Certified Authority of Workers Compensation (CAWC) Practice Test

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• Which rating mechanism adjusts premiums based on actual losses after a policy period?
• What is the purpose of RIGWAW in incident investigations?
• In what year did every state enact workers' compensation laws?
• What is the concept of vocational rehabilitation in California workers' compensation?
• The governing class code is used to determine what aspect of premium calculation?
• According to Crawford & Company, employees with an RTW program report an average of how many weeks to return to work for injured employees?
• Which statement about captive insurance organizations is accurate?
• Under-reserving is defined as which of the following?
• Which program involves the insured retaining a significant portion of losses through a high deductible?
• Which occupation list is considered harbor workers?
• Which statement best describes the return-to-work program's benefit?
• Which doctrine holds that an injury arises out of employment when the worker is exposed to a risk because of employment?
• Which statement is true about coverage under USL&H?
• Who initiates a California workers' compensation claim by filing the claim form?
• Which item is a trigger to initiate a loss control consultation?
• TRUE OR FALSE: USL&H protects maritime/harbor workers who are not crews of ships.
• What is the typical outcome goal of California workers' compensation vocational rehabilitation?
• What role does a Qualified Medical Evaluator (QME) play in California workers' compensation claims?
• Is the division of payroll for the standard exceptions allowed?
• What is the scope of appeals within California workers' compensation claims?
• What is the role of the claims administrator in a CA WC claim?
• First retro formula timing in a retrospective policy?
• On the Alternative Work Comp Plans Scale, which plan is listed as the highest level (lowest to highest)?
• What is the difference between pay-as-you-go and lump-sum settlement options in California workers' compensation?
• What is the purpose of obtaining a second medical opinion in a medical-legal evaluation?
• The 'lost wages' (indemnity) benefit is defined as what?
• What components contribute to effective data security in electronic WC records?
• What is the estimated annual cost of insurance fraud?
• Which equation expresses the relationship between EPL and D-ratio?
• Which term describes a permanent disability where the worker cannot perform any job?
• Permanent Disability is grant when?
• Which of the following is a direct Loss Control Objective?
• In California workers' compensation, indemnity refers to
• Which statement best describes the purpose of captives?
• Primary losses are losses that are less than or equal to the state's split point and are commonly referred to as what?
• Which statement is true about a hard market?
• What does apportionment mean in permanent disability determinations?
• Which market condition is associated with higher rates?
• Which term describes a financing method in which the employer self-funds losses and may employ a formal structure to handle those claims?
• Which law, enacted in 1908, governs railroad workers' compensation claims?
• What characterizes USL&H benefits with respect to wages?
• The IRS has adopted a list of 20 questions to determine whether workers are employees or independent contractors. What is the purpose of this list?
• Which occupation is explicitly excluded from LHWCA coverage?
• Which statement best describes coverage for occupational diseases under California workers' compensation?
• In a soft market, which statement is true?
• Which activity best illustrates the core purpose of case management in workers' compensation claims?
• In California workers' compensation terms, what does PD stand for?
• What does subrogation mean in workers' compensation?
• In workers' compensation terminology, what does RTW stand for?
• What determines whether a treatment in a workers' compensation claim is approved or denied?
• Under privacy and confidentiality obligations in CA WC claims, how should access to medical records be handled?
• Which option correctly represents the Indirect Cost Formula?
• Losses in experience rating are grouped into which two distinct categories?
• Realists are characterized by which belief?
• In studies of insurance fraud, which subgroup believes some behaviors are justified depending on circumstances?
• How does records retention impact WC claims?
• How is the manual premium calculated?
• Which scenario is excluded under LHWCA when dealing with small vessels under eighteen tons?
• Companies WITHOUT RTW programs get their employees back in?
• Which analytics approach is used to drive positive outcomes and lower loss costs?
• What are privacy and confidentiality obligations in CA WC claims?
