Michigan OT Jurisprudence Exam - Fully Solved
Practice Questions and Answers Study Guide
2025/2026
1. A licensed occupational therapist in Michigan receives a referral for an individual with a recent
spinal cord injury. The referral requests 'occupational therapy evaluation and treatment for
activities of daily living and upper extremity strengthening.' The therapist has never treated a
spinal cord injury but has general experience with physical disabilities. Which of the following
actions is most consistent with Michigan law and the AOTA Code of Ethics?
A. Accept the referral and treat the individual while consulting with a more experienced colleague.
B. Decline the referral because the therapist lacks specific competency in spinal cord injury.
C. Accept the referral but limit treatment to activities of daily living only.
D. Accept the referral and refer the individual to a physical therapist for upper extremity strengthening.
Answer: B
Rationale: Michigan law requires OTs to practice within their competency. The AOTA Code of Ethics
Principle 2 (Beneficence) and Principle 4 (Justice) mandate that practitioners provide services only
when they have the necessary skills. Declining the referral is ethically and legally correct. Consulting or
limiting scope does not resolve the lack of competency, and delegating to a PT is outside OT scope.
2. An occupational therapist in Michigan supervises an occupational therapy assistant (OTA) who
is working with a client recovering from a stroke. The OTA asks the therapist to review the
treatment plan and co-sign documentation. According to Michigan Administrative Code R
338.1265, which of the following best describes the required level of supervision?
A. Direct supervision, with the therapist on-site and immediately available.
B. General supervision, with the therapist available by telecommunication.
C. Close supervision, with the therapist in the same building.
D. Indirect supervision, with the therapist reviewing documentation within 30 days.
Answer: A
Rationale: Michigan rules require direct supervision for OTAs when the client is in an acute or unstable
condition, or when the OTA is performing interventions that require frequent re-evaluation. A stroke
recovery client typically requires direct supervision. General supervision is for stable, predictable
conditions. Close and indirect are not defined terms in Michigan OT rules.
3. An occupational therapist is evaluating a client with a work-related injury for the purpose of
determining return-to-work readiness. The employer requests a copy of the evaluation report.
Under Michigan's Public Health Code (MCL 333.16213) and HIPAA, which of the following is the
most appropriate response?
A. Provide the report directly to the employer without the client's consent because it is a work-related injury.
Page 1
,B. Obtain written authorization from the client before releasing any information to the employer.
C. Release the report only to the client's attorney, not the employer.
D. Provide a summary of findings to the employer without specific clinical details.
Answer: B
Rationale: Michigan law and HIPAA require patient authorization for disclosure of protected health
information to third parties, including employers, unless mandated by workers' compensation law.
However, even under workers' comp, the client's consent is generally needed for non-statutory requests.
Option A is incorrect because work-related injury does not automatically waive confidentiality. Options
C and D are not legally required without consent.
4. An occupational therapist in Michigan is considering using a new therapeutic modality that is
not explicitly listed in the state's Occupational Therapists' Rules. The modality is supported by
emerging evidence but is not yet widely accepted. Which of the following steps is most critical for
the therapist to take before using this modality?
A. Obtain written approval from the Michigan Board of Occupational Therapy.
B. Ensure the modality is within the scope of practice as defined by the rules and the AOTA scope of practice.
C. Complete a continuing education course on the modality.
D. Obtain a signed waiver from the client acknowledging the experimental nature of the modality.
Answer: B
Rationale: Michigan law requires OTs to practice within the defined scope of practice. If the modality is
not prohibited and falls within the domain of occupational therapy, it may be used. However, the
therapist must first determine if it is consistent with the scope. Board approval is not required for
individual modalities. CE and waivers are secondary to ensuring legality.
5. An occupational therapist is treating a client with chronic pain using cognitive-behavioral
strategies. The client's insurance company requests a copy of the treatment notes for audit
purposes. The therapist has not obtained a signed authorization from the client. Which of the
following is true under Michigan law?
A. The therapist may release the notes without authorization because insurance audits are permitted under
HIPAA.
B. The therapist must obtain the client's written authorization before releasing any information.
C. The therapist may release only the minimum necessary information without authorization.
D. The therapist may release the notes if the client has been informed of the audit in advance.
Answer: A
Rationale: Under HIPAA, covered entities may disclose protected health information for health care
operations, including insurance audits, without individual authorization. However, Michigan law may
have additional restrictions, but generally, audits are permitted. Option B is overly restrictive; Option C
is for non-routine disclosures; Option D is not sufficient.
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,6. An occupational therapist in Michigan is asked by a client to provide a letter of medical necessity
for a power wheelchair. The therapist has evaluated the client and determined that a power
wheelchair is medically necessary. However, the therapist knows that the client's insurance
typically denies such requests. Which of the following actions is most consistent with the AOTA
Code of Ethics and Michigan law?
