When does a QME use the ROM method in the spine? (4 answers)
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1. Multilevel involvement (T3-T5)
2. Re-injury (multiple episodes)
3. Recurrent radiculopathy
4. Illness (as opposed to injury)
An injured worker being treated within an approved MPN who does not agree with
the treating doctors opinion and treatment plan can seek opinions from how many
other doctors within the employers MPN?
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, 2 other doctors within the MPN
Temporary disability benefits (TDB) normally cannot be paid the longer than 104
weeks unless the injury involves what?
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1. Psychosis resulting from violence
2. Severe burns
3. Chronic lung disease
4. Hepatitis B&C
5. Amputations
*These can extend to 240 weeks
A QME evaluation for compensability (AOE/COE), do not send the QME report to
the_____?
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Local DEU
In 1989 and 1993, measures were enacted to address the QME process including....
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1. Med Legal fee schedule
2. Physician referral
3. QME advertising
4. Compensability of psychiatric and post termination
, 5. Fraud deterrence
6. Benefit payments for injured workers
What fund did the Boynton Act of 1913 establish?
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State Compensation Insurance Fund (SCIF)
How long can the employer control care (choose the PTP) if they have an MPN?
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Life of the claim
Which benefit is not guaranteed by the Worker's Compensation system in California?
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Cost of living expenses
What are the SJDB amounts for DOI before 01/01/2013?
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, $4,000- $10,000
What are the five major categories of QME disciplinary action?
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1) Consistent late reports
2) Lack of availability
3) Ex-Parte communications
4) Self referral
5) Reports do not meet DWC minimum standards
How does the MTUS help medical providers?
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1. Helps providers understand which EBM treatments have been effective
for IW's.
2. It also recommends the frequency, intensity and duration of treatment.
Supplemental reports must been completed and served within _____ days of the exam
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60 days of the exam
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1. Multilevel involvement (T3-T5)
2. Re-injury (multiple episodes)
3. Recurrent radiculopathy
4. Illness (as opposed to injury)
An injured worker being treated within an approved MPN who does not agree with
the treating doctors opinion and treatment plan can seek opinions from how many
other doctors within the employers MPN?
Give this one a try later!
, 2 other doctors within the MPN
Temporary disability benefits (TDB) normally cannot be paid the longer than 104
weeks unless the injury involves what?
Give this one a try later!
1. Psychosis resulting from violence
2. Severe burns
3. Chronic lung disease
4. Hepatitis B&C
5. Amputations
*These can extend to 240 weeks
A QME evaluation for compensability (AOE/COE), do not send the QME report to
the_____?
Give this one a try later!
Local DEU
In 1989 and 1993, measures were enacted to address the QME process including....
Give this one a try later!
1. Med Legal fee schedule
2. Physician referral
3. QME advertising
4. Compensability of psychiatric and post termination
, 5. Fraud deterrence
6. Benefit payments for injured workers
What fund did the Boynton Act of 1913 establish?
Give this one a try later!
State Compensation Insurance Fund (SCIF)
How long can the employer control care (choose the PTP) if they have an MPN?
Give this one a try later!
Life of the claim
Which benefit is not guaranteed by the Worker's Compensation system in California?
Give this one a try later!
Cost of living expenses
What are the SJDB amounts for DOI before 01/01/2013?
Give this one a try later!
, $4,000- $10,000
What are the five major categories of QME disciplinary action?
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1) Consistent late reports
2) Lack of availability
3) Ex-Parte communications
4) Self referral
5) Reports do not meet DWC minimum standards
How does the MTUS help medical providers?
Give this one a try later!
1. Helps providers understand which EBM treatments have been effective
for IW's.
2. It also recommends the frequency, intensity and duration of treatment.
Supplemental reports must been completed and served within _____ days of the exam
Give this one a try later!
60 days of the exam