• According to NCCI, more than how many lost work days can be attributed to occupational injuries or illness?
• Under the Fellow Servant Rule, who is liable for injuries caused by a coworker?
• Which benefit pays for medical bills resulting from a work-related injury?
• What is meant by the 'great trade off' in workers' compensation?
• Which statement best describes the 1972 amendment to the USL&H Act?
• Which statement correctly contrasts temporary disability with permanent disability in California workers' compensation?
• What is commonly known as the down-payment or deposit that helps start the workers' compensation policy?
• Which benefit covers rehabilitation services such as vocational or physical therapy?
• In what year did every state have enacted a workers' compensation law?
• Which of the following is NOT listed as a component of RIGWAW?
• Which of the following is a category of disability benefits in workers' compensation?
• Which statement best reflects the 'great trade off' concept in workers' compensation?
• What is the Annual Aggregate in an insurance policy?
• Who is the typical recipient of the Death Benefit in workers' compensation?
• Which concept describes a state-operated option that provides coverage to employers who can't obtain coverage in the voluntary market?
• Conformists are most closely associated with which belief?
• Which item is one of the six triggers to initiating a loss control consultation?
• What does a medical-legal evaluation involve in California workers' compensation claims?
• What best describes a Medical-Only claim?
• In workers' compensation, which arrangement features a fixed premium independent of loss experience?
• Which statement about subrogation is true in workers' compensation?
• The governing class code is used to describe the employer's what?
• What is the significance of penalties for late payment in CA WC?
• Which industry is the leading workplace violence industry?
• Which of the following lists the five standard exceptions?
• Which term describes a mechanism that ensures employers who cannot obtain coverage in the voluntary market can secure coverage through a residual market pool?
• Which statement about landward sites is true?
• Permanent Partial Disability becomes measurable up to which milestone?
• Which arrangement involves an employer funding its own losses up to a point and possibly self-insuring beyond?
• Indirect Costs can be up to how many times the Direct Costs?
• Which term refers to states that require coverage to be obtained through a state-run monopoly, rather than private insurers?
• Which industry had the most violent injuries from 2002 to 2013?
• Which statement best differentiates a permanent disability rating from wage-related benefits in California workers' compensation?
• What is the role of Utilization Review (UR) in California workers' compensation medical treatment?
• In California workers' compensation, what do the acronyms TTD and PTD stand for?
• Which term describes a program where the insured pays a deductible and the insurer covers the remainder for smaller losses?
• What is the significance of medical mobility in long-term WC claims?
• Which scenario constitutes agent fraud?
• Excess losses are losses that have a total greater than a state's split point and are referred to as what?
• Within the RIGWAW framework, which element involves collecting formal accounts of the incident in writing?
• What best describes a Loss Payment Fund?
• Is Permanent Partial Disability measurable until maximum medical improvement has been reached?
• Which types of evidence are typically used to establish causation in a California workers' compensation claim?
• Which of the following is a standard exception?
• Which statement is NOT identified as a reason safety programs fail?
• What is the purpose of the claim form in California workers' compensation?
• Which factor most directly governs whether a treatment is approved or denied in a workers' compensation claim?
• Which group is excluded from LHWCA coverage due to affiliation with a club, camp, recreational operation, restaurant, museum, or retail outlet?
• Which term refers to a market mechanism that places high-risk employers into a pool run by the state or private carriers?
• What is the role of the Division of Workers' Compensation (DWC) in California?
• What is a consequence of over-reserving?
• What is the purpose of case management in WC claims?
• Which term best describes a financing method where the employer funds its own losses rather than paying a premium to an insurer?
• In experience rating, which years are used?
• In contributory negligence, which statement best describes liability when the employee contributed to the injury?
• What factor is reviewed annually and determines which category a loss will be placed?
• Which statement is true of a large deductible plan?
• The eMod is calculated as which ratio?
• Which statement accurately describes a captive insurance organization?
