Free District of Columbia Casualty practice questions

Answer: C. Reasonable funeral expenses of up to $5,000

When a work injury causes death, the first element of the death benefit is reasonable funeral expenses, capped at $5,000. The benefit is limited both by reasonableness and by that dollar cap, so full payment with no limit is wrong, and neither $4,000 nor $7,500 is the figure the section sets.

Answer: C. It pays the room charge only up to what is reasonable and necessary for a semiprivate room

D.C. Code Sec. 31-2404(c)(2) provides that, except when the victim requires special or intensive care, PIP medical and rehabilitation benefits exclude hospital room charges above a reasonable and necessary charge for semiprivate accommodations. The benefit therefore reaches the room up to the semiprivate level, and the excess is excluded. The general rule covering reasonable charges is limited by this specific provision, the statute does not withhold payment for the room altogether, and the only exception it states is a need for special or intensive care, not a physician's approval.

Answer: A. The insurer must offer PIP to that person as optional coverage beyond the required insurance

D.C. Code Sec. 31-2404(a)(1) requires each insurer, in addition to the insurance required under Sec. 31-2406, to offer optional personal injury protection to each person required to have insurance. The duty to offer is placed on every insurer, so it is not left to the insurer's discretion, and the subsection does not condition it on a prior written request. Because the coverage is described as optional, the statute does not make PIP a compulsory part of every required policy.

Answer: B. Within 30 days after she knew, or with reasonable diligence should have known, that it was job related

D.C. Code Sec. 32-1513(a) requires notice within 30 days after the injury, or within 30 days after the employee is aware, or through reasonable diligence should have been aware, of the link between the injury and the employment. Because she could not have known of the work connection before March 3, her 30 days run from that awareness. A deadline counted from her first symptoms ignores the awareness rule. The statute sets 30 days, not 14 or 90, and measures them from the injury or from the employee's awareness, not from medical treatment or from the employer's knowledge. The notice is given to both the Mayor and the employer.

Answer: C. An amount the Mayor finds necessary, up to $50 a week

The employer must furnish whatever additional payment the Mayor determines is necessary to maintain an employee undergoing vocational rehabilitation, capped at $50 a week. The $25 and $100 figures misstate the cap, and the determination belongs to the Mayor, not the Commissioner.

Answer: D. From the first day of disability, because it lasted more than 14 days

The District withholds compensation for the first 3 days of disability, but where the injury causes disability lasting more than 14 days, compensation is allowed from the date the disability began. A 20-day disability passes that threshold, so the first 3 days are recovered. Starting payment on the 4th day applies a waiting period that the 14-day rule removes, the 14-day figure is the trigger for paying back to the start rather than a start date, and the waiting period is 3 days rather than a week. Medical benefits under Sec. 32-1507 are excepted from the waiting period.

Answer: C. The carrier must still pay compensation for injuries sustained during the policy

D.C. Code Sec. 32-1538(a)(2) requires every policy issued under the workers' compensation chapter to state that the employer's insolvency or bankruptcy, and any discharge in it, does not relieve the carrier of paying compensation for disability or death an employee sustains while the policy is in force. The carrier's duty therefore survives the employer's discharge rather than ending with it, and the obligation is not moved to the bankruptcy estate. This provision gives the carrier no right to cancel the policy because of the employer's insolvency.

Answer: A. A sworn statement from the claimant describing how the accident occurred

D.C. Code Sec. 31-2403.01(b) lists what an injured claimant must provide in writing: the accident date, the alleged tortfeasor's name and last known address, a copy of the accident report if one exists, the insurer's claim number if available, health care bills and documentation of any lost income, and the records of health care treatment for the injuries. A sworn statement describing how the accident occurred is not on that list, so it is the exception. Each of the other three choices restates an item the subsection requires.

Answer: B. $50,000

D.C. Code Sec. 31-2404(c)(5) states that the maximum medical and rehabilitation benefit payable for any victim shall not be less than $50,000, and insurers providing PIP must offer packages with $50,000 and $100,000 of that coverage per victim. $100,000 is the higher package an insurer must offer, not the floor. $12,000 is the minimum maximum for work loss under subsection (d)(2), and $4,000 is the cap on funeral benefits under subsection (e).

Answer: B. Make a written claim for compensation or damages and give the insurer the documents the statute lists

D.C. Code Sec. 31-2403.01(a) gives a claimant a right to documentation of the applicable coverage limits once the claimant has made a written claim for compensation or damages arising from a vehicle accident and has supplied the insurer with the documents listed in subsection (b), or in subsection (c) for a death claim. The section is titled pre-litigation discovery, so filing suit and serving discovery is not the trigger. The statute states its trigger without any admission of fault or any order from the Commissioner; the claimant obtains the documentation from the insurer directly.