Hawaii Insurance Workers Compensation Adjuster License Practice Exam

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Hawaii Insurance Workers Compensation Adjuster License Practice Exam - Quiz

In Hawaii, employers are expected to have insurance covers for their workers. For one to become a workers compensation adjuster, you need to have proper knowledge of claims, how to investigate them and negotiating settlements. Take the test below to gauge your knowledge on the insurance cover in preparation for getting the license.


Questions and Answers
  • 1. 

    In Hawaii, how long must an insurer or a self-insured ER retain records of W/C claims for the inspection of the insurance commissioner?

    • A.

      6 months

    • B.

      1 year

    • C.

      5 years

    • D.

      8 years

    Correct Answer
    D. 8 years
    Explanation
    In Hawaii, an insurer or a self-insured ER must retain records of workers' compensation (W/C) claims for 8 years for the inspection of the insurance commissioner. This is important for ensuring compliance with regulations and allowing the insurance commissioner to effectively monitor and investigate claims. By retaining records for this length of time, the insurance commissioner can review past claims and identify any potential issues or patterns that may require further action.

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  • 2. 

    WOTF individuals is most likely to have a valid W/C claim?

    • A.

      A retiree injured while visiting his former workplace

    • B.

      An EE who suffers a diabetic coma from failure to take prescribed medicine

    • C.

      A sole proprietor injured in an auto accident while driving to a friend's house

    • D.

      An EE injured while performing an operation for which he had not received training

    Correct Answer
    D. An EE injured while performing an operation for which he had not received training
    Explanation
    An employee injured while performing an operation for which he had not received training is most likely to have a valid workers' compensation claim. Workers' compensation typically covers injuries that occur during the course of employment, and this scenario suggests that the employee was engaged in work-related activities. Additionally, the fact that the employee was not trained for the operation further strengthens the argument that the injury was a result of the employer's negligence or failure to provide proper training.

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  • 3. 

    If a TTD claim in the state of Hawaii is not being contested, how long after the ER receives notice of the disability must benefits begin to be paid?

    • A.

      7 working days

    • B.

      10 days

    • C.

      14 days

    • D.

      21 days

    Correct Answer
    B. 10 days
    Explanation
    In the state of Hawaii, if a temporary total disability (TTD) claim is not being contested, the benefits must begin to be paid within 10 days after the employer receives notice of the disability. This ensures that injured workers receive the necessary financial support in a timely manner to cover their medical expenses and lost wages.

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  • 4. 

    Failing to provide WC coverage in Hawaii can result in what immediate financial penalty?

    • A.

      $10 per EE subject to a minimum penalty of $100

    • B.

      $100 per EE subject to minimum penalty of $1,000

    • C.

      $250, OR up to $10 per EE per day that coverage is not place

    • D.

      $100 for each day that coverage is not in place

    Correct Answer
    C. $250, OR up to $10 per EE per day that coverage is not place
    Explanation
    Failing to provide workers' compensation (WC) coverage in Hawaii can result in a financial penalty of $250, or up to $10 per employee per day that coverage is not in place. This means that the penalty can be a fixed amount of $250 or can vary depending on the number of employees and the duration of non-compliance.

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  • 5. 

    In Hawaii, which party submits a closing report upon the termination of VR services?

    • A.

      The provider of the services

    • B.

      The ER

    • C.

      The EE

    • D.

      The director of labor and industry relations

    Correct Answer
    A. The provider of the services
    Explanation
    The correct answer is the provider of the services. In Hawaii, when VR services are terminated, it is the responsibility of the service provider to submit a closing report. This report summarizes the services provided and the outcomes achieved during the VR process. The provider is expected to document the progress made by the individual receiving services and any recommendations for future support or assistance. This report helps to ensure transparency and accountability in the VR system in Hawaii.

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  • 6. 

    Would a claim under ER's liability insurance for an EE on business temporarily in France be covered?

    • A.

      No, because the EE was outside the covered state or territory

    • B.

      Yes, since the EE was temporarily outside the coverage territory

    • C.

      Yes, but only if French laws allowed the suit to be followed

    • D.

      No, because the ER's liability responds to claims occurring in the USA

    Correct Answer
    B. Yes, since the EE was temporarily outside the coverage territory
    Explanation
    The correct answer is "Yes, since the EE was temporarily outside the coverage territory." This means that the liability insurance would cover a claim for an employee who is on business temporarily in France. Even though the employee is outside the coverage territory, the fact that it is a temporary situation allows for coverage under the insurance policy.