• In companies with Return to Work programs, employees are returned to work in how many weeks on average?
• What is the job of a workers' compensation coordinator?
• How do you evaluate whether a treatment is within guidelines?
• Which of the following is NOT a condition of a hard insurance market?
• In influencing safety changes, what does Rewards involve?
• Which statement about Employers Liability Insurance (ELI) is correct?
• In workers' compensation, which disability category corresponds to a partial loss of wage-earning capacity?
• In manual premium calculation, which elements are used?
• What does 'assumption of risk' mean in the context of workers' compensation?
• What is the Additional Sales Needed formula?
• Which of the following is NOT a resource used to obtain information on classifications?
• In the indemnity calculation process, which element is essential to verify to ensure accurate payment?
• According to CAIF, what is the estimated total cost of insurance fraud per year?
• Which of the following is NOT a characteristic of a soft insurance market?
• Which organization provides the fraud cost estimate used in insurance policy discussions?
• Which term in a settlement agreement addresses outstanding medical provider liens?
• Which statement best defines a lien in California workers' compensation?
• Which term describes an insurer arrangement where control is retained by the insureds and the entity is closely held?
• Which term best describes traditional workers' compensation expense where premiums are set before the period and do not vary with actual losses?
• The situs for USL&H coverage refers to injuries or deaths resulting from an accident occurring where?
• In the medical-legal evaluation process, what step addresses disputed causation or impairment?
• The governing class code primarily affects which calculation?
• Which occupation is included in harbor worker classifications?
• Which formula represents manual premium calculation?
• How is navigable water defined for purposes of USL&H?
• What does reasonable medical necessity mean in California workers' compensation?
• Which practice best supports privacy and data integrity in electronic WC records?
• Which location is explicitly listed as a situs option when testing situs?
• Which defense was used by some employers between 1855 and 1927?
• Which of the following is NOT a situs option listed for situs testing?
• What is the #1 way to save costs in workers' compensation programs?
• What does the governing class code represent?
• How do age and occupation affect permanent disability determinations?
• A well-designed employer safety program primarily aims to achieve which outcome?
• What is the function of the WCAB's discovery process?
• In influencing safety changes, what does Modeling involve?
• Which statement is an advantage of a large deductible plan?
• Which of the following items is typically considered primary evidence in CA WC medical-legal decisions?
• Which statement about landward sites is true?
• Which statement best describes captives in general?
• What is an Agreed Medical Examiner (AME) and when is an AME used?
• A 'choice of law' provision determines which state's law applies to a workers' compensation arrangement. Which description is correct?
• The indirect Costs are typically up _____ times more costly than the direct costs.
• Data security in electronic workers' compensation records relies on which measures?
• Which of the following is listed as an exclusion under LHWCA?
• In workers' compensation terminology, what does MMI stand for?
• What is the significance of a Notice of Controversy (NOC) in WCAB proceedings?
• Which term denotes a state where a single insurer controls the workers' compensation market, limiting private carriers?
• Death Benefit in workers' compensation is best described as benefits paid to whom?
• Which of the following is NOT a standard exception?
• Which one of the following is NOT one of the six main triggers that initiate a loss control visit?
• Which statement best describes the relationship between impairment and disability regarding a worker's ability to work?
• Between 1855 and 1927 which defense did some employers use?
• In a California workers' compensation claim, apportionment can assign part of the impairment to preexisting conditions or non-work factors. Which of the following is a correct consequence?
• Loss control becomes important for which party in the soft market?
• What is a primary objective of Return to Work (RTW) programs?
• What is the evidence hierarchy in CA WC medical-legal decisions?
• Explain the concept of notice and proof of injury within California's workers' compensation system.
• What is the main objective of the classification process?
• How do UR and Independent Medical Review (IMR) differ?
• Which plan is described as 'with aggregate' in the Alternative Work Comp Plans Scale?
