Workers Compensation Adjuster Exam Flashcards
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How long is the time limit for the Workers Compensation Adjuster Exam?
60 minutes.
What is the exam fee for the Workers Compensation Adjuster Exam?
$29 (USD).
What passing score is required on the Workers Compensation Adjuster Exam?
70 percent.
What does a workers' compensation adjuster do?
Investigates, evaluates, and manages workers' comp claims — determining compensability, calculating benefits, coordinating medical care, and settling or denying claims.
What is Temporary Total Disability (TTD)?
Wage-replacement benefits paid while an injured worker is completely unable to work for a temporary period during recovery.
What is Permanent Partial Disability (PPD)?
Benefits for a lasting impairment that only partially limits the worker's earning capacity or bodily function after reaching maximum medical improvement.
What is Maximum Medical Improvement (MMI)?
The point at which an injured worker's condition has stabilized and is unlikely to improve further with additional treatment; it's used to assess permanent impairment.
What is 'compensability' in a workers' comp claim?
Whether an injury or illness arose out of and in the course of employment (AOE/COE), making it eligible for benefits.
What is subrogation in workers' compensation?
The insurer's right to recover benefits it paid from a liable third party who caused the injury.
What is the Average Weekly Wage (AWW) used for?
It's the worker's average pre-injury earnings, used as the basis for calculating indemnity (wage-loss) benefits.
What are indemnity benefits versus medical benefits?
Indemnity benefits replace lost wages (e.g., TTD, PPD); medical benefits pay for treatment of the work-related injury.
What is a 'first report of injury' (FROI)?
The initial notice/form documenting a workplace injury, filed to start the claims process and notify the insurer and state.
What does 'AOE/COE' stand for in claim investigation?
'Arising Out of Employment' and 'in the Course of Employment' — the two-part test used to determine whether an injury is work-related and compensable.
With a 60-minute limit and a 70% passing bar, roughly how should you pace yourself?
Budget your time across all questions and don't dwell too long on any single item — you must answer enough correctly to reach 70% before the 60 minutes expire.
What is workers' compensation?
A no-fault insurance system that provides benefits to employees who suffer job-related injuries or illnesses, regardless of who was at fault, in exchange for the employee generally giving up the right to sue the employer.