alternative to a full trial?
• Which two fingers are commonly affected by Dupuytren's Contracture?
• Which bone is the outer bone of the forearm on the side of the thumb?
• How many lumbar vertebrae are there?
• Under California workers' compensation rules, when is a document considered filed with the WCAB?
• If settlement of vocational rehabilitation is permitted and decided against the employee, this would defeat the employee's right to ______ ______________.
• If an employer fired an employee for reporting an industrial injury, you should:
• In the case of insurer delay due to filing error, what remedy should be pursued?
• A medical-only claim is defined as which of the following?
• Which entity is responsible for approving a Medical Provider Network plan submitted by the ER or insurer?
• Collarbone
• LC 4660 authorizes which entity to prepare, adopt, and amend a schedule?
• Coughing up blood is medically termed which of the following?
• Which of the following is true about AOE/COE in relation to workers' compensation?
• What is the minimum TD Rate for 2007?
• Fracture that spirals around the bone due to twisting.
• In the Colles fracture case of a 21-year-old baker, the permanent disability percentage is:
• An employee is injured at the place of employment when he burns himself in the kitchen while cleaning up after a meeting with other employees and his supervisor. The injury would have not occurred had the employee not been drinking with other employees during the meeting.
• Which of the following is true about late PD payments?
• How many days does an ER or insurance carrier have from the date of request to provide an employee with a change of physician form?
• An employee works 40 hours a week and earns $16 per hour. He has a second job working 20 hours per week and earning $12 per hour. If he is unable to work both jobs what is the temporary disability rate for an injury in 2008 that occurs on the $12 per hour job?
• Which condition triggers the 1/2 reduction in compensation?
• Which action constitutes a crime under LC 3215?
• Which of the following statements correctly describes the base rule for when a court or insurer reduces benefits due to misconduct?
• Zygoma involves what part of the body?
• Who must file the Self-Insurer's Annual Report on a form supplied by the director?
• Private self-insured employers are audited on a cycle. Audits must be completed within a cycle of how many years?
• According to the payout schedule, after the first payment, subsequent payments are made how often?
• If an employer forces workers to receive WC benefits at a lower rate, what is the employer's liability?
• What term refers to degenerative osteoarthritis of the joints of the vertebrae?
• For a period of disability paid more than two years after the DOI, the rate is determined by the law in effect on which date?
• Under Labor Code 3300, the sponsor of a bowling team is treated as what?
• If an employee is forced to accept less money than due, the employer may face civil penalties up to which amount?
• In the scenario with three persons wholly dependent for support on a deceased employee and additional partial dependents, the partial dependents would receive:
• Which description best defines an experienced claims adjuster under California workers' compensation?
• In the described third-party subrogation scenario, the workers' compensation lien is deducted before determining the net amount paid to the injured worker.
• Orthoscopy is best described as which examination?
• Which lung disease is caused by silica dust exposure?
• Diabetes out of control punches out at 3 pm, faints and fractures elbow. You should:
• Inward turning of the eyelid is called?
• Specific excess insurance is described as:
• In a scenario where the surviving spouse earns less than $30,000 prior to death, the spouse is considered what?
• Which of the following does not produce rateable disability?
• In 2004 the employee has an injury to the knee. There is no loss of motion, no instability and no thigh atrophy. The employee must wear a stretch knee brace. What is the standard rating?
• In the context of compensability investigations, which statement best describes the investigator's role?
• Which form is used to report a work injury to the insurer to initiate disability benefits?
• Under California workers' compensation, when may compensation be paid to an attorney or other agent?
• What is the net worth requirement listed for the SI plan?
• Which option identifies the party that initially files the adjudication application?
• What is the minimum TD Rate for 2006?
• Which of the following does not involve the lungs?
• What is the maximum burial expense for an injury in 2007 resulting in death?
• Which supplies blood to the heart muscle?
• If a WCAB issues a notice to pay benefits to a TPA, what is the proper course of action?
• For private self-insurers, what is the deadline to file the Self-Insurer's Annual Report?
• The manager shall value securities at which values, whichever is less?
• What is the medical term for inflammation of bone and cartilage?
• Which type of excess insurance addresses loss frequency by providing coverage once a cumulative per occurrence loss limit is breached?
• Which is the thigh bone?
• The phrase describing serious and willful misconduct is 'Beyond gross negligence'. What is the consequence for benefits?
• Loss of the natural lens of the eye is referred to by which term?
• The navicular bone belongs to which set of bones?
• In 2005, what is the maximum permissible add-on for subjective factors in workers' compensation ratings?
• In the workers’ compensation process, the DWC 500-E denial letter is best described as which of the following?
• The metatarsals are located in which part of the body?
• Which condition is described by pain in the legs following the path of the sciatic nerve?
• Injury from overstretching of ligaments or joints is called?
• When an injury causes both grip loss and atrophy, which rating applies?
• Arthroplast means?
• Average reserves for FMC are estimated as which of the following?
• During stipulation to a permanent disability award, a furniture company claims the employee owes them $2000. What is the proper action?
• How long can the presumption for public safety officers be extended?
• Without an Order of Credit, estimates of future liability may:
• A fracture attributed to repetitive use or overuse is described as what?
• If there is a new TPA, who is responsible for filing the report with the Director of Industrial Relations and what is the timeframe?
• The loss of a radial head is a 5% absolute. What is the absolute percent of loss of radial head?
• How many Chiro/Occupational/PHysical therapy can you have for an industrial injury?
• Who makes the director's decision to allow or deny self-insurance or to advise the application is deficient?
• In workers' compensation terminology, what does PD stand for?
• The plan for the Medical Provider Network (MPN) must be approved by which official?
• Are medical only claims included on the Annual Report?
• The condition caused by compression of the median nerve at the wrist is commonly known as which syndrome?
• In the described 4850 scenario, which category of benefits is being discussed?
• Rehabilitation benefits can be settled in which scenario?
• An employee, not paid for mileage, goes to the bank on his lunch break to cash his paycheck and is injured. The injury is:
• A finding that the injuries result from the injured worker's serious and willful misconduct means which of the following?
• What percentage is the standard for rating reduction of vision?
• A nursing student working part time 20 hours a week earns $10 per hour. Upon graduation her hours increase to 40 hours per week and she is promised a raise to $1,000 per week after receiving her nursing certificate. She has an injury in 2005 while working part-time graduates, completes and passes the nursing exam and receives her nursing certificate. Her temporary disability rate is:
• When a self-insured certificate has been revoked, the Director retains jurisdiction for what period of time?
• Which entity is included as an Employer under LC 3300?
• An employer asks an employee to sign a waiver releasing liability for a pre-existing condition. How is that waiver treated?
• Notwithstanding the maximum limitations of 4702, death benefits for minor children should continue until which event?
• What is the breastbone called?
• What is the term for an audit conducted outside of the normal audit schedule?
• Fracture of distal end of the radius with outward displacement?
• In the context of the substantial-cause threshold for psychiatric injury, which percentage best describes the required causation?
• If the director of IR determines that a privately insured employer has failed to pay required workers' compensation benefits, which self-insurer asset may be used to administer and pay the employer's compensation obligation?
• You do not have to notify the Manager of a change in status in which scenario?
• Which carpal bone is also known as the navicular bone?
• Which muscle is commonly referred to as the broad muscle of the back and is located along the lower back?
• A fracture attributed to the strain of repetitive use or overuse is called what?
• Which option is not a factor considered by the administrative Director when imposing penalties?
• A notice of Employee Death shall be filed with the Administrative Director within ___ days, where the employee left no surviving minor child.
• When is a document considered filed at the WCAB?
• Should you notify the chief of a change in status when the self-insurer has a material change in management?
• Which statement best describes how formal rating determinations are used as evidence?
• When would an IW be justified for missing or refusing to attend a medical exam arranged by the ER?
• The annual report for private insurer shall be filed on or before which date?
• Which of the following is not normally considered in knee disability rating?
• An employee is injured at work and is sent home. He is off work the next day and sees a doctor two days after the injury; three days after the injury he is hospitalized. When does the waiting period start?
• Which term best describes a standard procedure used in California state audits?
• When will the director audit self-insured employers for their adequacy of estimates of future liability of claims for all private self-insured employers?