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  • 7. 

    All of the following circumstances would be covered under W/C, except?

    • A.

      The worker was injured while violating a company rule at lunch break

    • B.

      The risk of injury was known to the worker

    • C.

      The injury was caused by the carelessness of a fellow worker

    • D.

      The injured worker was guilty of contributory negligence

    Correct Answer
    A. The worker was injured while violating a company rule at lunch break
    Explanation
    The worker was injured while violating a company rule at lunch break would not be covered under Workers' Compensation (W/C) because the injury occurred while the worker was engaged in a violation of company rules. Workers' Compensation typically covers injuries that occur during the course of employment and are not the result of intentional misconduct or violations of company policies. Since the worker was injured while violating a company rule, it can be inferred that their actions were not in line with their employment responsibilities, and therefore, the injury would not be covered under W/C.

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  • 8. 

    WOTF is true regarding consultations because the situation is life threatening or could cause serious harm?I. The attending physician will notify the ER ASAPII. The consultant will provide a copy of the consultation report to the attending physicianIII. The copy of the consultation report must be given to the ER w/in 14 calendar days of the examination

    • A.

      I and II

    • B.

      I, II and III

    • C.

      I and III

    • D.

      II and III

    Correct Answer
    B. I, II and III
    Explanation
    In situations where the consultation is necessary due to a life-threatening or potentially harmful situation, all three statements are true. Statement I states that the attending physician will notify the emergency room (ER) as soon as possible, which is crucial in urgent cases. Statement II states that the consultant will provide a copy of the consultation report to the attending physician, which is important for proper communication and coordination of care. Statement III states that the copy of the consultation report must be given to the ER within 14 calendar days of the examination, ensuring that the necessary information is documented and available for future reference.

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  • 9. 

    Part I of the W/C ER Liability Insurance Policy describes:

    • A.

      The insurer's duty to pay promptly, when due, the benefits required of the ER by the W/C statute

    • B.

      Those situations in which an IW can sue the insured

    • C.

      The coverage in the stats where a insured's operations are known

    • D.

      The insured's duties in the event of the injury

    Correct Answer
    A. The insurer's duty to pay promptly, when due, the benefits required of the ER by the W/C statute
    Explanation
    Part I of the W/C ER Liability Insurance Policy describes the insurer's duty to pay the benefits required by the Workers' Compensation (W/C) statute. This means that the insurer is obligated to promptly provide the benefits that the employer is required to give to the injured worker under the W/C laws. The policy outlines the insurer's responsibility to ensure timely payment of these benefits, which may include medical expenses, lost wages, and rehabilitation costs.

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  • 10. 

    WOTF is true about the Jones Act?I. It allows injure crew members to sue the ER for negligenceII. It allows the personal representative of a deceased crew member to sue the ERIII. It was named after Williams Jones, who lost his life on the high seas in 1933

    • A.

      I and III only

    • B.

      II and III only

    • C.

      I, II and III

    • D.

      I and II only

    Correct Answer
    D. I and II only
    Explanation
    The Jones Act allows injured crew members to sue the employer for negligence (I) and allows the personal representative of a deceased crew member to sue the employer (II). However, there is no information given in the question about the Act being named after Williams Jones, so option III cannot be considered true. Therefore, the correct answer is I and II only.

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  • 11. 

    If an injury to a Hawaii EE is ultimately found to be the fault of a party other than the ER, WOTF is FALSE?

    • A.

      The EE or his dependents may recover damages from the liable party

    • B.

      The ER, having already paid for compensation for the injury, shall have the right to recover damages from the liable party

    • C.

      IF the EE wins damages from a party other than the ER, the EE can retain those monies in addition to the compensation received from the ER

    • D.

      If the EE wins damages from a party other than the ER, the EE must reimburse the ER for the compensation payments it has made to the EE

    Correct Answer
    C. IF the EE wins damages from a party other than the ER, the EE can retain those monies in addition to the compensation received from the ER
    Explanation
    If the EE wins damages from a party other than the ER, the EE can retain those monies in addition to the compensation received from the ER. This means that if the injury is found to be the fault of someone other than the employer, the employee or their dependents can seek damages from that party. If they are successful in obtaining damages, they are entitled to keep that money in addition to the compensation already received from the employer. There is no requirement for the employee to reimburse the employer for the compensation payments made.

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  • 12. 

    In the case of a compensable injury in Hawaii, who normally chooses the physician for medical treatment?

    • A.

      The ER

    • B.

