ASCORERS STUVIA
QME EXAM LATEST UPDATE
QUESTIONS AND ANSWERS
A psychiatric injury is compensable if ...ANS: it is a diagnosed
mental disorder that causes disability or need for medical treat-
ment, and the employee can demonstrate that the events of
employment were the "predominant cause" of the injury.
a worker who suffers an on-the-job aggravation of a non-industrial
pre-existing disease or underlying condition has sustained a new
injury. ...ANS: What Is Considered an Aggravation of a Pre-
Existing Non-Industrial Condition?
All that is required is proof of a reasonable medical
probability. ...ANS: Is the Injury Work-Related (AOE/COE)?
ARRISING OUT OF EMPLOYMENT ...ANS: AOE
ASSURED AND FIXED BENEFIT ...ANS: The workers'
compensation system establishes defined benefits, which must be
paid for by the employer. Workers' compensation awards are
typically far less than comparable negligence awards in a civil suit.
For example, although the maximum workers' compensation death
benefit may be far less than the possible award in a civil wrongful
death suit, a civil action may take years to resolve while a death
claim can be re-solved in as little as a few months. Additional
recoveries are available to employees for an employer's serious and
willful misconduct and unlawful discrimination (Labor Code § 132a
and § 4553). Although group health coverage may include arbitrary
limits on the extent of treatment covered, workers' compensation is
, ASCORERS STUVIA
a statutory benefit with no arbitrary limits on the frequency,
duration, or extent of services.
COURSE OF EMPLOYMENT ...ANS: COE
Employees injured between January 1, 2004, and December 31,
2012, with injuries that result in permanent partial disability and
who do not return to work for the employer within 60 days of
termination of temporary disability may qualify for the SJDB
voucher, unless the employer offers and the employee rejects, or
fails to accept, modified work lasting at least 12 months. The benefit
comes in the form of a nontransferable voucher that can be used to
pay for education-related re-training or skill enhancement, or both,
at state-approved or state-accredited schools. ...ANS:
Supplemental Job Displacement Benefits
Employers are obligated to: ...ANS: • Provide a safe and healthful
workplace for their employees
• Carry insurance to meet their obligations under workers'
compensation law or to provide the DIR with proof of self-insurance
• Provide information about workers' compensation to their
employees, including infor-mation on where and how to file a claim
and on how to predesignate a personal physician
• Maintain records of occupational injuries and diseases
• Report immediately to the Division of Occupational Safety and
Health (DOSH), better known as Cal/OSHA, any death or serious
injury.
• Provide the claim form (DWC 1) within one working day of the
employer's knowledge of the injury
• Complete an Employer's Report of Occupational Injury or Illness
("Employer's First Report" Form 5020), within five days of being
notified by the employee of an occupational injury or illness.
QME EXAM LATEST UPDATE
QUESTIONS AND ANSWERS
A psychiatric injury is compensable if ...ANS: it is a diagnosed
mental disorder that causes disability or need for medical treat-
ment, and the employee can demonstrate that the events of
employment were the "predominant cause" of the injury.
a worker who suffers an on-the-job aggravation of a non-industrial
pre-existing disease or underlying condition has sustained a new
injury. ...ANS: What Is Considered an Aggravation of a Pre-
Existing Non-Industrial Condition?
All that is required is proof of a reasonable medical
probability. ...ANS: Is the Injury Work-Related (AOE/COE)?
ARRISING OUT OF EMPLOYMENT ...ANS: AOE
ASSURED AND FIXED BENEFIT ...ANS: The workers'
compensation system establishes defined benefits, which must be
paid for by the employer. Workers' compensation awards are
typically far less than comparable negligence awards in a civil suit.
For example, although the maximum workers' compensation death
benefit may be far less than the possible award in a civil wrongful
death suit, a civil action may take years to resolve while a death
claim can be re-solved in as little as a few months. Additional
recoveries are available to employees for an employer's serious and
willful misconduct and unlawful discrimination (Labor Code § 132a
and § 4553). Although group health coverage may include arbitrary
limits on the extent of treatment covered, workers' compensation is
, ASCORERS STUVIA
a statutory benefit with no arbitrary limits on the frequency,
duration, or extent of services.
COURSE OF EMPLOYMENT ...ANS: COE
Employees injured between January 1, 2004, and December 31,
2012, with injuries that result in permanent partial disability and
who do not return to work for the employer within 60 days of
termination of temporary disability may qualify for the SJDB
voucher, unless the employer offers and the employee rejects, or
fails to accept, modified work lasting at least 12 months. The benefit
comes in the form of a nontransferable voucher that can be used to
pay for education-related re-training or skill enhancement, or both,
at state-approved or state-accredited schools. ...ANS:
Supplemental Job Displacement Benefits
Employers are obligated to: ...ANS: • Provide a safe and healthful
workplace for their employees
• Carry insurance to meet their obligations under workers'
compensation law or to provide the DIR with proof of self-insurance
• Provide information about workers' compensation to their
employees, including infor-mation on where and how to file a claim
and on how to predesignate a personal physician
• Maintain records of occupational injuries and diseases
• Report immediately to the Division of Occupational Safety and
Health (DOSH), better known as Cal/OSHA, any death or serious
injury.
• Provide the claim form (DWC 1) within one working day of the
employer's knowledge of the injury
• Complete an Employer's Report of Occupational Injury or Illness
("Employer's First Report" Form 5020), within five days of being
notified by the employee of an occupational injury or illness.