• Is it acceptable to issue indemnity payments using an Ohio bank if the checks are immediately negotiable at a state-approved location?
• For an injury to the knee January 15, 2011, to a cook 38 years of age, after you adjust for occupation what does the rating do for the age?
• What is the filing deadline for the Self-Insurers Annual Report for private and public self-insurers?
• Which term describes the bone that bears relatively little body weight in the leg?
• The act of straightening a contracted limb is called what?
• Which expression correctly represents the TPD calculation?
• The navicular joint is located between which two bones?
• Which term describes the automatic qualification for total permanent disability due to certain injuries?
• Prior to 2017, how long did self-insurance plans have to approve applications?
• Which disease is listed in the material as Tuberculosis?
• In 2004 the knee injury: no loss of motion, no instability, no thigh atrophy; must wear stretch knee brace. What is the standard rating?
• In a PD 72% case involving serious misconduct, which outcome is most consistent with the source material?
• If an employee fails to return the QME form within the allowed period, what is the typical consequence?
• Reapplication to the Director for a Certificate of Consent to Self-Insure is required if an employer:
• Which statement best describes the purpose of liberal construction of workers' compensation statutes?
• A Safeway employee breaks his leg in 2010 with 10 weeks of TTD, is a max earner, recovers fully, and has no permanent impairment. How should indemnity be reserved?
• Which symptom is described as ringing in the ears?
• True/False: Where the injury is caused by Serious and willful misconduct of the EE the compensation otherwise recoverable shall be reduced by 1/2 where the injury results in death or PD of 70% or more.
• Which action may be good cause for revocation of a self-insurance certificate?
• Which entity has authority to impose penalties for failure to notify the excess carrier about a claim?
• The hip bone is which term?
• Damage to the trapezius muscle would primarily involve which region?
• A DEU rater with a report that apportions PD for an unrepresented worker must send the report to:
• The kneecap is known as which bone?
• What is the maximum burial expense for a death on or after January 1, 2013?
• Which factor is most closely associated with rating impairment for vision?
• Who approves securities values?
• Under AMA Guides apportionment is based on?
• In a case where an employee is terminated after filing a claim, which outcome is possible?
• Which term is a type of injury defined in the division?
• Which of the following best describes the preponderance of evidence?
• Which pairing correctly defines the term with its meaning?
• If a claim is not denied within 90 days, the denial can occur later only if what condition applies?
• Your review of a file indicates the employee has a valid claim for serious and willful misconduct of the employer. You should?
• If an employer offers to settle a claim with a release conditioned on the employee resigning, and the employee has a 15 percent permanent disability, which approach is appropriate?
• If an employee's Permanent Disability is 50%, what percent of the compensation should be paid to the employee?
• Which lung disease results from inhalation of silica dust?
• If an ER's UR department uses a nurse to approve or deny requests for medical treatment, which statement is correct?
• If an applicant has a prior PD award, what is the presumption about the prior PD existing at the time of a subsequent injury?
• Which statement best defines a greenstick fracture?
• All claim files shall be kept in maintenance for a period of how many years from the date of injury or the date of the last provision of benefits, whichever is later?
• What is the timeframe to file a claim for healthcare workers for HIV death benefits?
• Lacrimation refers to which of the following?
• Which term describes risk that is personal and not related to employment?
• A navicular fracture involves which region?
• The compensable consequences doctrine allows compensation for illnesses arising as a consequence of a compensable injury. True or false?
• What is the effect on the security deposit when an aggregate excess policy is purchased?
• What pain is not ratable?
• A child under the age of 18 years old, or a child of any age found by any trier of fact to be physically or mentally incapacitated from earning shall be ________ ________ to be wholly dependent for support upon a deceased EE.
• A self-insurer's certificate remains valid until what occurs?
• What is the bone in the forearm on the thumb side called?
• Does an aggregate stop-loss policy provide credit against the security deposit?
• Which of the following best describes the outcomes the director may communicate after reviewing a complete application?
• Which entity reviews apportionment PD report for an unrepresented worker?
• An irregular pupil
• Entropian means:
• What is the term for the bony segments of the spinal column, totaling 33?
• Which carpal bone is also known as the navicular bone of the hand?
• A medical clinic physician you refer patients to offers to take you to lunch weekly to thank you for referrals. What should you tell the doctor?
• Under LC 3211.5, which individuals are included in the term firefighter?
• What is a PD rating?
• In the context of state audits, what term describes the standard, ongoing process?
• If the employer offers a compromise and release for $12,500 contingent on resignation for a 15 percent permanent disability, what is your recommended position?
• If the employee desires a change of physicians or chiropractor he may petition the _________ _____________.
• Which pulmonary disease results from inhalation of free silica dust?
• If a panel is not signed within _____ days, the employee shall have the right to obtain a medical evaluation from any qualified medical evaluator of his or her choice within a reasonable geographic area.
• When an employee is seriously injured due to his own serious and willful misconduct, the compensation is reduced by 50% unless which condition applies?
• Which term denotes the fluid that lubricates joints?
• If an employee sustains a permanent disability and the injury is found to result from serious and willful misconduct, the compensation otherwise recoverable may be reduced by:
• Which region of the spine contains seven vertebrae?
• Which term means to remove tissue by cutting away?
• If the applicant's attorney requests his fee as provided in the STIP, what is the proper course of action?
• An Order of Credit affects how third-party recoveries interact with future liability?
• How do you avoid pyramiding for multiple parts of the body?
• Who prescribes reasonable rules and regulations relating to the various benefit notices for serving on the employee dealing with right to consult with an attorney, and notices dealing with the payment, nonpayment, or delay in the payment of TD, PD, and death benefits?
• Which term refers to high blood pressure?
• Removal of a disk is called?
• In a case where an employee is injured on December 1, coworker reports December 2, the employee returns a completed DWC-1 on December 3, and the physician takes the employee off work on December 6 through December 16, on which date does the waiting period begin?
• Within how many working days must the employer provide the employee with a DWC-1 claim form?
• Which rule is referenced at the beginning of the material?
• The outer bone of the forearm, on the side of the thumb.
• To be compensable, what percentage must a psych claim meet?
• Which term is used for surgical repair of a joint?
• Which of the following does not produce ratable disability?
• If the employer has an aggregate stop loss (aggregate excess) workers' compensation policy, does the ER receive credit against the security deposit?
• In case of finger amputation at the proximal joint with broken glasses, what should be paid?
• Colles fracture is commonly associated with injury to which bone region?
• There is a bank robbery and an employee victim of a violent act experiences a psych injury with 37% of the causation related to the industrial injury and 63% related to marital problems. Is the case compensable?
• Under which circumstance is the employer not required to notify the administrative director about an employee's death?
• How long does a self-insurance plan have to notify you that your application for self-insurance is deficient?
• If an injury is not denied within 90 days it is?
• An employee is injured during a lunch or coffee break on company premises. Is the injury compensable?
• Degenerative arthritis of the joints is known as which condition?
• An EE seriously injured due to his own serious and willful misconduct. The EE's compensation is reduced by 50% unless:
• Which two bones are described as weight-bearing bones of the leg?
• Which anatomical region houses the eyeball?
• An employee punches out at 3 pm, and in the company parking lot, faints and fractures his elbow. What is the correct course for the workers' compensation claim?
• Cannot submit the request for a QME form unless how many days have passed?
• Which bone forms the heel?
• Which term describes the action of turning the forearm so the palm faces down?
• For a private self-insurer that has not previously self-insured, which arrangement is required for the first three years?
• A trapezius injury would involve which anatomical region?
• A notice of employee death shall be filed with the Administrative Director within how many days, where the employee leaves no surviving minor child?
• If the ER desires a change of physicians or chiropractor, who may he petition?
• What is the medical term for surgical fixation of two levels of the spine to limit motion?
• What penalty and interest applies to HIV death benefits when filed late?
• How long do you have to file a petition to terminate liability for TD after terminating payments?
• MMI stands for which of the following?
• An employee has a finger amputation at the proximal joint and prescription glasses broken. Which should be paid?
• An employee's husband comes to work and shoots her as a result of a marital dispute. The injury is:
• The Uninsured Employers Fund applies to unlawfully collected amounts with which multiplier?