      The EE

    • C.

      The insurance company

    • D.

      The State of Hawaii

    Correct Answer
    B. The EE
    Explanation
    In the case of a compensable injury in Hawaii, the employee (EE) is normally the one who chooses the physician for medical treatment. This means that the injured employee has the right to select their own healthcare provider for treatment related to their work-related injury. The employee's choice of physician is important as it allows them to receive the necessary medical care and treatment that they deem fit for their injury.

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  • 13. 

    The insured maintains a business where workers compensation coverage can be written by private insurance companies. If he has EE's going to a state that is monopolistic for this coverage, what must he do to cover his EE's for W/C coverage?

    • A.

      Add the states to the ER's W/C policy

    • B.

      Purchase coverage for the EE's from the state

    • C.

      Secure general liability coverage

    • D.

      Purchase an umbrella policy

    Correct Answer
    B. Purchase coverage for the EE's from the state
    Explanation
    The insured must purchase coverage for the EE's from the state because the state is monopolistic for workers compensation coverage. This means that private insurance companies cannot provide workers compensation coverage in that state. Therefore, the insured must obtain coverage directly from the state in order to cover his EE's for workers compensation.

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  • 14. 

    In Hawaii, WOTF incidents would most likely not constitute a compensable W/C claim?

    • A.

      A factory EE was injured while driving his own car home from work

    • B.

      An EE was injured while under the influence of alcohol

    • C.

      An EE intentionally injured herself at work

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    All of the above incidents would most likely not constitute a compensable workers' compensation claim in Hawaii. In the first scenario, the employee was injured while driving his own car home from work, which typically falls outside the scope of employment. In the second scenario, the employee was injured while under the influence of alcohol, which is considered a violation of workplace safety policies and may disqualify the claim. In the third scenario, the employee intentionally injured herself at work, which is generally not covered under workers' compensation as it is considered self-inflicted.

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  • 15. 

    What is the waiting period in Hawaii before an EE becomes entitled to receive TTD benefits?

    • A.

      7 days

    • B.

      5 days

    • C.

      3 days

    • D.

      There is no waiting period

    Correct Answer
    C. 3 days
    Explanation
    The waiting period in Hawaii before an EE becomes entitled to receive TTD benefits is 3 days. This means that an employee must wait for three days before they are eligible to receive temporary total disability benefits.

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  • 16. 

    When an industrial injury results in death to a Hawaii EE, what funeral benefits, if any, are provided under the W/C law?

    • A.

      Up to 3 times the maximum week benefit rate

    • B.

      Up to 10 times the maximum week benefit rate

    • C.

      $5,000 maximum

    • D.

      No benefits are provided for funeral expenses

    Correct Answer
    B. Up to 10 times the maximum week benefit rate
    Explanation
    When an industrial injury results in death to a Hawaii EE, the W/C law provides funeral benefits of up to 10 times the maximum week benefit rate. This means that the amount of funeral expenses that can be covered under the law is significantly higher, providing financial support to the family of the deceased employee during their time of mourning and loss.

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  • 17. 

    Part II of the ER's Liability Coverage, provides WOTF W/C coverage?

    • A.

      Products

    • B.

      Contractual

    • C.

      Claims that not subject to W/C laws

    • D.

      Completed Operations

    Correct Answer
    C. Claims that not subject to W/C laws
    Explanation
    Part II of the ER's Liability Coverage provides coverage for claims that are not subject to Workers' Compensation (W/C) laws. This means that if an employee gets injured or becomes ill due to work-related reasons, they would typically file a claim under Workers' Compensation. However, if the claim falls outside the scope of Workers' Compensation laws, such as if the injury was caused by a third party or if it is a personal injury claim, Part II of the ER's Liability Coverage would provide coverage for such claims.

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  • 18. 

    Under a standard WC policy, the insurer is considered to have received notice of a claim:

    • A.

      When the EE informs the insurer

    • B.

      On the day the insurer receives notice of the claim by certified mail

    • C.

      When the ER informs the insurer

    • D.

      When the ER has notice of the claim

    Correct Answer
    D. When the ER has notice of the claim
    Explanation
    The correct answer is "When the ER has notice of the claim." In a standard workers' compensation policy, the insurer is considered to have received notice of a claim when the employer (ER) is aware of the claim. This means that as soon as the employer becomes aware of an employee's claim, the insurer is deemed to have received notice. This is an important factor in determining the timeline for processing and handling the claim.

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  • 19. 