A. Write the letter of medical necessity, including all relevant clinical findings, and submit it to the insurance
company.
B. Refuse to write the letter because the insurance is likely to deny the request.
C. Write a letter but downplay the client's functional limitations to avoid suspicion of fraud.
D. Refer the client to a physical therapist for the letter.
Answer: A
Rationale: The therapist has an ethical duty to advocate for the client's needs (Principle 4: Justice) and to
provide accurate documentation. Writing an honest, evidence-based letter is appropriate. Refusing to
write it (B) may be a breach of duty. Downplaying limitations (C) is fraudulent. Referring to PT (D) is
unnecessary and may delay care.
7. An occupational therapist is supervising an OTA who is providing intervention to a client with a
traumatic brain injury. The OTA reports that the client is becoming agitated during treatment.
The therapist is off-site but available by phone. According to Michigan rules, what is the
therapist's responsibility?
A. Instruct the OTA to continue treatment and monitor the client's behavior.
B. Direct the OTA to stop treatment and wait for the therapist to arrive on-site.
C. Provide verbal guidance to the OTA and document the supervisory contact.
D. Terminate the supervisory relationship and refer the client to another therapist.
Answer: C
Rationale: Michigan rules allow general supervision for stable clients, but if the client's condition
changes (agitation), the therapist must provide direct guidance. Providing verbal guidance and
documenting it is appropriate. Continuing without changes (A) is unsafe. Stopping treatment (B) may be
too drastic if guidance can resolve the issue. Terminating supervision (D) is not necessary.
8. An occupational therapist in Michigan is approached by a former client who asks for a copy of
their evaluation report. The therapist has not seen the client for two years. Which of the following
is the most appropriate response under Michigan law?
A. Provide the report immediately upon request.
B. Request that the client submit a written request and then provide the report within a reasonable time.
C. Inform the client that records are destroyed after two years and are unavailable.
D. Provide the report only if the client pays a copying fee and signs a release.
Answer: B
Rationale: Michigan law requires healthcare providers to provide access to records upon written request.
A verbal request is not sufficient; a written request is needed. Records must be retained for at least 7
years (MCL 333.16213). Destruction after two years (C) is false. While copying fees may be charged, the
primary requirement is a written request. Option A is incorrect because a written request is required.
Page 3
, 9. An occupational therapist is considering ending a therapeutic relationship with a client who has
not made progress after several months. The client still has goals that could be addressed. Under
the AOTA Code of Ethics and Michigan law, which of the following is the most appropriate course
of action?
A. Discharge the client immediately because lack of progress justifies termination.
B. Discuss the lack of progress with the client, explore alternatives, and provide referrals if necessary.
C. Continue treatment indefinitely until the client decides to stop.
D. Refer the client to another therapist without discussing termination.
Answer: B
Rationale: Ethical discharge requires collaboration and consideration of the client's needs. Discussing
lack of progress, exploring alternative approaches, and providing referrals respects autonomy and
beneficence. Immediate discharge (A) may be abandonment. Continuing indefinitely (C) is not
necessary. Referral without discussion (D) fails to involve the client.
10. An occupational therapist in Michigan is asked by a court to provide expert testimony
regarding the functional capacity of a plaintiff in a personal injury case. The therapist has never
performed a functional capacity evaluation (FCE) but has general OT experience. Which of the
following actions is most ethically and legally appropriate?
A. Accept the request and perform an FCE, relying on general OT knowledge.
B. Decline the request because the therapist lacks specific competency in FCE.
C. Accept the request but limit testimony to observations from standard OT evaluation.
D. Accept the request and consult with a colleague who has FCE expertise.
Answer: B
Rationale: Michigan law requires OTs to practice within their area of competency. Providing expert
testimony on FCE without specific training and experience would be outside the therapist's scope and
could be considered fraudulent or unethical. Declining is the appropriate action. Options A, C, and D do
not resolve the lack of competency.
11. An occupational therapist is evaluating a client with a recent traumatic brain injury. The client
demonstrates difficulty with sustained attention and impulsivity. Which standardized assessment
would be MOST appropriate to evaluate executive function deficits in this population?
A. Montreal Cognitive Assessment (MoCA)
B. Executive Function Performance Test (EFPT)
C. Allen Cognitive Level Screen (ACLS)
D. Functional Independence Measure (FIM)
Answer: B
Rationale: The EFPT is a performance-based assessment specifically designed to evaluate executive
function deficits in clients with neurological conditions, including TBI, by assessing task initiation,
organization, and self-monitoring. MoCA screens for general cognitive impairment but not executive
function in depth. ACLS measures cognitive levels based on task performance but is not specific to
executive function. FIM measures functional independence in daily activities but does not isolate
executive function.