• Under the Increased Risk Principle, true or false: an injury is compensable if the risk was greater to the worker than the public.
• What does bodily injury or occupational disease coverage in California workers' compensation include?
• Which entity administers the California workers' compensation program, providing standards, guidelines, and oversight of claims, medical treatment, and fees?
• Which party is primarily responsible for ensuring timely payment of wage-replacement benefits in a CA WC claim?
• Which is the KEY area in helping clients lower their costs from a loss control perspective?
• With a retrospective policy, when is the first retro formula applied?
• Which of the following is not listed as a benefit category in the material?
• Which of the following is not a typical duty of case management in workers' compensation claims?
• How is the medical-legal report typically obtained in California workers' compensation cases?
• What is the primary function of the California Workers' Compensation Appeals Board (WCAB)?
• Which term describes a system where a state operates a fund to provide workers' compensation coverage?
• What is the primary objective after going through the 6 steps to an injury investigation process (RIGWAW)?
• Loss control objectives include which of the following?
• What is the role of return-to-work coordination in workers' compensation claims?
• What are typical elements of a settlement agreement in California workers' compensation?
• How are overpayments or adjustments handled in California WC indemnity payments?
• Which jobs are excluded from USL&H coverage?
• Who is eligible to receive death benefits under California workers' compensation?
• What does a choice of law provision specify in a workers' compensation contract?
• What percentage of the surveyed population are Realists?
• Which person is explicitly excluded from LHWCA coverage as part of the exclusions?
• In California workers' compensation, which professionals typically provide independent medical evaluation (QME/AME)?
• In a medical-legal evaluation, which issues are typically assessed?
• Which statement best distinguishes impairment from disability in workers' compensation terminology?
• In CA WC medical-legal decisions, which type of evidence is considered secondary?
• Which state enacted a workers' compensation law in 1911?
• What is the purpose of a Medicare Set-Aside in settlements?
• Conformists are described as representing what portion of the surveyed population?
• Which term describes coverage that provides limits beyond the primary policy, often purchased to increase capacity?
• Which industry is the leading industry for workplace violence?
• What does "Situs - Adjoining Site" refer to in the context of USL&H?
• In California workers' compensation, what is a lien and who can file one?
• Which category describes a worker employed by a supplier, transporter, or vendor who is doing temporary business?
• A Captive is a closely held insurance company owned and controlled by their insureds.
• What is the role of an employer's safety program in preventing workers' compensation claims?
• What are the four workers compensation benefits payable to an injured worker or their dependents?
• Which statement about apportionment and awards is true?
• Injury investigation process RIGWAW's core objective?
• What is the Total Costs Formula?
• Which statement best describes a holdback agreement in adjustment settlements?
• Which of the following is NOT a qualifying criterion for a workers' compensation injury?
• Which of the following is a disadvantage commonly associated with a large deductible plan?
• What should be validated in wage statements for indemnity calculation?
• What is the involvement of attorneys in CA WC claims?
• In influencing safety changes, what does Correction involve?
• What best describes the Loss Payment Fund?
• Which of the following is a component of RIGWAW?
• Which statement about USL&H coverage is true?
• How many questions are in the IRS's list to determine employment status?
• Under the Longshore and Harbor Workers' Compensation Act, coverage applies to which person?
• Which benefit is described as providing rehabilitation, including vocational or physical therapy?
• What is the main responsibility of a Workers' Compensation Coordinator?
• How does the death benefit component function in California workers' compensation?
• What are common penalties for noncompliance with WCAB orders?
• Which description best defines a harbor worker?
• Which party determines the benefits under a workers' compensation arrangement according to the material?
• The 1972 amendment to the USL&H Act broadened situs to include more landward sites and added a status requirement. This change primarily affects which of the following?
• In CA workers' compensation practice, ethics and professional conduct primarily serve to do what?
• Which activity is excluded under LHWCA for recreational vessels under sixty-five feet?