1
QME exam| |COMPLETE MOST TESTED
QUESTIONS AND VERIFIED ANSWERS
|(100% correct solutions)|GET IT A+
RIGHT!!
Holds authority to appoint physicians as QME evaluators -
(ANSWER)Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator - (ANSWER)2 years (LC 139.2)
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)
2 reasons for termination/suspension of a QME w/o a hearing - (ANSWER)(1)
Licensing board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
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;
,2
(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.
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 (detereoration of original injury), compensability of
new body part added to claim)
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 to health care workers
*Specific injury* - (ANSWER)Occurs as the result of a single incident or exposure
, 3
*Cumulative injury* - (ANSWER)Results from repetitive trauma (mental or
physical) over a period of time
2 requirements for a condition to be considered an injury - (ANSWER)(1) Cause
disability; or
(2) Result in a need for medical treatment
Occupational disease - (ANSWER)Disease that in whole or part is caused by work
7 types of excluded injuries - (ANSWER)(1) Caused by employee's use of alcohol
or illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
(4) Resulting from altercations, in which the injured employee is the *initial
physical aggressor*;
(5) Resulting from the employee's commission of a felony, for which the
employee has been convicted (including "wobbly felonies," which are crimes that
may be prosecuted as misdemeanors or felonies)
(6) Resulting from off-duty recreational activities, in which participation in the
activities does not constitute part of the employee's work-related duties and the
activity is not an expressed or implicit condition of employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless certain
conditions exist
QME exam| |COMPLETE MOST TESTED
QUESTIONS AND VERIFIED ANSWERS
|(100% correct solutions)|GET IT A+
RIGHT!!
Holds authority to appoint physicians as QME evaluators -
(ANSWER)Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator - (ANSWER)2 years (LC 139.2)
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)
2 reasons for termination/suspension of a QME w/o a hearing - (ANSWER)(1)
Licensing board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
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;
,2
(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.
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 (detereoration of original injury), compensability of
new body part added to claim)
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 to health care workers
*Specific injury* - (ANSWER)Occurs as the result of a single incident or exposure
, 3
*Cumulative injury* - (ANSWER)Results from repetitive trauma (mental or
physical) over a period of time
2 requirements for a condition to be considered an injury - (ANSWER)(1) Cause
disability; or
(2) Result in a need for medical treatment
Occupational disease - (ANSWER)Disease that in whole or part is caused by work
7 types of excluded injuries - (ANSWER)(1) Caused by employee's use of alcohol
or illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
(4) Resulting from altercations, in which the injured employee is the *initial
physical aggressor*;
(5) Resulting from the employee's commission of a felony, for which the
employee has been convicted (including "wobbly felonies," which are crimes that
may be prosecuted as misdemeanors or felonies)
(6) Resulting from off-duty recreational activities, in which participation in the
activities does not constitute part of the employee's work-related duties and the
activity is not an expressed or implicit condition of employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless certain
conditions exist