    The premium adjustment made for the current year of W/C coverage is sometimes based on prior years' loss experience. This is called:

    • A.

      Loss rating

    • B.

      Scheduled rating

    • C.

      Experience modification rating

    • D.

      Loss adjustment rating

    Correct Answer
    C. Experience modification rating
    Explanation
    The premium adjustment made for the current year of W/C coverage is sometimes based on prior years' loss experience. This adjustment is known as the experience modification rating. This rating takes into account an employer's historical workers' compensation claims and compares them to the average claims experience for similar businesses. A higher experience modification rating indicates a higher likelihood of future claims, resulting in a higher premium, while a lower rating suggests a lower risk and a lower premium.

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  • 20. 

    For a claim to be compensable in Hawaii, written notice must be made to the director of labor and industry relations w/in how many years after the effects of the injury become manifest?

    • A.

      1 year

    • B.

      2 years

    • C.

      3 years

    • D.

      5 years

    Correct Answer
    B. 2 years
    Explanation
    In order for a claim to be compensable in Hawaii, written notice must be made to the director of labor and industry relations within 2 years after the effects of the injury become manifest. This means that if someone experiences an injury and the effects of that injury become evident, they must notify the director within 2 years in order for their claim to be considered compensable.

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  • 21. 

    WOTF EE's would be considered a Longshoreman?

    • A.

      One who works aboard an ocean liner out at sea

    • B.

      One who loads ships at the dock

    • C.

      One who works for a shoreline restoration firm

    • D.

      A truck driver hauling a load from a ship

    Correct Answer
    B. One who loads ships at the dock
    Explanation
    A Longshoreman is someone who works at the dock and is responsible for loading ships. They handle cargo, operate machinery, and ensure that the ship is properly loaded. This job requires physical strength and the ability to work in a fast-paced environment. Longshoremen play a crucial role in the shipping industry, as they ensure that goods are loaded safely and efficiently onto ships for transportation.

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  • 22. 

    WOTF work-related injuries would be deemed to be PTD in Hawaii?

    • A.

      Permanent and total loss of sight in both eyes

    • B.

      Loss of 1 hand and 1 foot

    • C.

      A skull injury resulting in insanity

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    All of the mentioned work-related injuries would be deemed to be Permanent Total Disability (PTD) in Hawaii. These injuries, including permanent and total loss of sight in both eyes, loss of 1 hand and 1 foot, and a skull injury resulting in insanity, are severe and debilitating enough to render the individual permanently and totally disabled. Therefore, all of these injuries would qualify for PTD status in Hawaii.

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  • 23. 

    Under Hawaii law, for what period of time is an ER responsible to pay for an injured EE's medical care?

    • A.

      Up to 6 months

    • B.

      Up to 1 year

    • C.

      Up to 5 years

    • D.

      As long as is reasonably required

    Correct Answer
    D. As long as is reasonably required
    Explanation
    Under Hawaii law, an employer is responsible for paying for an injured employee's medical care for as long as it is reasonably required. This means that there is no specific time limit set by the law, and the employer must continue to cover the medical expenses until the injured employee has fully recovered or no longer requires treatment. The duration of coverage will depend on the individual circumstances and the medical needs of the injured employee.

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  • 24. 

    WOTF would fall outside the scope of WC laws?

    • A.

      A part-time EE injured in a work-related accident

    • B.

      A truck driver injured while driving the company truck

    • C.

      An EE accidently injured a bystander who was observing a construction project

    • D.

      An EE contracted a disease w/in the factory

    Correct Answer
    C. An EE accidently injured a bystander who was observing a construction project
    Explanation
    The question is asking which scenario would fall outside the scope of workers' compensation laws. Workers' compensation laws typically cover injuries or illnesses that occur in the workplace or during work-related activities. In the given scenarios, all except for the one where an employee accidentally injured a bystander would generally be covered by workers' compensation. This is because the bystander was not an employee and the injury did not occur to the employee themselves.

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  • 25. 

    Dependent children of a worker killed on the job will receive income benefits:

    • A.

      For 5 years following death

    • B.

      Until age 18 or longer if still in an accredited school

    • C.

      Until age 18

    • D.

      Until age 21

    Correct Answer
    B. Until age 18 or longer if still in an accredited school
    Explanation
    Dependent children of a worker killed on the job will receive income benefits until they reach the age of 18. However, if they are still attending an accredited school at the age of 18, they may continue to receive the benefits until they complete their education or reach a higher age. This ensures that the children have financial support during their formative years and while they pursue their education.

