QME Competency Exam Prep
Guide
Who holds authority to appoint physicians as QME evaluators? - -
Administrative Director (AD) (LC 139.2)
-What is the term of appointment as QME evaluator? - -2 years (LC 139.2)
-What are the 3 requirements when seeking appointment as QME? - -(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? - -(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? - -(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? - -
(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? - -(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 - -30 days, in writing
Guide
Who holds authority to appoint physicians as QME evaluators? - -
Administrative Director (AD) (LC 139.2)
-What is the term of appointment as QME evaluator? - -2 years (LC 139.2)
-What are the 3 requirements when seeking appointment as QME? - -(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? - -(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? - -(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? - -
(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? - -(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 - -30 days, in writing