• The first temporary disability (TD) payment is due how many days after the date of the last TD payment?
• Which term means inflammation of a joint?
• The bone of the upper arm.
• Which term describes abnormal sensations such as burning or numbness in response to touch?
• What is the maximum TD Rate for 2008?
• Under LC 3206, when an employee dies, who benefits from compensation?
• Which of the following is a plausible value for the maximum temporary disability rate in 2010 from the options?
• Who is responsible for enforcing benefit notices and timeliness of first payments?
• An injury occurs in late December but is not reported until January of the next year. In which claim log is the injury recorded?
• Which statement best defines a medical-only claim?
• When is a proof of service necessary?
• Apportionment of permanent disability is based on which factor?
• What is the term for the end of the radius at the elbow?
• How many cervical vertebrae are in the human spine?
• Where is the olecranon located?
• The interim report for private self-insurers is due on which date?
• You are paying temporary disability pursuant to an award. How long do you have to file a petition to terminate liability for continuing payments after terminating payments?
• A private self-insurer granted an initial individual certificate to self-insure Worker's Compensation liabilities that have not previously self-insured must contract with a ______ for the ______ full calendar years of self-insurance.
• How should injuries with an aggravation be handled?
• A chef with average weekly earnings of $1300 is injured and later returns to work part-time earning $450 per week. What is the correct wage loss temporary disability rate?
• Which of the following actions is an example of discrimination under Labor Code 132A?
• Ectropion is defined as the outward turning of which structure?
• An injury occurs in late December but is not reported until January of the next year. In which Claim Log is the injury recorded?
• Which bone in the lower leg bears most of the body's weight?
• Which bone is the hip bone commonly called?
• Which fund pays benefits to injured workers when employers illegally fail to pay benefits?
• The definition of nucleus pulposus is which of the following?
• Who handles claims when the self-insured employer's certificate to self-administer is revoked?
• What is the deadline for an adjuster to pay or dispute a medical bill after knowledge of the injury?
• An employee has an injury in February 2000. In July 2000 he has an aggravation of his injury. You should:
• Which statement best describes a Qualified Medical Evaluator?
• An employee is traveling on business at the request of his employer and while stopped for lunch at a restaurant the employee is injured. The claim would be:
• Which statement correctly reflects the 2006 death benefits description by number of dependents?
• Where is the lacrimal bone located?
• Which description matches a fracture where the bone is broken into several pieces?
• Which of the following is not a joint procedure used to treat arthritis?
• What is the hip socket called?
• Which labor code or form is used to notify the Administrative Director of employee death?
• What is the threshold to qualify for presumption of total dependency for a spouse at time of death?
• What is the statute of limitations for subrogation claims?
• A partial fracture in which only one side of the bone is broken is called which type?
• The employer has an aggregate stop loss excess insurance policy. It is:
• Lateral movement of a part of the body, usually the shoulder or hip, away from the body is called?
• A Petition for Reconsideration must be filed within how many days of service of an F&A by the WCAB?
• In self-insurance programs, what is the primary method to ensure timely payment of benefits and compliance with law?
• Which form is associated with submission of medical reports and other data, with a 5-day deadline?
• Which DWC notice requires proof of service?
• What is the income requirement listed for the SI plan for five years?
• An applicant's attorney calls and wants his attorney's fee as provided in the STIP. You should:
• Which statement is true about PD determination for a minor with TD context?
• The judge's order approving a settlement issues June 5, 1992, but payment is not made until August 15, 1992, because the order was misfiled by the carrier. The employee is entitled to?
• What is the public Self-Insured coverage period according to the material?
• What is the bone of the upper arm?
• In the case of the willful failure to secure the payment of compensation, the amount of compensation otherwise recoverable for injury or death shall be increased by ___________
• The smallest and most fragile bone of the face, near the eye is the which bone?
• Persisting for a long time
• Robbery at a bank case where an employee alleges a psychiatric injury has 37% related to the industrial injury and 63% related to other problems. Is the case compensable?
• Which joint is the primary hinge joint of the lower limb?
• What does permanent and stationary status indicate in impairment evaluation?
• Which change does not require notifying the director about a change in status?
• Which fracture is commonly described as a Colles fracture?
• Which statement best describes the preponderance standard?
• To which office must the actuarial study and summary be submitted?
• Doheny fracture refers to which of the following?
• Ringing in the ears is called?
• What term means double vision?
• During the first three years, the SI plan must be administered by which entity?
• If accurate weekly wages cannot be determined from the wage statement accompanying an Employer's First Report of Injury, how should the temporary disability rate be determined?
• To whom shall the employer or insurance carrier submit a plan for the medical provider network?
• Which fracture is commonly associated with twisting injuries and produces a helical fracture line around the bone?
• For an injury resulting in death, burial expenses are allowed up to what amount?
• How often is the late filing penalty calculated when a report is late?
• Which form is used by employers to report occupational injuries?
• Can a spouse earning $30,000 or less be claimed as a dependent?
• A foreman and coworkers drink after work; a coworker who is intoxicated backs his truck and injures himself while leaving. Is the injury compensable under California workers' compensation?
• What is fibromyalgia?
• Who must petition the Administrative Director to change treating physicians?
• The 50% reduction is not applied if the injury results in death or permanent disability of 70% or more.
• Under California Labor Code 3202.5, which evidentiary standard must be met to prove all issues?
• If an attorney for the IW requests that payments be sent to his office, you should:
• Which statement best describes the relationship between permanent and stationary status and MMI?
• How often must each audit be conducted at minimum?
• The employee is receiving salary continuation from the employer in lieu of temporary disability. Is a DWC notice required?
• Pain is disabling when it affects what?
• What should you do if an employer directs you to deny a compensable claim?
• Which hand bone is navicular bone?
• In impairment rating, the standard is based on which measure, as defined by AMA guidelines?
• A retired employee working as a reserve police officer is injured and has temporary disability and permanent disability. You should pay temporary disability and permanent disability at what rate?
• In workers' compensation, which term describes a condition that arises as a result of a compensable injury and is treated as part of the claim?
• As an out-of-state self-insurer where must the claims files be kept and maintained?
• Which statement best describes Group Self-Insurance?
• Which description corresponds to a penalty for discharging or administering compensation obligations in a dishonest manner?
• Under AMA Guides, apportionment is based on?
• Which vertebral region has five fused bones forming part of the pelvis area?
• What is the maximum specific excess allowed for the group?
• Which rule is referenced as the '5-5-5 Rule' in the material?
• What is an actuarial summary?
• Which condition is characterized by high blood pressure?
• Which carpal bone is most frequently fractured?
• In the bartender earnings scenario, what is the weekly value of the meal that is considered for earnings if the employee had to pay?
• A physician offers to take you to lunch weekly to thank you for referrals. What should you tell the doctor?
• Under the rebate statute, acts of offering, delivering, receiving, or accepting any rebate or other consideration are guilty of which crime?
• How many sacral vertebrae are there?
• A nurse receives a findings in award for HIV-related disease in April 2002 and dies in May 2007. A death case may be filed within how long?
• How many vertebrae are there in the human adult vertebral column?
• Which bone is the longer of the two forearm bones on the side of the little finger?
• An applicant's attorney calls and wants his attorney's fee as provided in the STIP. You should:
• Physician is suspended if convicted of a felony or misdemeanor involving fraud or abuse of the Medicare program, or Worker's Comp. system. Which labor code section governs this suspension?
• The employer is required to provide all medical and hospital treatment reasonably required to cure or relieve from the effects of the injury.
• Disability from moderate instability of the knee is indicated by which finding?
• In 2013, up to $6,000 in the form of a voucher is provided as part of which benefit?
• Complete immobility of the great toe takes what standard rating?
• Bending the wrist toward the palm is known as which movement?
• The DEU under the direction of AD will issue four types of ratings?
• The permanent disability rating of 13% in a Colles fracture case is based on which comparison?
• If an employee is receiving salary continuation in lieu of temporary disability, is a DWC notice required?
• What is the maximum burial expense payment for DOI prior to January 1, 1991?
• The femoral head articulates with the acetabulum to form which joint?
• Otitis media involves what part of the body?
• Which term is used to describe the limb segment closest to the body's trunk?
