QUESTIONS AND VERIFIED CORRECT
ANSWERS
◉ 1. NO FAULT
2. EXCLUSIVE REMEDY
3. ASSURED FIXED BENEFIT. Answer: WHAT ARE THE 3
COMPONENTS OF THE WORK COMP SYSTEM
◉ 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.. Answer: NO FAULT
◉ less the employer is uninsured, the worker cannot pursue other
forms of recovery from the employer, even if the employer was
grossly negligent.. Answer: EXCLUSIVE REMEDY
◉ 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.. Answer: ASSURED AND
FIXED BENEFIT
◉ deliberately self-inflicted injuries are excluded from coverage.
Answer: WHAT TYPE OF INJYURIES ARE EXCLUDED
◉ For injuries that result from the serious and willful misconduct of
the employer, the employee's compensation is increased by half.
Answer: WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS
MISCONDUCT OF THE EMPLOYER?
◉ 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. Answer: WHAT HAPPENS IF THE
INJURY IS DUE TO SERIOUS MISCONDUCT OF THE EMPLOYEE?
◉ 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