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Flashcards in Workers' Compensation- Done Deck (27):
0

Workers compensation laws are designed to....

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

1

Workers compensation is a ----- statutory program

State

2

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

To sue the employer

3

Common law prior to workers compensation laws maintained that...

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

4

Three common law defenses formerly used by employers

1. Assumption risk
2. Fellow servant rule
3. Contributory negligence

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Assumption risk

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

6

Fellow servant rule

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

7

Contributory negligence

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

8

Significant milestones in workers compensation

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

9

Provisions under workers compensation

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

10

Federal Workers Compensation Acts

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

11

FECA

Applies to civilian employees if US government

Does not apply to military personnel

12

State funds

Insurance companies owned and operated by the state

13

Types of state funds

1. Monopolistic
2. Competitive

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Monopolistic state fund

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

Some state allow self insurance

15

Competitive state funds

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

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Purpose of employer self insurance

1. To reduce costs
2. Maximize cash flow

17

Two basic coverages provided

1. Workers compensation
2. Employers liability

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Benefits under workers compensation

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

19

Impairment

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

20

Disability

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

21

Other factors considered with disability

1. Age
2. Education
3. Economic and social environment
4. Energy requirements of an individual's occupation

22

AOE

Arising out of employment

23

COE

In the course of employment

24

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

1. It must arise out of employment (AOE)
2. It must occur in the course of employment (COE)

25

Arising out of employment

Must be a causal relationship between the employment and the injury

26

Course of employment

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

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