QME COMPETENCY EXAM PREP GUIDE
WITH COMPLETE SOLUTIONS
Who holds authority to appoint physicians as QME evaluators? - ANSWER-
Administrative Director (AD) (LC 139.2)
What is the term of appointment as QME evaluator? - ANSWER-2 years (LC 139.2)
What are the 3 requirements when seeking appointment as QME? - ANSWER-(1) Pass
the QME competency exam; (2) Complete a 12-hour course in disability eval report
writing; (3) Devote at least 1/3rd of total practice time to providing direct medical
treatment (or have served as a AME on 8+ occasions in past 12 mos prior to
application)
What are the 2 reasons for termination/suspension of a QME without a hearing? -
ANSWER-(1) Licensing board suspends/revokes/terminates license to practice; (2)
Failure to pay required fee (upon appointment and yearly thereafter)
What are the 6 reasons for discipline (suspension/termination) of QMEs after a hearing?
- ANSWER-(1) Violation of material statutory or administrative duty; (2) Failure to follow
medical procedures or qualifications; (3) Failure to comply with the timeframe
standards; (4) Failure to meet licensing/certification requirements; (5) Preparation of
medical-legal evaluations that fail to meet the minimum standards for those reports as
established by the administrative director or the appeals board; (6) Making material
misrepresentations or false statements in an application for appointment or
reappointment as a qualified medical evaluator.
What are the 3 types of substantive medical disputes resolved by QMEs? - ANSWER-
(1) Compensability of the claim; (2) Permanent disability; (3) 'Catch-all' (temporary
disability, work restrictions, new and further disabilities after permanent disability
(deterioration of original injury), compensability of new body part added to claim)
What is the definition of 'injury' in compensability claims? - ANSWER-(1) An injury or
disease arising out of employment; (2) A 'derivative' injury caused by treatment of an
injury arising out of employment; (3) Any reaction to or side effect from preventative
health care the employer provides
Time frame in which either party in unrepresented cases may object to a medication
determination by the treating physician - ANSWER-30 days, in writing
Time limit for unrepresented injured worker to submit request for a QME panel after
receiving form from employer - ANSWER-10 days
WITH COMPLETE SOLUTIONS
Who holds authority to appoint physicians as QME evaluators? - ANSWER-
Administrative Director (AD) (LC 139.2)
What is the term of appointment as QME evaluator? - ANSWER-2 years (LC 139.2)
What are the 3 requirements when seeking appointment as QME? - ANSWER-(1) Pass
the QME competency exam; (2) Complete a 12-hour course in disability eval report
writing; (3) Devote at least 1/3rd of total practice time to providing direct medical
treatment (or have served as a AME on 8+ occasions in past 12 mos prior to
application)
What are the 2 reasons for termination/suspension of a QME without a hearing? -
ANSWER-(1) Licensing board suspends/revokes/terminates license to practice; (2)
Failure to pay required fee (upon appointment and yearly thereafter)
What are the 6 reasons for discipline (suspension/termination) of QMEs after a hearing?
- ANSWER-(1) Violation of material statutory or administrative duty; (2) Failure to follow
medical procedures or qualifications; (3) Failure to comply with the timeframe
standards; (4) Failure to meet licensing/certification requirements; (5) Preparation of
medical-legal evaluations that fail to meet the minimum standards for those reports as
established by the administrative director or the appeals board; (6) Making material
misrepresentations or false statements in an application for appointment or
reappointment as a qualified medical evaluator.
What are the 3 types of substantive medical disputes resolved by QMEs? - ANSWER-
(1) Compensability of the claim; (2) Permanent disability; (3) 'Catch-all' (temporary
disability, work restrictions, new and further disabilities after permanent disability
(deterioration of original injury), compensability of new body part added to claim)
What is the definition of 'injury' in compensability claims? - ANSWER-(1) An injury or
disease arising out of employment; (2) A 'derivative' injury caused by treatment of an
injury arising out of employment; (3) Any reaction to or side effect from preventative
health care the employer provides
Time frame in which either party in unrepresented cases may object to a medication
determination by the treating physician - ANSWER-30 days, in writing
Time limit for unrepresented injured worker to submit request for a QME panel after
receiving form from employer - ANSWER-10 days
