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Exam (elaborations)

QME Exam Already Verified A+

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QME Exam Already Verified A+ Q1: When was the first workers' compensation act passed in the United States? A1: The first workers' compensation act was enacted in 1911, just seventeen days after the tragic fire at the Triangle Shirtwaist Company factory in New York, which claimed 146 lives. ...

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  • August 5, 2024
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  • 2024/2025
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QME Exam Already Verified A+


Q1: When was the first workers' compensation act passed in the United States?

A1: The first workers' compensation act was enacted in 1911, just seventeen days after the tragic fire at
the Triangle Shirtwaist Company factory in New York, which claimed 146 lives.



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Q2: What are the three main components of the workers' compensation system?

A2: The workers' compensation system is comprised of:

1. No Fault - Employers are responsible for providing benefits regardless of who was at fault for the
injury, as long as it occurred during the course of employment.

2. Exclusive Remedy - Employees cannot pursue additional legal claims against their employers for
workplace injuries, even in cases of gross negligence, provided the employer is insured.

3. Assured Fixed Benefit - The system guarantees defined benefits for injured workers, which employers
are obligated to pay. These benefits are typically lower compared to potential awards from civil lawsuits,
but workers’ compensation claims are resolved much more quickly.



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Q3: Which types of injuries are excluded from coverage under workers' compensation?

A3: Injuries that are deliberately self-inflicted are not covered by the workers' compensation system.



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Q4: What is the impact on compensation if an injury results from the serious and willful misconduct of
the employer?

A4: If an injury is due to the employer's serious and willful misconduct, the injured worker's
compensation is increased by 50%.



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, Q5: How is compensation affected if the injury is the result of the injured employee's serious
misconduct?

A5: In cases where the injury is caused by the employee's serious and willful misconduct, compensation
benefits are reduced by 50%. However, this reduction does not apply if the injury resulted in a death or
permanent disability of 70% or more, if the employer failed to comply with safety regulations, or if the
employee was under 16 years old at the time of the injury.



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Q6: What reforms were implemented in 2003 and 2004 regarding workers' compensation?

A6: In 2003 and 2004, several reforms were introduced, including:

1. Establishing medical provider networks from which injured workers must choose their treating
physicians.

2. Instituting utilization review processes to assure that medical treatments align with evidence-based
guidelines.

3. Imposing restrictions on physical therapy and chiropractic care.

4. Implementing a medical treatment utilization schedule (MTUS) to govern care consistency.



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Q7: What significant changes occurred in workers' compensation in 2013?

A7: Measures enacted in 2013 included:

1. Increasing the permanent disability benefits available to injured workers and streamlining the
permanent disability rating process.

2. Facilitating the resolution of medical treatment disputes through independent medical review and
addressing bill payment disagreements with independent review.

3. Enhancing medical provider networks.

4. Updating the Official Medical Fee Schedule and establishing fee guidelines for various services,
including copy services, interpreter costs, vocational experts, and in-home healthcare.



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