• If a physician knowingly fails to comply with LC4628 when signing a medical-legal report, the physician is subject to ______.
• A Colles fracture involves which bone?
• Fracture in which the bone is broken and splintered in two or more pieces is called what?
• Which settlement tactic is considered against public policy?
• In a scenario where serious and willful misconduct reduces compensation by 50%, the reduction is avoided if the injury results in death or what else?
• If the excess carrier refuses to pay the claim, which action is the most likely described?
• What is the maximum burial expense for claims filed between 2007 and 2012?
• Using the higher PD rating when there are conflicting ratings affects the estimation of which liability component?
• Which bone is on the little finger side of the forearm?
• In SIP provisions, can an injured worker bring a civil action for damages, and does the exclusive remedy apply?
• An employee traveling on business and stopping for lunch injures themselves at a restaurant. The claim would be:
• Which agency issues the Certificate of Consent to Self-Insure?
• Which statement is true regarding automatic dependency when the worker dies and has a child under 18?
• If an injury occurs in December but is reported in January, in which Claim Log is it recorded?
• For injuries in 2005, what is the maximum permissible add-on for subjective complaints?
• An employee has an admitted injury resulting in permanent disability of 72% and is guilty of serious and willful misconduct. What should the board award?
• Which statement best describes utilization review?
• Synovial means which of the following?
• Which of the following is not an activity of daily living?
• Under CHP heart trouble presumption, how many years of service are required before the presumption arises?
• Private self-insured employers shall submit what annually?
• Labor Code 4850(b) specifically addresses which group?
• In a third-party recovery, which lien condition gives the first right of recovery to the Employer?
• What is the general effect of the coming and going rule in workers' compensation?
• An impairment with an 8% impairment standard yields a corresponding whole person impairment of what percent?
• For private insured employers, by what date must actuarial studies and summaries be completed and filed each calendar year?
• If a physician didn't perform a particular exam or prepare the report, you should:
• A knee injury produces no objective disability but a stretch knee brace is prescribed. What is the rating for the knee?
• One of the bones in the hand; aka navicular bone.
• An uninjured worker files a claim on September 3, 2007 with a date of injury of August 29, 2007, and there is no documentation to support the injury while the worker was terminated May 30, 2007. What should you do?
• Under 4650 Payments, what is the maximum period to pay?
• Employee must give out notice about workers' compensation to all of the following except:
• Means the recovery allowed in an action at law as contrasted with compensation
• Which option best describes the compensability in the parking lot scenario?
• A 47-year-old actor with a chemical burn to the upper extremity causing cosmetic disfigurement and a 5% WPI would have what rating?
• Inflammation of a joint?
• Under the dependency rules, if there are three fully dependent for support on a deceased employee and additional partial dependents, the partial dependents would receive:
• If an EE has 11% in permanent disability what is the amount of SJDB?
• Which statement correctly describes the relationship between vision impairment and rating when permanent and stationary occurs in a bilateral loss of vision?
• Which combination of burial expense limits is correct?
• The ganglion cyst is best described as which?
• Which entity is explicitly listed as a potential recipient for petitions about physician changes?
• The scaphoid bone is located in which region of the body?
• Lateral movement of the hand toward the radius (thumb).
• The olecranon is a bony prominence of which joint?
• Which period has the smallest burial expense limit?
• Otitis media involves which part of the body?
• An employee is traveling on business and, while commuting in employer-provided vans, is injured. The injury is:
• A seasonal employee works six months a year and is a maximum earner; during the off-season, what is the temporary disability rate?
• Which action is illegal under anti-discrimination protections for injured workers?
• When both instability and thigh atrophy are present, how is the overall rating determined?
• In the vertigo scenario, which option shows the standard rating of 50 percent?
• The penalty for failing to obtain workers compensation coverage is what percentage of the compensation paid?
• What standard must a public safety officer demonstrate to make a psychiatric injury compensable?
• Every self-insurer must file a Self-Insurer's Annual Report on or before:
• What is the impairment qualification amount for the 50-99 age range?
• Under LC 4610, can a nurse in UR approve or deny requests for medical treatment?
• How long does Self Insurance plans have to notify you that your application for self insurance is deficient?
• What is the least amount of loss of motion of a finger(s) that is ratable using the 1997 Schedule?
• What does the acronym TD stand for in workers' compensation terminology?
• In Death Benefit Rates 2006-2015, which option corresponds to $250,000?
• In California workers' compensation, the rules are to be liberally construed by the courts.
• Who handles claims when the self-insured employer's certificate to self-administer is revoked?
• Which term best describes the overall concept of ‘Employer’ as presented in these materials?
• Controls loss severity by placing a cap on losses the insured must pay arising out of a single occurrence. What is specific excess insurance?
• For transferring liability, from whom must approval be sought?
• How many days does a physician have to submit a Doctor's First Report of Occupational Injury or Illness?
• When would an IW be justified for missing or refusing to attend a medical exam arranged by his ER?
• Who may modify, delay or deny requests for authorization of treatment?
• A 27 year old chemist has a chemical burn to the eyes resulting in a 14% whole person impairment. What rating is typically assigned?
• What is the maximum period for TTD payments for a single injury on or after April 19, 2004?
• What is the penalty for failure to deposit and maintain a security deposit?
• Within how many days must notice of an employee death be filed with the Administrative Director if there are no minor children?
• Loss of an eye is called?
• During stipulation to a permanent disability award, you receive a call from a furniture company about a debt. What should you do?
• Which term best describes the body that governs the self-insurer's security fund?
• If a petition for Reconsideration is denied, within how many days must a Petition for Writ of Review be filed? (Alternate wording)
• For a 2004 bilateral loss of vision that becomes permanent and stationary, how is the disability rated?
• What does synovial mean?
• A 100% upper extremity impairment corresponds to a whole person impairment of what percentage in the provided rating system?
• Heel bone
• In the injury scenario where the employee was injured on Friday, January 10, 2008, reported the injury on January 12, and filed a claim form on January 15, 2008, what is the employer's date of knowledge for Labor Code section 5402?
• A married employee and spouse adopt their grandchild. The employee dies in a work-related accident. How many dependents are recognized?
• A 40 year old forester with an elbow injury resulting in loss of motion and a 50% upper extremity impairment has what rating?
• A Doheny fracture is a:
• In California workers' compensation, when does the waiting period begin after a work injury?
• What are the supplemental job displacement benefit amounts by PD rating?
• An experienced indemnity examiner must have how many hours and years of experience?
• UR Review Policies and Procedures shall be filed with the:
• In a third-party case with a $100,000 recovery, attorney fees $36,000, costs $4,000, and a workers’ compensation lien of $40,000, what is the net recovery to the injured worker after credit for the third-party recovery?
• What is the penalty for refusing to comply with known and legally indisputable compensation obligations?
• What is the penalty percentage for failing to obtain workers' compensation coverage?
• For a disability paid more than two years after the DOI but within the first two years, the rate is determined by the law in effect on which date?
• Awards of the appeals board carry interest at the same rate as which of the following?
• What does the Personal Comfort Doctrine relate to in workers' compensation?
• An injured employee with dependents is incarcerated for an unrelated offense. Temporary disability otherwise payable is:
• An injury occurs in late December 2009 but is not reported until January 2010. In which claim log is the injury recorded?
• Outside MPN conditions
• DIA-510 is associated with reporting what event?
• A worker with loss of use of both hands is categorized as which type of permanent disability?
• In WCAB document filings, which date determines when the document is considered filed?
• Which bone forms the elbow's bony prominence?
• Which entities are subject to audits by the Administrative Director?
• Audits are conducted by which office?
• Which bone is known as the breastbone?
• Which movement is described as bending the ankle toward the sole?
• What is the standard rating for a knee with a long leg brace prescribed without objective disability?
• The metacarpus refers to which region?
• You do not have to notify the chief of a change in status where:
• When can you close a claims file?
• A trapezius muscle injury would most directly impact which of the following regions?
• Which statement is true about the Official Medical Fee Schedule in California workers' compensation?
• Under what condition can volunteers be deemed employees for workers' comp?
• Which term refers to the process of chewing?
• Which relative is eligible for the same special death benefit as a totally dependent minor child when they are totally dependent?
• When there are conflicting PD ratings, which rating must be used for estimating future liabilities?
