QME Test 1 Questions with Correct Answers
1911, SEVENTEEN DAYS AFTER THE DEVISTATING FIRE AT THE TRIANGLE
SHIRTWAIST COMPANY FACTORY IN NEW YORK TOOK 146 LIVES
when was the 1st work comp act passed?
1. NO FAULT
2. EXCLUSIVE REMEDY
3. ASSURED FIXED BENEFIT
WHAT ARE THE 3 COMPONENTS OF THE WORK COMP SYSTEM
e employer is required to pay benefits no matter who caused the injury, as long as the
injury arose out of or occurred in the course of employment.
NO FAULT
less the employer is uninsured, the worker cannot pursue other forms of recovery from
the employer, even if the employer was grossly negligent.
EXCLUSIVE REMEDY
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 a statutory benefit with no
arbitrary limits on the frequency, duration, or extent of services.
ASSURED AND FIXED BENEFIT
deliberately self-inflicted injuries are excluded from coverage
WHAT TYPE OF INJYURIES ARE EXCLUDED
For injuries that result from the serious and willful misconduct of the employer, the
employee's compensation is increased by half
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE
EMPLOYER?
For injuries that result from the serious and willful misconduct of the injured employee,
benefits are reduced by half, unless the injury resulted in death or a per-manent
disability of 70% or more; the injury resulted from failure of the employer to comply
with the law or safety and health regulations; or the employee was under 16 years old at
the time of in-jury
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE
EMPLOYEE?
measures were enacted that allowed employers (1) to establish medical pro-vider
networks—from which injured workers are required to select treating doctors, (2) to
conduct utilization review to ensure that medical care was consistent with evidence-
based guidelines, and (3) to limit the amount of physical therapy and chiropractic
treatment. These measures also affect-ed permanent disability ratings and benefit
payments to injured workers. An evidence-based medi-cal treatment utilization
schedule (MTUS), or set of guidelines, was also adopted.
1911, SEVENTEEN DAYS AFTER THE DEVISTATING FIRE AT THE TRIANGLE
SHIRTWAIST COMPANY FACTORY IN NEW YORK TOOK 146 LIVES
when was the 1st work comp act passed?
1. NO FAULT
2. EXCLUSIVE REMEDY
3. ASSURED FIXED BENEFIT
WHAT ARE THE 3 COMPONENTS OF THE WORK COMP SYSTEM
e employer is required to pay benefits no matter who caused the injury, as long as the
injury arose out of or occurred in the course of employment.
NO FAULT
less the employer is uninsured, the worker cannot pursue other forms of recovery from
the employer, even if the employer was grossly negligent.
EXCLUSIVE REMEDY
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 a statutory benefit with no
arbitrary limits on the frequency, duration, or extent of services.
ASSURED AND FIXED BENEFIT
deliberately self-inflicted injuries are excluded from coverage
WHAT TYPE OF INJYURIES ARE EXCLUDED
For injuries that result from the serious and willful misconduct of the employer, the
employee's compensation is increased by half
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE
EMPLOYER?
For injuries that result from the serious and willful misconduct of the injured employee,
benefits are reduced by half, unless the injury resulted in death or a per-manent
disability of 70% or more; the injury resulted from failure of the employer to comply
with the law or safety and health regulations; or the employee was under 16 years old at
the time of in-jury
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE
EMPLOYEE?
measures were enacted that allowed employers (1) to establish medical pro-vider
networks—from which injured workers are required to select treating doctors, (2) to
conduct utilization review to ensure that medical care was consistent with evidence-
based guidelines, and (3) to limit the amount of physical therapy and chiropractic
treatment. These measures also affect-ed permanent disability ratings and benefit
payments to injured workers. An evidence-based medi-cal treatment utilization
schedule (MTUS), or set of guidelines, was also adopted.
