Building Code Administrators and Inspectors Florida Principle and Practice Licensure Practice Exam

Who is responsible for deciding the amount and type of benefits an employee can receive under Workers' Compensation?

1. The employee

2. The employer

3. The insurance carrier

4. The state agency

The correct answer is: The insurance carrier

The insurance carrier is responsible for deciding the amount and type of benefits an employee can receive under Workers' Compensation. This decision-making process is guided by the Workers' Compensation laws and regulations that are in place in the jurisdiction where the injury occurred. When an employee files a Workers' Compensation claim, the insurance carrier evaluates the claim, considering factors such as the nature and extent of the employee's injury, the medical treatment required, and the impact on the employee’s ability to work. Based on this evaluation, the insurance carrier determines the appropriate benefits including medical expenses, lost wages, rehabilitation services, and other related costs. While the employer plays a role in providing Workers' Compensation insurance and ensuring compliance with safety regulations, it is ultimately the insurance carrier that assesses the claim and establishes the benefits. The state agency may provide oversight and regulations, but the direct responsibility for benefits rests with the insurance carrier.