• What term describes swelling caused by body tissues retaining an excessive amount of fluid?
• Which term refers to inflammation in the spine and joints?
• If you deny an employee's claim and just before the one-year anniversary the employee meets with an information and assistance officer who takes the matter under submission, the statute of limitations is tolled during the consideration and for how many days after issuance of a recommendation?
• A compound fracture is?
• Inability to close mouth or chew properly, overgrown teeth
• After approval, in how many days must the SI program commence?
• For a Non discrimination policy 132a. what is not a possible punishments?
• Your client is a city. An employee injures his shoulder, goes on TTD, then moves to county; who is responsible for the 4850?
• Who will The WCAB say is responsible for the 4850 in a case where the city employee injures themselves, later works for the county, and both apply for 4850?
• An employee's husband comes to where she works and shoots her as a result of a marital dispute. The injury is:
• Should the number of fatality cases be included on the annual report?
• If the applicant has received a prior PD award, what is conclusively presumed?
• What term describes high blood pressure?
• Which condition involves radiating pain along a nerve root?
• What is the role of the Self-Insurers Security Fund when a self-insurer becomes insolvent?
• Which term describes the back surface or posterior aspect of the body?
• The first payment of temporary disability is due no later than ___ days after knowledge of the injury and disability?
• Failure of the employer to secure payment of compensation as provided in LC 3700 is which of the following?
• Which statement about suspension of physicians or practitioners is correct?
• In California, a self-insured program is best described as:
• A greenstick fracture is best described as
• Vocational rehabilitation can be settled in how many days?
• Before reducing benefits, what formal action is required?
• Which scenario is recognized as an exception to the going-and-coming rule?
• A Petition for Reconsideration must be filed within how many days of service of an F&A by the WCAB?
• A knee injury produces no objective disability for work restrictions but the physician prescribes a stretch knee brace. What is the rating for the knee?
• Lacrimation is defined as which condition?
• Which bone forms the anterior chest wall?
• The root meaning of spondyl is which?
• Which PD range has an SJDB cap of $6000?
• Which term describes the turning outward of the eyelid?
• A cardiac condition results in preclusion from heavy lifting. What is the scheduled rating?
• Given pre-injury weekly earnings of $1,300 and post-injury earnings of $450, what is the wage-loss TD rate?
• Which factor is used to determine a California impairment rating when considering pre-existing disabilities?
• You are paying Temporary Disability pursuant to an award. How long do you have to file a petition to terminate liability for TD after terminating payments?
• What is the focus of Utilization Review (4610)?
• Under which provision can an employer request a second medical opinion?
• Aggregate excess insurance is described as:
• Dupuytren's contracture affects which structure of the hand?
• A 100% upper extremity impairment is what percentage of a whole person impairment?
• In a scenario where you reduce a medical bill by $500 under the Official Medical Fee Schedule and the physician bills the applicant who pays, what is the physician's responsibility?
• To whom do you apply for a Certificate of Consent to Self-Insure?
• A 27-year-old chemist sustains a chemical burn to the eyes in 2010 with a 14% whole person impairment. What is the rating?
• For a seasonal employee who works six months per year, what is the TD rate out of season?
• An employee's husband comes to where she works and shoots her as a result of a marital dispute. The injury is:
• What is forward displacement of one vertebra over another called?
• In 2007, which document invokes the jurisdiction of the Workers' Compensation Appeals Board (WCAB)?
• Removal of the eye is called?
• Which statement about burial benefits is true?
• What percentage corresponds to complete immobility of the great toe?
• The ER is entitled to see all information in a claim file that affects the ER, except certain medical information. The required term to fill the blank is:
• A volunteer nurse's aid for a non profit hospital injures her back lifting a patient. The injury is:
• A Doheny fracture is?
• You are in the process of stipulation to a permanent disability award with the employee when you receive a call from a furniture company who says the employee owes them $2000. You should:
• Which bone is known as the heel bone?
• Which PD range corresponds to an $8,000 Permanent Disability benefit?
• When the employee is represented and a second opinion is sought, which professional is designated to provide the second opinion?
• Disability number associated with complete immobility of the index finger?
• An injured worker incurred $600 in medical costs in 2004, $1,200 in 2005, and $800 in 2006. How should future medical expenses be reserved per year?
• Within how many days is the employer or insurance carrier supposed to receive the report of an evaluating physician?
• The lacrimal bone is located in which part of the body?
• In these calculations, DOI stands for Date of Injury.
• A fracture description for involvement of multiple fingers is known as which?
• Which term denotes pain along the course of the sciatic nerve?
• Under self-insurance rules, every private self-insurer which has not been self-insured previously shall:
• Which fracture is defined as not rupturing the skin?
• The metatarsals are located in which part of the body?
• In handling a third-party case, which outcome aligns with protecting the employer's financial interests?
• TD Rate 2013 corresponds to which rate?
• In third-party recoveries with liens, who has priority in distribution?
• What is the penalty amount per violation for less serious violations?
• Close medical only claims should be included on the annual report.
• A 39-year-old baker, Group 420, has a knee injury with slight instability precluding heavy lifting. What is the level of permanent disability?
• Aggravation refers to:
• Which office is typically responsible for enforcing SIP provisions?
• Formal rating determinations shall be deemed to constitute evidence:
• Which term denotes inflammation of bone and cartilage?
• One of the tarsal bones of the foot is which?
• Which percentage corresponds to the Moderate level in the spine disability schedule?
• When estimating future medical cost for an injured worker who has reached maximum medical improvement, the estimate should be based on what?
• You do not agree with the Agreed Medical Examiner's findings. You should:
• Fracture in which there is no external wound.
• Conjunctivitis involves which part of the eye?
• Aggregate disability payments for a TD claim in 2006 shall not extend for more than how many weeks?
• Loss of the radial head is ____% absolute
• Is proof of service required on a delay?
• How is the AWE of active and reserve police officers for the purposes of TTD and TPD determined?
• Under Labor Code 132A, compensation shall be increased by 1/2 but not more than $10,000. Which option correctly states the increase and cap?
• Which scenario best fits a medical only claim?
• Mary and John Doe adopt their 8 year old grandson Joseph. John dies in a work-related accident. Mary is a dependent spouse. How many dependents are there?
• In the applicable code, SHALL indicates what?
• Death benefits are provided for one dependent, two dependents, or three dependents. Which of the following is the correct set of amounts for one, two, and three dependents respectively?
• If an individual has 100% upper extremity impairment, what percentage of the whole person impairment does this represent?
• What is the penalty for inducing employees to accept less compensation than they are due?
• A farm labor age 15 years 9 months is injured and there is a serious and willful misconduct of the employee. what is his permanent disability rate?
• What is the California Self-Insurer's Security Fund?
• An employee is at home for a workers' compensation injury receiving TD. He contracts measles from one of his children. What are you liable for?
• To whom must the Disability Evaluation Unit Rater send a report that apportions permanent disability?
• Fracture in which the bone breaks and bone extends through the skin is called what?
• Under the Personal Comfort Doctrine, which statement is accurate about compensability?
• Which definition describes immobility of the index, middle, ring, and little finger?
• In a case where an injured employee with dependents is incarcerated for an unrelated offense, temporary disability benefits otherwise payable are paid to whom?
• In the event of a delay in payment due to the insurer filing the order in the wrong file, the employee may be entitled to which combination?
• Reserves may be capped at which level with respect to any specific excess Worker's Compensation insurance?
• An employee is seriously injured as a result of his own serious willful misconduct. The compensation is reduced by 50% unless which of the following exceptions applies?
• What is the burial expense amount for January 1, 2013?
• What should adjuster do to protect the employer's rights in subrogation?
• Which statement is true about Director's jurisdiction after revocation?
• What is the maximum penalty for the most serious types of violations?
• Which bone is the upper arm bone?
• What is the medical term for forward displacement of a vertebra over the vertebra below, commonly occurring at the L4-L5 level?
• Which of the following is included in the Annual Report for self-insurers?
• A twenty year old employee is injured at work but does not report it as required by work procedures. The employer finds out, investigates and determines it is not work related and denies it but does not report it to the TPA. The TPA gets a Notice to Pay Benefits from the WCAB. What should the TPA do?