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  • 26. 

    WOTF is true regarding W/C coverage in Hawaii?

    • A.

      It must be purchased from an insurer domiciled in Hawaii

    • B.

      Private insurers compete with the State Workers Compensation Fund

    • C.

      It may be purchased from an authorized insurance carrier or it may be self-insured

    • D.

      It is written exclusively by the Hawaii State Fund

    Correct Answer
    C. It may be purchased from an authorized insurance carrier or it may be self-insured
    Explanation
    Workers' compensation (W/C) coverage in Hawaii can be obtained either from an authorized insurance carrier or through self-insurance. This means that employers have the option to purchase coverage from a licensed insurance company or choose to self-insure, which involves setting aside funds to cover their employees' workers' compensation claims. The answer states that W/C coverage can be purchased from an authorized insurance carrier or be self-insured, providing the correct information about the options available for obtaining coverage in Hawaii.

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  • 27. 

    Hawaii's WC laws state quite specifically WHO is entitled to benefits, and to WHERE THE WORK TAKES PLACE in order for benefits to apply. In WOTF situations would the law not apply?

    • A.

      To all work injuries to "cover employments" sustained w/in the state

    • B.

      The an EE who was hired in Hawaii (while a resident of Hawaii) but injured in some other state

    • C.

      To an EE hired in another state (while a resident of that state) but injured in Hawaii

    • D.

      To an EE hired in another state (while a resident of that state) by a Hawaii ER but injured in some other state

    Correct Answer
    D. To an EE hired in another state (while a resident of that state) by a Hawaii ER but injured in some other state
    Explanation
    The Hawaii WC laws state that benefits only apply to work injuries that occur within the state, regardless of the employee's residency. In the given situation, the employee was hired by a Hawaii employer while residing in another state, but the injury occurred in a different state. Since the injury did not take place in Hawaii, the employee would not be entitled to benefits under Hawaii's WC laws.

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  • 28. 

    As a result of a work injury, Tom has lost the use of his thumb. How long can he receive benefits for this PPD in Hawaii?

    • A.

      15 weeks

    • B.

      30 weeks

    • C.

      75 weeks

    • D.

      160 weeks

    Correct Answer
    C. 75 weeks
    Explanation
    Tom can receive benefits for this Permanent Partial Disability (PPD) in Hawaii for a duration of 75 weeks. This means that he will be compensated for the loss of use of his thumb for a period of 75 weeks.

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  • 29. 

    Under Hawaii's W/C law, what amount, in addition to other prescribed benefits, could an EE receive when a work-related injury results in disfigurement?

    • A.

      $5,000

    • B.

      $10,000

    • C.

      $20,000

    • D.

      $30,000

    Correct Answer
    D. $30,000
    Explanation
    Under Hawaii's Workers' Compensation law, an employee could receive an additional amount of $30,000 in addition to other prescribed benefits when a work-related injury results in disfigurement.

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  • 30. 

    WOTF is correct regarding the Foreign Coverage Endorsement?

    • A.

      Coverage applies to EE's hired w/in the limits of the USA while they are traveling or temporarily residing outside the US, its territories or possessions, or Canada.

    • B.

      EE's hired outside the limits of the US are not covered

    • C.

      EE's hired w/in the US can be covered abroad for 90 days or less

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The correct answer is "All of the above". This means that all of the statements mentioned in the options are correct regarding the Foreign Coverage Endorsement. The coverage applies to employees hired within the limits of the USA while they are traveling or temporarily residing outside the US, its territories or possessions, or Canada. Employees hired outside the limits of the US are not covered. Additionally, employees hired within the US can be covered abroad for 90 days or less.

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  • 31. 

    A person who reviews or audits billings for medical services is:

    • A.

      An examiner appointed by the insurance commissioner

    • B.

      An independent bill reviewer

    • C.

      A public adjuster

    • D.

      None of the above

    Correct Answer
    B. An independent bill reviewer
    Explanation
    An independent bill reviewer is a person who reviews or audits billings for medical services. They are not appointed by the insurance commissioner or a public adjuster. They work independently to ensure that the billings are accurate and comply with the relevant regulations and guidelines.

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  • 32. 

    WOTF is covered under the Federal Employees Compensation Act?I. Federal employees exempt under state workers compensation lawsII. Active duty military membersIII. Members of the Merchant Marine under the Jones ActIV. Longshoremen and harbor workers

    • A.

      I only

    • B.

      I, II, and III only

    • C.

      I and III only

    • D.

