When was the 1st work comp act passed? - answer✔1911, SEVENTEEN DAYS AFTER THE
DEVISTATING FIRE AT THE TRIANGLE SHIRTWAIST COMPANY FACTORY IN NEW
YORK TOOK 146 LIVES
WHAT ARE THE 3 COMPONENTS OF THE WORK COMP SYSTEM - answer✔1. NO
FAULT
2. EXCLUSIVE REMEDY
3. ASSURED FIXED BENEFIT
NO FAULT - answer✔e employer is required to pay benefits no matter who caused the injury, as
long as the injury arose out of or occurred in the course of employment.
EXCLUSIVE REMEDY - answer✔less the employer is uninsured, the worker cannot pursue
other forms of recovery from the employer, even if the employer was grossly negligent.
ASSURED AND FIXED BENEFIT - answer✔The workers' compensation system establishes
defined benefits, which must be paid for by the employer. Workers' compensation awards are
typically far less than comparable negligence awards in a civil suit. For example, although the
maximum workers' compensation death benefit may be far less than the possible award in a civil
wrongful death suit, a civil action may take years to resolve while a death claim can be re-solved
in as little as a few months. Additional recoveries are available to employees for an employer's
serious and willful misconduct and unlawful discrimination (Labor Code § 132a and § 4553).
Although group health coverage may include arbitrary limits on the extent of treatment covered,
workers' compensation is a statutory benefit with no arbitrary limits on the frequency, duration,
or extent of services.
WHAT TYPE OF INJYURIES ARE EXCLUDED - answer✔deliberately self-inflicted injuries
are excluded from coverage
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE
EMPLOYER? - answer✔For injuries that result from the serious and willful misconduct of the
employer, the employee's compensation is increased by half
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE
EMPLOYEE? - answer✔For injuries that result from the serious and willful misconduct of the
injured employee, benefits are reduced by half, unless the injury resulted in death or a per-
manent disability of 70% or more; the injury resulted from failure of the employer to comply
with the law or safety and health regulations; or the employee was under 16 years old at the time
of in-jury
WHAT MEASURES WERE ENACTED IN 2003 AND 2004 - answer✔measures were enacted
that allowed employers (1) to establish medical pro-vider networks—from which injured
workers are required to select treating doctors, (2) to conduct utilization review to ensure that
medical care was consistent with evidence-based guidelines, and (3) to limit the amount of
physical therapy and chiropractic treatment. These measures also affect-ed permanent disability
ratings and benefit payments to injured workers. An evidence-based medi-cal treatment
utilization schedule (MTUS), or set of guidelines, was also adopted.
WHAT MEASURES WERE ENACTED IN 2013 - answer✔In 2013, measures were enacted
that made wide-ranging changes, which included (1) increasing permanent disability paid to
injured workers and simplifying the permanent disability rating meth-od, (2) resolving medical
treatment disagreements through independent medical review and bill payment disputes through
independent bill review, (3) improving medical provider networks, and (4) updating the Official
Medical Fee Schedule and establishing fee schedules for copy services, in-terpreters, vocational
experts, and in-home health care.
MEDICAL UNIT - answer✔Which unit investigates complaints filed against QMEs con-cerning
violations of the Labor Code and regulations as well as other statutes for misconduct com-mitted
in the QME process
WHAT ARE THE KEY COMPONENTS OF COMPENCABILITY - answer✔• How to Take a
Complete Occupational History
• How to Define:
o An Injury
o First Aid
• Aggravation
• Recurrence
• Arising Out of Employment (AOE)
• Occurring in the Course of Employment (COE)
• Causation
• Presumptions
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