• In vocational rehabilitation settlements, which statement reflects a condition under which Voc Rehab may be settled?
• A cardiac condition is resulting in preclusion from heavy lifting. What is the scheduled rating?
• Which item is not considered indemnity in workers' compensation claims?
• If the injured worker (IW) is under 18 years old and has a permanent disability, how are earnings for purposes of benefits determined?
• The security deposit of a private self-insurer shall apply to all subsidiaries and affiliates included under the master certificate of consent to self-insure.
• Which date is used to calculate the duration limit for aggregate disability payments?
• An employee is at home on temporary disability for a workers' compensation injury and contracts measles from a child. Which benefits are payable for the measles under the compensable consequences doctrine?
• Which term describes an injury that results from repetitive trauma over a period of time?
• The judge's order approving a settlement issued June 5, 1992, but payment was delayed due to misfiling. The employee is entitled to what?
• Which bone participates in forming the zygomatic arch?
• In 2004, when rating bilateral vision loss, how is the disability rated?
• An injury resulting in practically total paralysis or permanent mental incapacity is presumed as which?
• ______ means medical emergencies of the evaluator or evaluators family, death in the evaluators family, natural disaster or other community catastrophes that interrupt the operation of the evaluators business.
• What is the rating for a 30 year old heavy furniture assembler with a soft tissue injury to the cervical spine causing a loss of range of motion resulting in an 8% impairment standard?
• An exclusive remedy is:
• If a petition for reconsideration is denied, within how many days must a Petition for Writ of Review be filed?
• Which category is not a ratable disability?
• For injuries beginning in 2006, the aggregate temporary disability benefit is capped at how many weeks from the start of the disability?
• An employee suffers an injury in 1992 resulting in a permanent disability award; the Appeals Board finds the injury was a result of serious and willful misconduct. The compensation otherwise recoverable may be reduced by:
• Which nerve is associated with carpal tunnel syndrome?
• An employee is in the break room drinking vodka. A conveyor falls seriously injuring him and the doctor at the hospital says the employee was intoxicated. You should:
• Which term refers to a bloodborne infectious disease in the list?
• Which statement best describes the nature of the maximum temporary disability rate?
• TD Rate 2010-2011 corresponds to which rate?
• An employee has an injury in February 2000 and, in July 2000, has an aggravation. How should the file be handled?
• If an employee's attorney requests that payments be sent to the attorney's office, what should the administrator normally do?
• A worker's pre-injury weekly earnings are $1,200 and post-injury weekly earnings are $700. What is the wage loss TD rate?
• If the employee dies as a result of the injury, how does misconduct-related 50% reduction apply?
• Occasional severe back pain takes what standard rating?
• In the 2004-2013 period, what is the Permanent Disability benefit amount for a PD rating less than 15%?
• In a scenario with multiple jobs, which earnings are used to determine the temporary disability rate?
• The employer encourages the employees to carpool and provides vans for the employees. An injury that occurs while commuting is:
• Formal rating determinations shall be deemed to constitute evidence for what purpose?
• The dominant hand is ____ than the non-dominant hand:
• The Director may not accept as a deposit to secure incurred liabilities for the payment of compensation and the performance of obligations of a self-insured ER. Which is not an acceptable deposit?
• Forward displacement of a vertebra is described by which term?
• What is the specified percentage range for substantial cause?
• In the context of a self-insured employer, which scenario describes not paying an audit fee?
• Which term describes dizziness, often with spinning sensation?
• Utilization review process to be established with penalties for failure to meet certain requirements is governed by which Labor Code?
• An employee is terminated following an industrial injury because he filed a claim for compensation benefits. The EE is entitled to:
• Who may petition for a change of employee-selected physician?
• An employee who does not receive mileage reimbursement for his use of car, while on an unpaid lunch hour, is injured while on his way to the bank to cash his paycheck. You should:
• Which scenario yields a 40 percent knee rating?
• Which bone is not in the leg?
• Inflammation of a joint is medically termed what?
• Palmarflexion of the wrist involves which movement?
• Probable earnings at age 18 are used to determine which factor?
• The MPN includes physicians primarily engaged in the treatment of which injuries?
• If the employer objects to the report and the employee is unrepresented, the administrative director will do which of the following to obtain a second opinion?
• An employee is injured at work but does not report as required by procedures. The employer investigates and denies the claim, but does not report to the TPA. The TPA later receives a Notice to Pay Benefits from the WCAB. What should the TPA do?
• Overflow of tears is known as?
• The statute of limitations for a subrogation claim is?
• Carpal tunnel syndrome involves compression of which nerve?
• If an employer fires an employee for reporting an industrial claim, what should you advise the employee to do?
• The deficiency notice period for an application for self-insurance is 14 days. Which option correctly states this timing?
• Which statement best describes a medical-only claim?
• Shall when used in a legal context means?
• Which term is the shoulder girdle bone?
• Which of the following is not a type of rating the Disability Evaluation Bureau can prepare?
• Palmarflexion of the wrist means moving the wrist in which direction?
• Labor Code 138.4 concerns injuries involving loss of time and suspending a physician or provider convicted of fraud or abuse of Medi-Cal, Medicare or workers' compensation system. Which professionals can be suspended?
• Under Labor Code 3208.3, injuries can be described as which two categories?
• How many days does an injured employee have to object to the report of a primary treating physician?
• If you do not agree with the Agreed Medical Examiner's findings, you should:
• Which surgical procedure involves replacing a diseased joint?
• Under Labor Code 3206, what does the term 'compensation' include?
• The employee is receiving salary continuation in lieu of temporary disability. Is a DWC notice required?
• What is the amount of the petition for credit for the TPA in the same scenario?
• What is the general rule for determining a disability rating when multiple impairments are present?
• True or False: The private interim report covers January 1 to June 30 and the public interim report covers July 1 to December 31.
• How does a group self-insurer meet the funding and solvency requirements?
• What is the monetary threshold to qualify for total dependency?
• What specialist would you refer the employee to for a herniated disc?
• When both instability and thigh atrophy are present what is the rating?
• A medical clinic physician who refers patients to you offers to take you out to lunch weekly to thank you for referrals. What should you tell the doctor?
• Which action would be consistent with public policy regarding settlement offers tied to resignation?
• A trapezius muscle lesion would affect which location?
• The standard rating for reduction of vision is which of the following?
• Under Labor Code 3353, any person rendering a service to another other than as an independent contractor is presumed an ______.
• What term describes a tear of the medial meniscus of the knee?
• Which anatomical region is most clearly associated with injury to the trapezius muscle?
• Which statement correctly describes subjective pain in the rating process?
• Under the Personal Convenience Doctrine, does an injury from changing oil count as compensable?
• Which action is appropriate when a physician offers ongoing weekly meals to thank you for referrals?
• Which is the largest artery in the body?
• What term describes the only solution or compensation available to a plaintiff in a specific legal scenario?
• In anatomical terms, what term describes the nearest point of attachment to the trunk?
• How are future liabilities on the annual report estimated?
• If an employer is guilty of serious and willful misconduct the employee's compensation is:
• Which statement best describes the meaning of 'date of knowledge' when knowledge is obtained on a date after the injury?
• Which agency issued the Notice to Pay Benefits that prompted the TPA's action in the described case?
• Commute injuries are compensable if the employment subjects the employee to what?
• The term 'Employer' includes which of the following as defined in this division?
• Which statement accurately describes a medical-only claim?
• How many days do you have to dispute a medical bill?
• A worker is a maximum earner for an injury in 2006 and a TD payment is made in 2008. Which rate best applies?
• Within how many days must an employee be offered a choice of participating physicians after a request is received?
• Which option is NOT listed as a deposit type that the Administrative Director may accept?
• Which fracture is a common fracture of the distal radius?
• If the treating doctor's office calls to say an employee is released to return to work on a date and TD is cut off, but the employee returns later, what is the appropriate action?
• The Interim Certificate of Consent to Self-Insure is issued by whom, and for how long?
• In 2004 an employee becomes permanent and stationary for a bilateral loss of vision injury. How is the disability rated?
• An employee arrives early and is injured in the parking lot by a passerby; is the injury compensable?
• Which bone is involved in a Colles fracture?
• Which statement best describes who qualifies as a 'self-insurer' in California workers' compensation?
