Workers’ Compensation Adjuster Training Quiz Questions, Produced by AI

Section 1: Introduction to Workers' Compensation

1. What is the primary purpose of workers' compensation insurance?
   a) To punish negligent employers
   b) To provide financial and medical support to injured workers
   c) To replace health insurance
   d) To increase employer profits
2. Which of the following is not a typical stakeholder in a WC claim?
   a) Injured worker
   b) Employer
   c) Real estate agent
   d) Insurance carrier

Section 2: Claim Lifecycle Overview

3. What is the first step in the workers' compensation claim process?
   a) Settlement negotiation
   b) First Report of Injury (FROI)
   c) Medical evaluation
   d) Wage calculation
4. Which document is most critical during the investigation phase?
   a) Employee’s resume
   b) Medical bill
   c) Witness statement
   d) Job application

Section 3: Medical Benefits & Treatment Guidelines

5. What is the purpose of utilization review?
   a) To deny all claims
   b) To verify medical necessity of treatment
   c) To calculate wage loss
   d) To determine fault
6. Which of the following is typically covered under WC medical benefits?
   a) Cosmetic surgery
   b) Preventive care
   c) Treatment for work-related injuries
   d) Gym memberships

Section 4: Indemnity Benefits

7. Temporary Total Disability (TTD) benefits are provided when:
   a) The worker is permanently disabled
   b) The worker can work part-time
   c) The worker cannot work at all temporarily
   d) The worker is terminated
8. How is Average Weekly Wage (AWW) typically calculated?
   a) Based on the highest weekly wage
   b) Based on the lowest weekly wage
   c) Based on a set state minimum
   d) Based on earnings over a defined period

Section 5: Legal & Regulatory Compliance

9. Which of the following could result in penalties for an employer?
   a) Timely reporting of injury
   b) Providing modified duty
   c) Failing to carry WC insurance
   d) Offering health benefits
10. Subrogation allows the insurer to:
    a) Pay benefits directly to the worker
    b) Recover costs from a third party
    c) Deny claims without investigation
    d) Increase premiums arbitrarily

Section 6: Communication & Documentation

11. Which of the following is a best practice for claim notes?
    a) Use vague language
    b) Include personal opinions
    c) Be clear, factual, and timely
    d) Avoid documenting phone calls
12. Effective communication with injured workers should be:
    a) Delayed until claim closure
    b) Frequent, empathetic, and informative
    c) Limited to written correspondence
    d) Avoided to reduce liability

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