QME FINAL EXAM 2024 ACTUAL EXAM COMPLETE 300
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) ALREADY GRADED A+
Holds authority to appoint physicians as QME evaluators - CORRECT
ANSWER >>>>Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator - CORRECT ANSWER >>>>2
years (LC 139.2)
3 requirements when seeking appointment as QME - CORRECT
ANSWER >>>>(1) Pass the QME competency exam;
(2) Complete a 12-hour course in disability eval report writing;
(3) Devote at least 1/3rd of total practice time to providing direct
medical treatment (or have served as a AME on 8+ occasions in past 12
mos prior to application)
2 reasons for termination/suspension of a QME w/o a hearing -
CORRECT ANSWER >>>>(1) Licensing board
suspends/revokes/terminates license to practice
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(2) Failure to pay required fee (upon appointment and yearly
thereafter)
6 reasons for discipline (suspension/termination) of QMEs after a
hearing - CORRECT ANSWER >>>>(1) Violation of material statutory or
administrative duty;
(2) Failure to follow medical procedures or qualifications;
(3) Failure to comply with the timeframe standards;
(4) Failure to meet licensing/certification requirements;
(5) Preparation of medical-legal evaluations that fail to meet the
minimum standards for those reports as established by the
administrative director or the appeals board;
(6) Making material misrepresentations or false statements in an
application for appointment or reappointment as a qualified medical
evaluator.
3 types of substantive medical disputes resolved by QMEs - CORRECT
ANSWER >>>>(1) Compensability of the claim;
(2) Permanent disability;
(3) "Catch-all" (temporary disability, work restrictions, new and further
disabilities after permanent disability (detereoration of original injury),
compensability of new body part added to claim)
Definition of *injury* in compensability claims - CORRECT ANSWER
>>>>(1) An injury or disease arising out of employment;
(2) A *derivative* injury caused by treatment of an injury arising out of
employment;
(3) Any reaction to or side effect from preventative health care the
employer provides to health care workers
*Specific injury* - CORRECT ANSWER >>>>Occurs as the result of a
single incident or exposure
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*Cumulative injury* - CORRECT ANSWER >>>>Results from repetitive
trauma (mental or physical) over a period of time
2 requirements for a condition to be considered an injury - CORRECT
ANSWER >>>>(1) Cause disability; or
(2) Result in a need for medical treatment
Occupational disease - CORRECT ANSWER >>>>Disease that in whole or
part is caused by work
7 types of excluded injuries - CORRECT ANSWER >>>>(1) Caused by
employee's use of alcohol or illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
(4) Resulting from altercations, in which the injured employee is the
*initial physical aggressor*;
(5) Resulting from the employee's commission of a felony, for which the
employee has been convicted (including "wobbly felonies," which are
crimes that may be prosecuted as misdemeanors or felonies)
(6) Resulting from off-duty recreational activities, in which participation
in the activities does not constitute part of the employee's work-related
duties and the activity is not an expressed or implicit condition of
employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless
certain conditions exist
4 basic conditions to establish a workers' compensation claim -
CORRECT ANSWER >>>>(1) *Injury* (physiological or psychological
harm);
(2) Employment relationship;
(3) Injury caused by the employment (This is also referred to as arising
out of employment [AOE].);
(4) Occurred in the course of the employment (COE)
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