QME Examination Test Questions FINAL
QME Examination Test Questions FINAL
QME Examination Test Questions FINAL
QME Examination Test Questions FINAL
QME Examination Test Questions FINAL
QME Examination Test Questions FINAL
QME Examination Test Questions FINAL
QME Examination Test Questions FI...
QME Examination Test Questions FINAL
"Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of
a crime and may be subject to imprisonment in the state prison for up to ____ years or a fine of up to
$50,000 or both - ANSWER-five (5) years
"Disability = Impairment + Loss earning capacity + Occupational title + Age" - ANSWER-Formula for
PD
1911 - California adopted - ANSWER-The development of the State Compensation Insurance Fund
(SCIF)
A check or Money Order is pain by the Physician for the IBR fee in the amount of - ANSWER-$195 ??
A copy of the notice to request time extension to file a QME report must be sent to - ANSWER-
Medical Unit at DWC
A local work comp Judge's decisions may be appealed by a part to - ANSWER-WCAB Commissioners
A PTP has fulfilled his or her reporting duties by sending ___ copy of a required report to the claims
administrator - ANSWER-one (1)
A trade-off between Employers and Employees is referred to as - ANSWER-The Historic Compromise
A violation of L.C. 139(a) conflict of interest referral is a misdemeanor subject to civil penalties up to
$____ per offense - ANSWER-$5,000
A worker who is nor represented by an attorney is referred to as - ANSWER-an unrepresented worker
An application for IBR (DWC form IBR-1) can be completed and submitted electronically by
registering as a user on the ___ IBR tracking system - ANSWER-Maximus Federal
An attorney or a court reporter may NOT be present at ___ exams - ANSWER-Psychiatric
An employer must report injuries to Cal/OSHA of any death or serious injury within _____ - ANSWER-
24 hours
An employer with an MPN which of the following CANNOT be pre-designated - ANSWER-D.C.
An injured worker may not be kept waiting for more than ___ after the scheduled appointment time
- ANSWER-one (1) hour
Apportionment is included in which of the following reports - ANSWER-PR-4
California passed its first workers' compensation act (voluntary) in ___ - ANSWER-1911
California passed its first workers' compensation act after a devastating fire at the ____ in New York
City claimed the lives of 146 young workers - ANSWER-Triangle Shirtwaist Company
Chronic Pain Guidelines went into effect ___ - ANSWER-07/18/2009
Death benefits are payments to a spouse, the children, or other dependents, including reasonable
burial expenses, not exceeding $____ for injuries before 01/01/2013 and $_____ for injuries on or
after 01/01/2013 - ANSWER-Before 01/01/2013 $5,000
After 01/01/2013 $10,000
Disputes over medical treatment for all dates of injury are now resolved by physicians through ____ -
ANSWER-IMR
, QME Examination Test Questions FINAL
Electronic bills are paid within ___ days of receipt of the bill and supporting documentation -
ANSWER-15 days
Employers are not required to pay for .... - ANSWER-Self Inflicted injuries
Ex Parte communication with an agreed Medical Evaluator or s QME selected from a panel .... -
ANSWER-Is PROHIBITED
Factors of Disability include the following - ANSWER-Subjective Factors
Objective Factors
Work Restrictions
Loss Pre-Injury Capacity
Failure to file a DFR could delay benefits to patients, prevent payment to physician, and could result
in a civil penalty of not less than $___ - ANSWER-$50
For a QME evaluation for compensability only (AOE/COE), DO NOT send the QME report to the
following Part(ies)? - ANSWER-Local DEU
For dates of injuyr AFTER 01/01/2005, a QME must use - ANSWER-American Medical Association
Guide to the Evaluation of Permanent Impairment, 5th edition
For DOI after 01/01/1990 or DOI after 01/01/2003, DISABLED MINORS receive benefits - ANSWER-
For life
For DOI on or after 01/01/2005 the PTP final report must include the information on the ___ Form -
ANSWER-PR-4
For injuries on or after January 1, 1994 and before 01/01/2004 most workers will be limited to a
_____ cap on Vocational Rehabilitation benefits under that plan - ANSWER-$16,000
For paper billing forms for health care providers, the physician must use - ANSWER-CMS 1500 forms
For psychiatric injuries that result from a violent act, or from direct exposure to a significant violent
act, the actual events of employment must have been a "substantial cause" of the injury, in that they
contributed at least ___ % of the causation from all sources combined - ANSWER-35%
For treatment guidelines California's Evidence-Based Guidelines is the ____ - ANSWER-MTUS
From January 1, 2008, to the present, TD may last up to ___ weeks within five years from the DOI -
ANSWER-104
IBR applies to any medical bill for which the date of service is on or after - ANSWER-01/01/2013
If full wages are paid, an IW may still receive TD benefits - ANSWER-FALSE
If IW is unrepresented, the QME serves the QME report on the _____ - ANSWER-DEU, Employee &
Claims Administrator
If the claims administrator denies treatment recommended by the PTP, the IW may request ___ using
the request form included with the claims administrator's written decision to deny treatment -
ANSWER-IMR
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