• Which of the following is a type of SI audit?
• Which term denotes complete loss of vision?
• Which statement describes the inclusion of benefits for workers and dependents in compensation?
• What are the four degrees of subjective pain?
• A Pott's fracture involves which part of the body?
• In challenging an Agreed Medical Examiner's findings, which approach directly communicates with the medical examiner and includes counsel?
• What is the least amount of loss of motion of a fingers that is ratable using the 1997 schedule?
• A totally dependent minor grandchild is entitled to the same special death benefit under LC 4703.5 as a totally dependent minor child.
• Which item must accompany a denial notice to be considered properly served?
• Removal of a disk from the spine is called what?
• When an employer and employee file third-party actions and obtain a recovery, who has the first right of recovery?
• Arthroplasty is best described as?
• What is the minimum group income for five years?
• Apportionment is based on which factor?
• How is the AWE of active members of regular organized volunteer fire departments for the purposes of TTD and TPD determined?
• Which PD range has an SJDB cap of $10000?
• Which condition could convert a near-work injury in a parking lot into compensable?
• The Latissimus dorsi is a large muscle located in which region?
• Labor code 4062 (b) addresses objection to medical procedures when employer objects to treating physician's recommendations
• The director's audit program must address the adequacy of estimates of future liabilities of claims for all private self-insured employers. The focus is on which of the following?
• Where are the written UR policies and procedures filed?
• Signed into law by Governor Jerry Brown September 18, 2012, the bill made wide-ranging changes to California's Worker's Compensation system, including increased benefits to injured workers, and cost saving efficiencies for employers. Most provisions took effect January 1, 2013. Which Senate bill is this?
• Conjunctivitis involves the lining of the eye.
• Which statement best describes the relationship between injury reporting and the date of knowledge?
• Which fluid is found within a synovial joint?
• The calcis is the heel bone.
• Under the rules, the employer shall render one change of physician on request of the employee.
• What term describes the forearm rotation with the palm facing up?
• Which bone forms the prominence of the cheek?
• A 39-year-old auto mechanic has slight instability of the knee, no atrophy and a preclusion from heavy lifting. What is the level of permanent disability?
• Which statement best describes the validity of the Certificate to Self Insure after a self-insurance program is initiated?
• The fee paid by self-insured to cover a stable funding source is based on what?
• A private employer which has secured the payment of compensation pursuant to LC3701 is what type of self-insurer?
• What are the three basic elements of rating for a knee disability?
• Which of the following is the smallest permanent disability percentage listed in the knee case options?
• A foreman and coworkers are drinking on the loading dock after work. A coworker injures himself while leaving because he was intoxicated. Is the injury compensable?
• In the UPS driver example, the injury arose out of and in the course of employment. This is an example of which concept?
• The thigh bone is called which bone?
• When a knee brace is prescribed, it indicates what?
• Which condition is characterized by chronic widespread diffuse joint pain, fatigue, and tender points?
• Which lung disease is caused by asbestos exposure?
• Which statement about compensation is true?
• In a case where a 2010 eye burn yields a 14% whole person impairment, what is the rating?
• Navicular bone in the hand called what?
• What is the most common type of arthritis?
• Utilization Review is defined in which Labor Code section?
• What condition is described as double vision?
• The expectoration of blood or blood-stained sputum is known as what?
• If IW files a claim and there is no documentation to support the injury and the IW was terminated before the injury date, what should you do?
• Which of the following is not an Activity of Daily Living?
• A bank robbery victim who sustains a psych injury has 37% related to the industrial injury and 63% related to marital problems. Is the case compensable?
• Carpal tunnel syndrome involves which nerve?
• The ER or insurance carrier shall submit a plan for the Medical Provider Network for approval by:
• What term describes the termination of a workers' compensation surety bond when the surety issues written notice to the Chief, the beneficiary?
• How should you reserve for the 2004 injury when a second injury occurs after a prior PD award?
• You reduce a medical provider's bill by $500 pursuant to the Official Medical Fee Schedule. The physician bills the applicant who pays and advises you. What is the physician's responsibility?
• The metacarpus refers to which part of the body?
• What is the civil penalty maximum mentioned?
• The limitation on HIV death claims is up to what amount?
• The descriptions minimal, slight, moderate, and severe refer to which factors?
• If a claim is not denied within 90 days, the claim may be denied later based on what?
• What must occur for a Compromise and Release (C&R) to be valid?
• What do the future liabilities on the Annual Report represent?
• The disability evaluation bureau can prepare what kind of ratings?
• What is the required timeframe for the treating physician to provide a medical report?
• In a nonprofit's workers' compensation coverage, what must occur for volunteers to be covered?
• What is fibromyalgia?
• Complete immobility of the great toe takes what standard rating?
• The thigh bone.
• As a self-insured administrator how long do you have to maintain the claims file?
• TD Rate for 2017 is which rate?
• Which type of excess insurance controls loss severity by placing a cap on losses arising out of a single occurrence?
• Which of the following does not involve the lungs?
• In the context of a workers' compensation claim for a violent act, substantial cause means which of the following percentages of causation from all sources combined?
• The socket that receives the head of the femur is called the acetabulum. Which option correctly names this socket?
• How can a self-insured Worker's Compensation claim liabilities be transferred to another entity?
• Which pairing correctly matches the injury types to their time frame?
• For all DOI occurring on or after 01/01/2018: emergency treatment services and medical treatment rendered for a body part accepted as compensable by the ER and addressed by the medical treatment utilization schedule, by a member of the MPN or HCO or by predesignated physician, within 30 days following the DOI shall be authorized without prospective UR. Which entity is listed as acceptable to address the treatment?
• Which term denotes the fluid in joints?
• Which term refers to the muscle commonly known as the trapezius?
• What is the penalty for late filing an annual report for a self-insurer?
• In the finger amputation scenario, which items are payable?
• In 2013 and before, how many days to object and request a second opinion?
• Which term refers to inflammation of a joint?
• A 21 year old baker has a Colles fracture of the wrist in his dominant hand resulting in grip strength readings of the data 65, 55, 60 / 107, 106, 105. What is the permanent disability?
• What is the rating for a 47 year old actor with a chemical burn to an upper extremity producing a cosmetic disfigurement resulting in a 5% WPI?
• What is a compound fracture?
• When an employee is receiving salary continuation in lieu of temporary disability, which notice must be given to the DWC?
• Which term describes absence of the lens of the eye?
• Which statement correctly describes filing UR policies and procedures?
• Which best describes 'Compensation' in this division?
• UR policy and procedures must be filed with whom?
• A high school teacher leaves school after the day; district-owned lot; two blocks away; at a red light a man forces entry into her car and assaults her. Which statement is correct?
• If an applicant's attorney files an application for adjudication of claim and you are not represented, which documents do you file with the WCAB?
• Which chronic condition is characterized by widespread pain, tenderness, fatigue, and sleep disturbance?
• The annual report form for self-insurers is provided by whom?
• What is the exception to reduce benefits of an injured worker?
• In the burial benefit schedule, what percentage is assigned to the Slight/Moderate category?
• If a settlement payment is delayed due to misfiling by the carrier, the employee is entitled to what?
• The head of the femur fits the:
• When can you close a claims file?
• An injury occurs in late December but is not reported until January of the next year. In which claim log is the injury recorded?
• A metacarpus refers to which part of the body?
• Which provision provides for continuation of workers' compensation benefits when the private self-insured ER's security deposit is inadequate or not immediately accessible?
• When is the Self-Insurers Annual Report due for private self-insurers and public self-insurers?
• If there are three persons wholly dependent for support on a deceased employee and additional partial dependents, the partial dependents would receive:
• Colles fracture involves which bone?
• Which permanent disability is presumed to be total in character?
• What is the medical term for abnormal touch sensations such as burning, prickling, or numbness?
• Permanent disability with a rating less than 100 percent is called:
• George Parisotto holds which title?
• If the self-insured employer's certificate to self-administer is revoked, who handles the claims?
• Burial expense before January 1, 1991 was what amount?
• Fracture of the lower part of the fibula and tibia just above the ankle. The most common fracture above the ankle.
• In human anatomy, how many vertebrae are typically present in the adult spine?