      I and IV only

    Correct Answer
    A. I only
    Explanation
    The correct answer is "I only". This means that only federal employees who are exempt under state workers compensation laws are covered under the Federal Employees Compensation Act. The Act does not cover active duty military members, members of the Merchant Marine under the Jones Act, or longshoremen and harbor workers.

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  • 33. 

    An EE is asked to operate a piece of machinery known to be in need of repair. The EE refuses and the ER insists that the EE operate the machine or face being laid off the job. The EE uses the machine and is severely injured and loses a limb. His wife sues the ER. What workers compensation coverage might protect the ER?

    • A.

      Statutory coverage only

    • B.

      The policy would not cover this type of claim

    • C.

      Dependents do not have recourse in this situation

    • D.

      ER's liability coverage would respond

    Correct Answer
    D. ER's liability coverage would respond
    Explanation
    In this scenario, the correct answer is "ER's liability coverage would respond." Liability coverage typically protects employers from claims made by employees who are injured on the job. In this case, the EE was injured while operating a piece of machinery that was known to be in need of repair. The EE's refusal to operate the machine was overridden by the ER, who insisted that they do so under the threat of being laid off. As a result, the EE suffered a severe injury and lost a limb. In this situation, the ER's liability coverage would likely respond to the lawsuit filed by the EE's wife, seeking compensation for the injuries sustained.

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  • 34. 

    If a request for consultation with the same medical specialty has been denied, the attending physician may not resubmit the same request for consultation w/ the same medical specialty after _____ days.

    • A.

      10

    • B.

      15

    • C.

      30

    • D.

      45

    Correct Answer
    D. 45
    Explanation
    If a request for consultation with the same medical specialty has been denied, the attending physician may not resubmit the same request for consultation with the same medical specialty after 45 days. This means that if the physician's initial request for consultation was denied, they must wait for a period of 45 days before they can submit another request for consultation with the same medical specialty. This policy is likely in place to prevent excessive or unnecessary consultations and to ensure that resources are used effectively.

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  • 35. 

    What WC benefits, if any, can dependent children of an EE killed in an industrial accident expect to receive in most states?

    • A.

      Income benefits up to 5 years following the death

    • B.

      Income benefits until reaching the age of 18

    • C.

      Income benefits until reaching the age of 21 and enrolled full-time in school

    • D.

      No benefits

    Correct Answer
    C. Income benefits until reaching the age of 21 and enrolled full-time in school
    Explanation
    Dependent children of an employee killed in an industrial accident can expect to receive income benefits until they reach the age of 21 and are enrolled full-time in school. This means that they will receive financial support until they complete their education or turn 21, whichever comes first. This is a common provision in most states' workers' compensation programs to ensure that the children of deceased employees are provided for financially during their formative years.

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  • 36. 

    ER's liability coverage under the workers compensation policy could cover the legal liability of an ER in which of the following situations?

    • A.

      Exempt employments

    • B.

      Illegal employment

    • C.

      Non-compensable injuries

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The correct answer is "All of the above". ER's liability coverage under the workers compensation policy can cover the legal liability of an ER in situations involving exempt employments, illegal employment, and non-compensable injuries. This means that the policy provides coverage for any legal liabilities that may arise in these situations, ensuring that the ER is protected financially.

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  • 37. 

    WOTF is the most correct concerning premiums in a standard WC policy?

    • A.

      The premium shown on the information page is the final premium

    • B.

      The insurer has 3 years after policy expiration to audit the insured's payroll records in order to determine the final premium

    • C.

      The insurer has 12 months from policy expiration to determine actual payrolls and work classifications and bill the insured accordingly

    • D.

      The insured has the option of having its payrolls audited and a premium adjustment being done

    Correct Answer
    B. The insurer has 3 years after policy expiration to audit the insured's payroll records in order to determine the final premium
    Explanation
    The correct answer states that the insurer has 3 years after the policy expires to audit the insured's payroll records and determine the final premium. This means that the premium shown on the information page is not necessarily the final premium, as it can be adjusted based on the audit findings. The other options do not mention the possibility of an audit or the timeframe for determining the final premium, making them less correct.

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  • 38. 

    In Hawaii, how long will WC death/income benefits be paid to the surviving spouse of an EE, when an industrial accident results in death to the EE?

    • A.

      For up to 5 years from the DOI, or death of the spouse, whichever occurs first

    • B.

      For up to 10 years from the DOI, or death of the spouse, whichever occurs first

    • C.

