The CRC exam, for Certified Rehabilitation Counselors

Several staff at an office spend time on copying, mail sorting, and supply restocking. A counselor proposes combining these tasks into a new position for a client with an intellectual disability. This strategy is:

1. job sharing.
   Job sharing splits one full-time position between two workers; it does not assemble a new job from scattered tasks.
2. job carving.
   Job carving builds a new position out of tasks taken from several coworkers' jobs, matched to what the client does well, as in the copying, mail, and restocking example.
3. transitional duty.
   Transitional duty is temporary modified work for an injured employee on the way back to the regular job, not a permanent new position for a job seeker.
4. job restructuring.
   Job restructuring modifies the duties of an existing job, for example by swapping marginal tasks; it does not create a separate position from other employees' work.

An injured worker's physician states that he has reached maximum medical improvement. This means:

1. his benefits end automatically
   MMI usually changes the type of workers' compensation benefit, for example from temporary to permanent partial, under state rules; benefits do not simply stop.
2. he has fully recovered
   MMI is not a cure; many workers reach it with permanent restrictions, which is why an impairment rating often follows.
3. he may return to full duty
   Reaching MMI says nothing about whether he can do his old job; work restrictions at MMI may still rule out full duty.
4. his condition has plateaued
   Maximum medical improvement means further recovery is not expected with more treatment; the condition has stabilized, possibly with lasting limitations.

A client has both Medicare and Medicaid. For a service covered by both programs, which pays first?

1. Medicare
   For people with both programs (dual eligibles), Medicare pays first and Medicaid pays last, picking up costs Medicare does not cover.
2. Medicaid
   Medicaid is the payer of last resort by law, so it pays after Medicare and other insurance, not before.
3. the client chooses
   Coordination of benefits follows fixed federal rules; the beneficiary does not pick which program pays first.
4. each pays half
   The programs do not split costs evenly; Medicare pays its share first and Medicaid covers allowable remaining costs.

The MOST common initial course of multiple sclerosis is:

1. steadily static
   MS is not described as static; this invented label confuses a stable, nonprogressive condition such as an old spinal cord injury with a disease that relapses or progresses.
2. secondary progressive
   Secondary progressive MS is a later phase that often follows years of relapsing-remitting disease, so it cannot be the most common initial course.
3. relapsing-remitting
   About 85 percent of people with MS start with relapsing-remitting disease: attacks of new or worse symptoms followed by partial or full recovery.
4. primary progressive
   Primary progressive MS, with steady worsening from onset and no distinct relapses, affects only about 10 to 15 percent of people with MS.