HCC QME EXAM LATEST
If an IW is not being treated in an MPN or HCO and did not
predesignate, they may switch to a new doctor one time ___________ -
ANSWERS-During the First 30 Days
Non-MPN upon request of the employee for a change of physicians, the
maximum amount of time permitted by law for the employer or
insurance carrier to provide the employee with an alternate physician or
if requested by the employee, a chiropractor or acupuncturist is
___________ working days from the date of the request - ANSWERS-5
working days
A worker is injured on June 24, 2008, his vocational rehab benefits are?
- ANSWERS-Replaced by a supplemental job displacement benefit.
The employee who has designated a personal physician may change
personal physicians how often Prior to an injury? - ANSWERS-At any
time
Presumptions for fire fighters, forestry officers, peace officers, and
correctional employees cover conditions that manifest or develop during
the period of active service and following termination of service for up
to_____ years? - ANSWERS-5 years
END OF
PAGE
1
, HCC QME EXAM LATEST
California passed its first workers' compensation act (voluntary) in -
ANSWERS-1911
Following request for additional information, the UR decision must then
be made within __________________ from the date of first receipt of
the RFA - ANSWERS-14 days
If the request for IMR is made by a provider of emergency medical
treatment, the deadline for filing the application for IMR is
within___________ of receipt of the UR decision? - ANSWERS-30
days
A claims administrator must submit all records within_____________
days of the IMR request? - ANSWERS-15 days
Original signature of the medical legal report is mailed to the _____? -
ANSWERS-The Claims Administrator
Factors of Disability are only required for medical legal reports before
_____? - ANSWERS-01/01/2005
END OF
PAGE
2
, HCC QME EXAM LATEST
When an injured worker is unrepresented the QME serves the report on
who? - ANSWERS-1. DEU
2. Employee
3. Claims Administrator
Where does the DEU rater find the wage information of the IW? -
ANSWERS-DEU 101 Request for Summary Rating with Records
Occasional, Intermittent, Constant, and Frequent are terms called? -
ANSWERS-Words of Art
What did the 1913 Boynton Act require? - ANSWERS-That most
employers have workers' compensation coverage
For injuries on or after January 1, 1994 and Before 01/01/04 most
workers will be limited to a ___________________ cap on Vocational
Rehabilitation benefits under that plan? - ANSWERS-$16,000
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
END OF
PAGE
3
, HCC QME EXAM LATEST
report and not to exceed ______________ days? - ANSWERS-5 days
and 14 days
A QME certification is valid for how may years? - ANSWERS-2 years
(LC 139.2)
What are 3 requirements a physician must complete to become a
certified QME? - ANSWERS-(1) QME competency exam
(2) 12-hour course in 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
months prior to application)
What are 2 reasons for termination/suspension of a QME without a
hearing? - ANSWERS-(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 QME
that would require a hearing? - ANSWERS-(1) Violation of material
statutory or administrative duty;
(2) Failure to follow medical procedures or qualifications;
END OF
PAGE
4
If an IW is not being treated in an MPN or HCO and did not
predesignate, they may switch to a new doctor one time ___________ -
ANSWERS-During the First 30 Days
Non-MPN upon request of the employee for a change of physicians, the
maximum amount of time permitted by law for the employer or
insurance carrier to provide the employee with an alternate physician or
if requested by the employee, a chiropractor or acupuncturist is
___________ working days from the date of the request - ANSWERS-5
working days
A worker is injured on June 24, 2008, his vocational rehab benefits are?
- ANSWERS-Replaced by a supplemental job displacement benefit.
The employee who has designated a personal physician may change
personal physicians how often Prior to an injury? - ANSWERS-At any
time
Presumptions for fire fighters, forestry officers, peace officers, and
correctional employees cover conditions that manifest or develop during
the period of active service and following termination of service for up
to_____ years? - ANSWERS-5 years
END OF
PAGE
1
, HCC QME EXAM LATEST
California passed its first workers' compensation act (voluntary) in -
ANSWERS-1911
Following request for additional information, the UR decision must then
be made within __________________ from the date of first receipt of
the RFA - ANSWERS-14 days
If the request for IMR is made by a provider of emergency medical
treatment, the deadline for filing the application for IMR is
within___________ of receipt of the UR decision? - ANSWERS-30
days
A claims administrator must submit all records within_____________
days of the IMR request? - ANSWERS-15 days
Original signature of the medical legal report is mailed to the _____? -
ANSWERS-The Claims Administrator
Factors of Disability are only required for medical legal reports before
_____? - ANSWERS-01/01/2005
END OF
PAGE
2
, HCC QME EXAM LATEST
When an injured worker is unrepresented the QME serves the report on
who? - ANSWERS-1. DEU
2. Employee
3. Claims Administrator
Where does the DEU rater find the wage information of the IW? -
ANSWERS-DEU 101 Request for Summary Rating with Records
Occasional, Intermittent, Constant, and Frequent are terms called? -
ANSWERS-Words of Art
What did the 1913 Boynton Act require? - ANSWERS-That most
employers have workers' compensation coverage
For injuries on or after January 1, 1994 and Before 01/01/04 most
workers will be limited to a ___________________ cap on Vocational
Rehabilitation benefits under that plan? - ANSWERS-$16,000
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
END OF
PAGE
3
, HCC QME EXAM LATEST
report and not to exceed ______________ days? - ANSWERS-5 days
and 14 days
A QME certification is valid for how may years? - ANSWERS-2 years
(LC 139.2)
What are 3 requirements a physician must complete to become a
certified QME? - ANSWERS-(1) QME competency exam
(2) 12-hour course in 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
months prior to application)
What are 2 reasons for termination/suspension of a QME without a
hearing? - ANSWERS-(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 QME
that would require a hearing? - ANSWERS-(1) Violation of material
statutory or administrative duty;
(2) Failure to follow medical procedures or qualifications;
END OF
PAGE
4