Page 4
Practice Questions and Answers Study Guide
2025/2026
1. A licensed occupational therapist in Michigan receives a referral for an individual with a recent
spinal cord injury. The referral requests 'occupational therapy evaluation and treatment for
activities of daily living and upper extremity strengthening.' The therapist has never treated a
spinal cord injury but has general experience with physical disabilities. Which of the following
actions is most consistent with Michigan law and the AOTA Code of Ethics?
A. Accept the referral and treat the individual while consulting with a more experienced colleague.
B. Decline the referral because the therapist lacks specific competency in spinal cord injury.
C. Accept the referral but limit treatment to activities of daily living only.
D. Accept the referral and refer the individual to a physical therapist for upper extremity strengthening.
Answer: B
Rationale: Michigan law requires OTs to practice within their competency. The AOTA Code of Ethics
Principle 2 (Beneficence) and Principle 4 (Justice) mandate that practitioners provide services only
when they have the necessary skills. Declining the referral is ethically and legally correct. Consulting or
limiting scope does not resolve the lack of competency, and delegating to a PT is outside OT scope.
2. An occupational therapist in Michigan supervises an occupational therapy assistant (OTA) who
is working with a client recovering from a stroke. The OTA asks the therapist to review the
treatment plan and co-sign documentation. According to Michigan Administrative Code R
338.1265, which of the following best describes the required level of supervision?
A. Direct supervision, with the therapist on-site and immediately available.
B. General supervision, with the therapist available by telecommunication.
C. Close supervision, with the therapist in the same building.
D. Indirect supervision, with the therapist reviewing documentation within 30 days.
Answer: A
Rationale: Michigan rules require direct supervision for OTAs when the client is in an acute or unstable
condition, or when the OTA is performing interventions that require frequent re-evaluation. A stroke
recovery client typically requires direct supervision. General supervision is for stable, predictable
conditions. Close and indirect are not defined terms in Michigan OT rules.
3. An occupational therapist is evaluating a client with a work-related injury for the purpose of
determining return-to-work readiness. The employer requests a copy of the evaluation report.
Under Michigan's Public Health Code (MCL 333.16213) and HIPAA, which of the following is the
most appropriate response?
A. Provide the report directly to the employer without the client's consent because it is a work-related injury.
Page 1
,B. Obtain written authorization from the client before releasing any information to the employer.
C. Release the report only to the client's attorney, not the employer.
D. Provide a summary of findings to the employer without specific clinical details.
Answer: B
Rationale: Michigan law and HIPAA require patient authorization for disclosure of protected health
information to third parties, including employers, unless mandated by workers' compensation law.
However, even under workers' comp, the client's consent is generally needed for non-statutory requests.
Option A is incorrect because work-related injury does not automatically waive confidentiality. Options
C and D are not legally required without consent.
4. An occupational therapist in Michigan is considering using a new therapeutic modality that is
not explicitly listed in the state's Occupational Therapists' Rules. The modality is supported by
emerging evidence but is not yet widely accepted. Which of the following steps is most critical for
the therapist to take before using this modality?
A. Obtain written approval from the Michigan Board of Occupational Therapy.
B. Ensure the modality is within the scope of practice as defined by the rules and the AOTA scope of practice.
C. Complete a continuing education course on the modality.
D. Obtain a signed waiver from the client acknowledging the experimental nature of the modality.
Answer: B
Rationale: Michigan law requires OTs to practice within the defined scope of practice. If the modality is
not prohibited and falls within the domain of occupational therapy, it may be used. However, the
therapist must first determine if it is consistent with the scope. Board approval is not required for
individual modalities. CE and waivers are secondary to ensuring legality.
5. An occupational therapist is treating a client with chronic pain using cognitive-behavioral
strategies. The client's insurance company requests a copy of the treatment notes for audit
purposes. The therapist has not obtained a signed authorization from the client. Which of the
following is true under Michigan law?
A. The therapist may release the notes without authorization because insurance audits are permitted under
HIPAA.
B. The therapist must obtain the client's written authorization before releasing any information.
C. The therapist may release only the minimum necessary information without authorization.
D. The therapist may release the notes if the client has been informed of the audit in advance.
Answer: A
Rationale: Under HIPAA, covered entities may disclose protected health information for health care
operations, including insurance audits, without individual authorization. However, Michigan law may
have additional restrictions, but generally, audits are permitted. Option B is overly restrictive; Option C
is for non-routine disclosures; Option D is not sufficient.
Page 2
,6. An occupational therapist in Michigan is asked by a client to provide a letter of medical necessity
for a power wheelchair. The therapist has evaluated the client and determined that a power
wheelchair is medically necessary. However, the therapist knows that the client's insurance
typically denies such requests. Which of the following actions is most consistent with the AOTA
Code of Ethics and Michigan law?
