QME Examination Final Exam Questions With Complete Solutions(100%pass!!)

QME Examination Final Exam Questions With Complete Solutions(100%pass!!) Treating physician reports and medical-legal evaluations are used to establish - correct answer...eligibility for benefits Unrepresented worker - if the employee does not inform the employer of the selection within ____ days of the assignment of a panel of qualified medical evaluators, then the employer may select the physician from the panel - correct answer...10 SB-228 reforms of 2003 (Governor Davis) primarily addressed the following issues - correct answer...ACOEM Guidelines - 24 visit limit For a QME evaluation for compensability only (AOE/COE), DO NOT send the QME report to the following Part(ies)? - correct answer...Local DEU SB-899 reforms of 2004 (Governor Schwarzenegger) primarily addressed the following issues? - correct answer...AMA Impairment Guides and MPNs Which of the following is not a term used in California as ratable "word of art"? - correct answer...Often Who selects the QME - correct answer...Patient In 1913, the Boynton Act - correct answer...Required most employers to have workers' compensation coverage A trade-off between Employers and Employees is referred to as - correct answer...The Historic Compromise You are required to keep and maintain all the medical-legal BILLINGS for _____ years from the date of examination - correct answer...3 years The employer provides workers' compensation BENEFITS - correct answer...regardless of fault A copy of the notice to request time extension to file a QME report must be sent to - correct answer...Medical Unit at DWC The employer is required to pay benefits no matter who caused the injury, as long as the injury is - correct answer...AOE/COE If there is a serious and willful misconduct by the employEE the award may be - correct answer...decreased by 1/2 If the employer is UNINSURED for workers' compensation the injured worker can - correct answer...Sue in Civil Court, Receive punitive damages for pain and suffering, have the District Attorney fine the Employer For dates of injuyr AFTER 01/01/2005, a QME must use - correct answer...American Medical Association Guide to the Evaluation of Permanent Impairment, 5th edition Unlawful discrimination for reporting a work injury is protected under - correct answer...L.C. 132a The chief method to apportion permanent disability is to use the - correct answer...subtraction method If the injured worker is not hospitalized and misses seven (7) days of work he/she is not paid TD for - correct answer...the first three (3) days "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 - correct answer...five (5) years Payments to compensate an employee who does not completely recover from an injury - correct answer...PD "Disability = Impairment + Loss earning capacity + Occupational title + Age" - correct answer...Formula for PD Means approximately 90-100 percent of the time, as a ratable "word of art" - correct answer...Constant 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 - correct answer...$16,000 If there are no surviving dependents, the death benefit is paid to - correct answer...Department of Industrial Relations (DIR) The independent JUDICIAL BODY in California work comp is called - correct answer...WCAB Medical providers who request authorization in writing for a specific course of treatment for an injured worker must receive a prompt response within ___ working days of receipt of the report not to exceed ____ days - correct answer...response within five (5) working days, not to exceed fourteen (14) The DWC Unit that rates your panel QME reports - correct answer...DEU Who appoints and monitors Qualified Medical Evaluators, and can suspend or terminate QME status - correct answer...DWC Medical Unit The employer is required to pay for "medical, surgical, chiropractic and hospital treatment... which is reasonably required ____ from the effects of the injury - correct answer...to cure OR relieve The Physician responsible to manage the care of the injured worker - correct answer...Primary Treating Physician (PTP) Who CANNOT be Medical-Legal Evaluating Physician - correct answer...Physical Therapist (PT) The three Physicians assigned by DWC Medical Unit to do a Med-Legal evaluation - correct answer...Qualified Medical Evaluators (QME) When the payment for TREATMENT is not made as required, the "unreasonably unpaid" amount can be increased by a penalty of - correct answer...15% The injured worker must inform the employer about the injury or illness within ____ of the "date of injury" - correct answer...30 days The employer must furnish the worker with a claim form (DWC-1) within ___ of learning of the injury - correct answer...one (1) working day The employee's claim is initiated once the employer learns of the injury from - correct answer...Any source The worker MUST complete and return the ____ to the employer to initiate a claim in California - correct answer...DWC-1 Claim Form If there is no MPN, an employee may pre-designate a Chiropractor or Acupuncturist and may switch care to that Chiropractor or Acupuncturist _____ after notifying the employer - correct answer...Immediately An employer must report injuries to Cal/OSHA of any death or serious injury within _____ - correct answer...24 hours Labor Code section 4600 refers to - correct answer...A Statute