      Until death or remarriage of the spouse

    • D.

      Until death of the spouse, regardless of remarriage

    Correct Answer
    C. Until death or remarriage of the spouse
    Explanation
    The correct answer is "Until death or remarriage of the spouse." In Hawaii, WC death/income benefits will be paid to the surviving spouse of an employee until the spouse either passes away or gets remarried. This means that if the spouse remains unmarried, they will continue to receive the benefits for the rest of their life.

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  • 39. 

    WOTF is true regarding the payment of benefits for PTD or PPD after the death of an EE?

    • A.

      Payments stop upon death of the EE

    • B.

      A lump sum payment will be made to the dependents of the EE

    • C.

      The unpaid balance of benefits will be paid to the EE's spouse and dependents as long as death was not a result of the injury to which benefits are being paid

    • D.

      None of the above are true

    Correct Answer
    C. The unpaid balance of benefits will be paid to the EE's spouse and dependents as long as death was not a result of the injury to which benefits are being paid
    Explanation
    In the case of PTD (Permanent Total Disability) or PPD (Permanent Partial Disability), the unpaid balance of benefits will be paid to the employee's spouse and dependents as long as the death was not a result of the injury for which benefits are being paid. This means that if the employee dies due to a cause unrelated to the injury, the remaining benefits will be paid to their spouse and dependents. However, if the death is a result of the injury, the payments will stop upon the death of the employee. Therefore, the correct answer is that the unpaid balance of benefits will be paid to the employee's spouse and dependents as long as death was not a result of the injury to which benefits are being paid.

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  • 40. 

    If an insurance company intends to cancel a WC policy in Hawaii, the insurer must give how many days' notice to the insured?

    • A.

      60

    • B.

      30

    • C.

      10

    • D.

      45

    Correct Answer
    C. 10
    Explanation
    In Hawaii, if an insurance company intends to cancel a Workers' Compensation (WC) policy, they must provide the insured with a notice period of 10 days. This means that the insurer must inform the insured at least 10 days in advance before canceling the policy. This gives the insured enough time to make alternative arrangements or address any issues before the cancellation takes effect.

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  • 41. 

    All of the following are true about WC benefits, EXCEPT:

    • A.

      After a period of disability, retroactive benefits may be paid

    • B.

      The waiting period applies to medical and disability benefits

    • C.

      Death benefits may include a burial allowance and income to survivors

    • D.

      Rehabilitation benefits may be provided

    Correct Answer
    B. The waiting period applies to medical and disability benefits
    Explanation
    The waiting period applies to medical and disability benefits. This means that there is a certain period of time that an injured worker must wait before they can start receiving medical and disability benefits. However, this statement is incorrect because the waiting period actually does not apply to medical and disability benefits.

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  • 42. 

    What is the penalty in Hawaii for an ER or insurance carrier which fails to properly pay total disability benefits?

    • A.

      $100 per violation

    • B.

      A payment of up to $2,500 into the special compensation fund

    • C.

      $1,000 per violation

    • D.

      Loss of business license after the 2nd violation

    Correct Answer
    B. A payment of up to $2,500 into the special compensation fund
    Explanation
    In Hawaii, if an ER or insurance carrier fails to properly pay total disability benefits, they may be required to make a payment of up to $2,500 into the special compensation fund. This fund is likely set up to provide financial assistance to individuals who have been denied their rightful disability benefits. By making this payment, the ER or insurance carrier is compensating for their failure to fulfill their obligations and ensuring that the affected individuals receive the support they are entitled to.

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  • 43. 

    WOTF best describes the reason for using various work classifications in the calculation of workers compensation premiums?

    • A.

      To prevent discrimination by the ERs

    • B.

      To assure a proper profit margin for insurers

    • C.

      To accurately reflect the risks of each ER

    • D.

      To encourage safety in the workplace

    Correct Answer
    C. To accurately reflect the risks of each ER
    Explanation
    The reason for using various work classifications in the calculation of workers compensation premiums is to accurately reflect the risks of each employer. Different types of work carry different levels of risk, and by classifying employers based on the type of work they do, insurers can determine the appropriate premium that reflects the level of risk associated with that particular employer. This ensures that employers are paying a fair and accurate premium based on the specific risks they pose, rather than a one-size-fits-all approach.

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  • 44. 

    WOTF is not considered in WC experience modification calculations?

    • A.

      An accounting of the insured's actual losses

    • B.

      A credibility factory based on premiums paid by the insured

    • C.