A. Write the letter of medical necessity, including all relevant clinical findings, and submit it to the insurance
company.
B. Refuse to write the letter because the insurance is likely to deny the request.
C. Write a letter but downplay the client's functional limitations to avoid suspicion of fraud.
D. Refer the client to a physical therapist for the letter.
Answer: A
Rationale: The therapist has an ethical duty to advocate for the client's needs (Principle 4: Justice) and to
provide accurate documentation. Writing an honest, evidence-based letter is appropriate. Refusing to
write it (B) may be a breach of duty. Downplaying limitations (C) is fraudulent. Referring to PT (D) is
unnecessary and may delay care.
7. An occupational therapist is supervising an OTA who is providing intervention to a client with a
traumatic brain injury. The OTA reports that the client is becoming agitated during treatment.
The therapist is off-site but available by phone. According to Michigan rules, what is the
therapist's responsibility?
A. Instruct the OTA to continue treatment and monitor the client's behavior.
B. Direct the OTA to stop treatment and wait for the therapist to arrive on-site.
C. Provide verbal guidance to the OTA and document the supervisory contact.
D. Terminate the supervisory relationship and refer the client to another therapist.
Answer: C
Rationale: Michigan rules allow general supervision for stable clients, but if the client's condition
changes (agitation), the therapist must provide direct guidance. Providing verbal guidance and
documenting it is appropriate. Continuing without changes (A) is unsafe. Stopping treatment (B) may be
too drastic if guidance can resolve the issue. Terminating supervision (D) is not necessary.
8. An occupational therapist in Michigan is approached by a former client who asks for a copy of
their evaluation report. The therapist has not seen the client for two years. Which of the following
is the most appropriate response under Michigan law?
A. Provide the report immediately upon request.
B. Request that the client submit a written request and then provide the report within a reasonable time.
C. Inform the client that records are destroyed after two years and are unavailable.
D. Provide the report only if the client pays a copying fee and signs a release.
Answer: B
Rationale: Michigan law requires healthcare providers to provide access to records upon written request.
A verbal request is not sufficient; a written request is needed. Records must be retained for at least 7
years (MCL 333.16213). Destruction after two years (C) is false. While copying fees may be charged, the
primary requirement is a written request. Option A is incorrect because a written request is required.
Page 3
, 9. An occupational therapist is considering ending a therapeutic relationship with a client who has
not made progress after several months. The client still has goals that could be addressed. Under
the AOTA Code of Ethics and Michigan law, which of the following is the most appropriate course
of action?
A. Discharge the client immediately because lack of progress justifies termination.
B. Discuss the lack of progress with the client, explore alternatives, and provide referrals if necessary.
C. Continue treatment indefinitely until the client decides to stop.
D. Refer the client to another therapist without discussing termination.
Answer: B
Rationale: Ethical discharge requires collaboration and consideration of the client's needs. Discussing
lack of progress, exploring alternative approaches, and providing referrals respects autonomy and
beneficence. Immediate discharge (A) may be abandonment. Continuing indefinitely (C) is not
necessary. Referral without discussion (D) fails to involve the client.
10. An occupational therapist in Michigan is asked by a court to provide expert testimony
regarding the functional capacity of a plaintiff in a personal injury case. The therapist has never
performed a functional capacity evaluation (FCE) but has general OT experience. Which of the
following actions is most ethically and legally appropriate?
A. Accept the request and perform an FCE, relying on general OT knowledge.
B. Decline the request because the therapist lacks specific competency in FCE.
C. Accept the request but limit testimony to observations from standard OT evaluation.
D. Accept the request and consult with a colleague who has FCE expertise.
Answer: B
Rationale: Michigan law requires OTs to practice within their area of competency. Providing expert
testimony on FCE without specific training and experience would be outside the therapist's scope and
could be considered fraudulent or unethical. Declining is the appropriate action. Options A, C, and D do
not resolve the lack of competency.
11. An occupational therapist is evaluating a client with a recent traumatic brain injury. The client
demonstrates difficulty with sustained attention and impulsivity. Which standardized assessment
would be MOST appropriate to evaluate executive function deficits in this population?
A. Montreal Cognitive Assessment (MoCA)
B. Executive Function Performance Test (EFPT)
C. Allen Cognitive Level Screen (ACLS)
D. Functional Independence Measure (FIM)
Answer: B
Rationale: The EFPT is a performance-based assessment specifically designed to evaluate executive
function deficits in clients with neurological conditions, including TBI, by assessing task initiation,
organization, and self-monitoring. MoCA screens for general cognitive impairment but not executive
function in depth. ACLS measures cognitive levels based on task performance but is not specific to
executive function. FIM measures functional independence in daily activities but does not isolate
executive function.
Page 4
