Which scenario best fits a medical only claim?

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Prepare for the California Self‑Insurance Plans (SIP) Exam with our interactive quiz. Benefit from multiple-choice questions, detailed explanations, and essential tips to enhance your knowledge and succeed in your exam!

Multiple Choice

Which scenario best fits a medical only claim?

Explanation:
Medical-only claims cover medical treatment only, with no wage-replacement benefits and no time off from work. When an injury results in lost time, it becomes an indemnity claim because the employee is unable to work and wage replacement is involved. So the scenario that clearly fits medical-only is one where treatment is limited to basic medical care and there is no time off — typically first aid only. A single doctor visit or a follow-up could still be medical-only if it doesn’t cause time off, but the case that shows time off (lost time) signals indemnity rather than medical-only.

Medical-only claims cover medical treatment only, with no wage-replacement benefits and no time off from work. When an injury results in lost time, it becomes an indemnity claim because the employee is unable to work and wage replacement is involved. So the scenario that clearly fits medical-only is one where treatment is limited to basic medical care and there is no time off — typically first aid only. A single doctor visit or a follow-up could still be medical-only if it doesn’t cause time off, but the case that shows time off (lost time) signals indemnity rather than medical-only.

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