      Amount of EE payroll

    • D.

      The amount of losses expected for the same work classifications

    Correct Answer
    C. Amount of EE payroll
    Explanation
    In workers' compensation experience modification calculations, the amount of employee payroll is not considered. The experience modification factor is determined based on the insured's actual losses, a credibility factor based on premiums paid by the insured, and the amount of losses expected for the same work classifications. The amount of employee payroll does not directly affect the calculation of the experience modification factor.

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  • 45. 

    In Hawaii, failure by an insurer or self-insured ER to pay non-contested WC benefits w/in required timeframes may result in what penalty, if any?

    • A.

      An additional amount of 5% for each month the compensation remains unpaid

    • B.

      Shutdown of all Hawaii operations

    • C.

      No penalty of receiving a final warning notice form the director of labor and industry relations

    • D.

      An additional amount equal to 20% of the unpaid compensation

    Correct Answer
    D. An additional amount equal to 20% of the unpaid compensation
    Explanation
    Failure by an insurer or self-insured ER to pay non-contested WC benefits within the required timeframes in Hawaii may result in an additional penalty equal to 20% of the unpaid compensation. This penalty serves as a deterrent for insurers and employers to ensure timely payment of workers' compensation benefits.

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  • 46. 

    It is possible that medical care benefits to an injured Hawaii EE may be suspended. WOTF would cause such a suspension?

    • A.

      The EE continues to act rudely toward the medical providers staff

    • B.

      The EE has failed to take prescribed medication on at least 4 or more occasions

    • C.

      The EE refuses to accept or obstructs the service of a properly-selected physician

    • D.

      The EE is continually late to medical appointments

    Correct Answer
    C. The EE refuses to accept or obstructs the service of a properly-selected physician
    Explanation
    If an injured Hawaii employee refuses to accept or obstructs the service of a properly-selected physician, it may lead to the suspension of medical care benefits. This is because the employer or insurance provider has the right to select a physician to provide medical treatment for the injured employee, and if the employee refuses to cooperate with this selection, it can result in the suspension of their medical care benefits.

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  • 47. 

    When a Hawaii EE sustains an injury requiring medical treatment beyond first aid, how long does the ER have to report the accident to the director of the labor and industry relations?

    • A.

      48 hours

    • B.

      3 business days

    • C.

      7 working days

    • D.

      10 working days

    Correct Answer
    C. 7 working days
    Explanation
    The ER has 7 working days to report the accident to the director of the labor and industry relations in Hawaii. This allows the ER enough time to gather all necessary information and documentation related to the injury before reporting it. It also ensures that the director is notified within a reasonable timeframe to take appropriate action if needed.

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  • 48. 

    In Hawaii, what percentage of an EE's AWW is paid in case of a work related claim that results in a PTD?

    • A.

      70%

    • B.

      80%

    • C.

      75.50%

    • D.

      66.66%

    Correct Answer
    D. 66.66%
    Explanation
    In Hawaii, when an employee experiences a work-related claim that leads to Permanent Total Disability (PTD), they are entitled to receive 66.66% of their Average Weekly Wage (AWW) as compensation. This means that if an employee is unable to work due to a work-related injury or illness resulting in PTD, they will receive approximately two-thirds of their usual weekly earnings as financial support.

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  • 49. 

    An ER is about to start working in a new state and will hire workers who reside there. Would the ER's current standard-form workers compensation policy automatically provide coverage for the new state?

    • A.

      Never

    • B.

      Yes, if the new state was listed on the information page in part 3C. Other states insurance.

    • C.

      Only if form WC0244 " New States Coverage" endorsement was attached to the policy

    • D.

      Yes but only for 30 days

    Correct Answer
    B. Yes, if the new state was listed on the information page in part 3C. Other states insurance.
    Explanation
    The ER's current standard-form workers compensation policy would automatically provide coverage for the new state if the new state was listed on the information page in part 3C, which covers other states insurance.

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  • 50. 

    An applicant for a WC adjuster license in Hawai must be at least how old?

    • A.

      18

    • B.

      21

    • C.

      25

    • D.

      23

    Correct Answer
    A. 18
    Explanation
    An applicant for a WC adjuster license in Hawaii must be at least 18 years old. This age requirement ensures that individuals applying for the license have reached a legal age and are considered adults, capable of taking on the responsibilities associated with being a workers' compensation adjuster. Being 18 years old also aligns with the minimum age requirement for many other professional licenses and certifications.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 18, 2016
    Quiz Created by
    Dkmags
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