• Which provision prohibits discrimination against an employee who is injured in the course and scope of employment?
• For a 30-year-old heavy furniture assembler with a soft tissue cervical spine injury causing a loss of range of motion and an impairment standard of 8%, what is the resulting rating?
• Which remedy is described for discrimination under Labor Code 132A?
• How long do you have to maintain the claims file as a self-insured administrator?
• Which action is appropriate if a physician did not perform the exam and the report is in question?
• Fracture of the lower part of the fibula and tibia just above the ankle is called what?
• An injured worker with aphakic eye and vision 20/50 correctable to 20/25 is rated at what standard percentage?
• The surgical removal of the eye is called what?
• Which body reviews a permanent disability apportionment report for an unrepresented worker?
• A 47 year old actor has a chemical burn to an upper extremity producing a cosmetic disfigurement resulting in a 5% WPI. What is the rating?
• When an employee reports an injury, what should the employer do?
• If an insurer reasonably believes that a fraudulent act has been committed in connection with a workers' compensation claim, within how many days must the authorities be notified?
• A worker suffers an injury due to serious and willful misconduct. The indemnity reduction is 50% unless which condition applies?
• The aggregate stop loss policy is:
• When is the interim report due?
• Volunteers are not covered unless _____.
• In an aphakic eye with vision 20/50 correctable to 20/25, what is the standard rating?
• Which range corresponds to the impairment amount of $8000?
• Reapplication to the Director for a Certificate of Consent to Self-Insure is required if an employer fails to initiate a self-insurance program within how many months?
• A nurse received an F&A in April 2002 for HIV and dies in May 2007. A death case may be filed within how long?
• Which agency issues the Certificate of Consent to Self-Insurance?
• Inflammation of bone and cartilage is described by which term?
• Which description best defines minimal/mild pain?
• The temporary disability rate for a baker with earnings of $1400 per week, for an injury on May 1, 2010 is?
• What is the maximum earnings a spouse can have to be claimed as a dependent?
• What describes an alternative composite deposit?
• Which medical specialist would you refer a patient with a herniated disc to?
• How many days does an employer or insurance carrier have to provide an employee with a change of physician form after a request?
• Which action requires approval from the Director?
• Defective product manufactured by the employer and provided for the employee's use by a third party, leads to which employer liability?
• What is the primary purpose of the DWC-1 form?
• A self-insured employer has not adequately funded their trust account, preventing you from making payments on claims. You are required to report it to the Manager within:
• Which term denotes inflammation of bone and cartilage?
• To obtain a Certificate of Consent to Self-Insure, you apply to which official?
• For psyche claims, payments are issued to whom when dependents exist?
• Which item is not accepted by the director as a deposit to secure incurred liabilities for payment of compensation and performance of obligations to a self-insured employer?
• Which bone is located in the lower leg and bears most weight?
• An employer desiring a change of employee-selected physician can petition the?
• If the treating physician's request for epidural injections is denied by a UR nurse after referral, is this acceptable?
• The turning of the palm so that the underside faces downward.
• Under the coming and going rule, injuries sustained en route to or from work are:
• A knee injury produces no objective disability or work restrictions but the physician prescribes a long leg brace. What is the standard rating for the knee?
• Under the independent contractor framework, the statement 'The principal controls the result, not the means' is true.
• If temporary disability has been paid at the wrong rate, what is the required remedy?
• Which document is typically filed within five days after a work-related injury or illness to notify the insurer?
• What does the acronym TPA stand for in workers' compensation administration?
• Who issues certificate of intent to self insure?
• In that third-party case, what is the workers' compensation lien amount?
• When is the first payment of temporary disability due after the injury?
• What is the surgical repair of a joint called?
• Which description defines moderate pain?
• A break across the bone is called which fracture?
• UR policies and procedures shall be filed with
• Which bone is located in the face and forms part of the orbit?
• After a decision of the court of appeal, what may the aggrieved party file?
• Do UR Policies and Procedures and a description of the process have to be filed with the administrative director?
• Under the independent contractor definition, the principal has control over which aspect?
• Who appoints physicians who serve as QMEs?
• You find a doctor's medical-legal bill in a claims file 62 days after the bill was date stamped received. You should:
• The Administrative Director audits insurers, self-insured employers, and third-party administrators to determine obligations under which Labor Code section?
• Before 2013, SJDB vouchers were issued in tiered amounts by category; what was the voucher amount for the 0-15 category?
• Burial expenses for an injury in 2013 resulting in death are allowed up to how much?
• When an employer and employee pursue a third-party recovery, whose lien has the first right to the net recovery, provided the lien does not exceed the net amount recovered?
• When an employee suffers loss of both eyes or loss of sight or loss of both hands, what is the presumed disability status?
• What is an actuarial study?
• Which bone forms the hip socket?
• The treating physician providing continuing treatment is required to provide you with a medical report within how many days?
• In impairment rating examples, the 30-year-old with an 8% impairment results in a 15% rating. Which option lists the correct rating?
• Which of the following is not among the four conclusively presumed totally disabled conditions?
• Who administers the plan during the first five years?
• Surgical fixation of a joint?
• If two or more persons are wholly dependent for support upon a deceased employee, how many partial dependents shall receive benefits?
• Osteochondritis is inflammation of bone and cartilage
• What is the penalty for failure to file a complete or timely annual report?
• Inflammation of the vertebrae is called?
• Who has the authority to revoke a self-insured certificate?
• What is the name of the lateral portion of the hip bone?
• The rate for the supplemental job displacement benefit is determined by the law in effect on which date?
• Is it a felony to offer compensation to a claims adjuster?
• If a physician didn't perform a particular exam or prepare the report you should:
• ER or insurer shall submit plan for the Medical Provider Network for approval by which entity?
• For an injury in 2006, aggregate disability payments for temporary disability shall not extend for more than how many weeks from the start of temporary disability?
• Penalty to ER who fails to secure payment of compensation is double the amount of premium, minimum _____________
• For a spouse to be claimed as a dependent under workers' compensation, the spouse's earnings must not exceed what threshold?
• A disability is considered permanent and stationary when the employee has reached what milestone under AMA Guidelines?
• What action is required if an employer fails to initiate a self-insurance program within six months?
• A petition for Writ of Review must be filed within how many days after a Petition for Reconsideration is denied?
• Forward displacement of a vertebra over a lower segment is called?
• Which factor is described as not directly observable or measurable?
• Rehabilitation benefits can be settled under which condition?
• If a dependent turns 18, do death benefits continue?
• A finding that injuries resulted from the injured employee's serious and willful misconduct means:
• You should deny a claim when there is no documentation to support the injury and the injured worker was terminated before the injury date.
• An employee injured in 2000 dies in 2006 from his injuries. What is the amount of the death benefit?
• Which factor could support compensability when drinking condoned by supervisor?
• In the bartender scenario, what is the employer's cost of the free daily meal?
• In impairment notation, UE stands for which body part?
• What is the maximum amount of the 1/2 compensation increase described in the termination scenario?
• For injuries occurring on or after January 1, 2004 how many chiropractor, occupational therapy, or physical therapy visits is an employee entitled to per industrial injury?
• How much can you pay for burial expenses for DOI on 1/1/91-12/31/12?
• What is the title of a member of the Workers’ Compensation Appeals Board?
• Which pain is not ratable?
• Which disease appears in the list among infectious or exposure categories?
• Ectropian means:
• A high school teacher leaves schol after the end of the day. The school, located ina bad neighborhood provides parking for her in a district owned lot at the school . The teacher pulls out of the school lot onto the city street and approximately two blocks from the school while stopped at a red light a man forces his way into her car, assaults her and steas her purses.
• Which statute is sometimes called the ER's Bill of Rights?
• Which document is referenced as Original Medical Reports in adjudication filings when unrepresented?
• Which agency handles the Workers' Compensation Appeals Board (WCAB) matters referenced in self-insurance disputes?
• Reduction in vision to 20/200 or less using the 1997 PD Rating Schedule corresponds to which term?
• The Uninsured Employers Fund multiplier is 3x. Which option reflects that?
• If an injury occurs in December and is reported in January, which claim log is it recorded in?
• Which code corresponds to Employer Request to Change Physicians?
• The nucleus pulposus is best described as which of the following?