QME Competency Examination STUDY
Guide
What info is not essential to determine industrial aggravation of chronic pre-existing medical
condition? - ANS An understanding of industrial risk factors for the condition.
QME Review of Medical Records - ANS Review all the records and summarize all
information relevant to disputed issues.
Worker injured june 24, 2008; his vocational rehab benefits - ANS Are replaced by a
supplemental job displacement benefit
QME Advertising under labor code: - ANS Permitted to advertise services in a legal journal
Date of Injury (DOI) for Cumulative Injury - ANS The date when the employee first realizes
the work-related disability
Employer's must pay for Medical Treatment of any non-industrial condition that prevents: -
ANS full implementation of necessary care for the industrial injury.
Prophylactic Work Restrictions - ANS safeguard the injured worker from further harm.
Reporting Cause of Disability in med-legal report: - ANS Mandated to be direct and definite
QME History of Injury: - ANS Inquire about the immediate events following the injury
Compensable Injury Definition as per Labor Code - ANS Includes any work-related
aggravation of a pre-existing physical or mental condition
In med-legal eval written in Nov 2004, lab and diagnostic test results or findings are _____
factors - ANS Objective
AMA Guidelines for Impairment Rating, for persistent pain add 3% for the pain when: - ANS
Any case involving excessive pain not already included in the impairment rating.
State-Established Protocols for QME Evaluations in 2004: - ANS psychiatry, pulmonary,
cardiac, neuromusculoskeletal, and immunological evaluations.
Face to Face Time Definition - ANS Includes the time spent by the physician in history-taking
and physical examination.
, Content of Medical-Legal Report - ANS Should include a specific or differential diagnosis.
Mandatory Inclusion in Report - ANS The declaration in its entirety
QME or AME Evaluation is performed if the employer or employee: - ANS disagrees with the
treating physician's disability evaluation.
QME Accreditation - ANS Process for QME approval under Labor Code section 139.2
Permanent Disability Determination - ANS Assessment of lasting impairment affecting work
capacity
Substantial Evidence - ANS Sufficient proof to support a claim or decision
Rating by Analogy - ANS Assigning disability rating based on similar cases
Industrial Cancer - ANS Work-related cancer due to occupational exposure
Apportionment Determinations - ANS Allocation of disability causes in a claim
Causation - ANS Establishing the link between an event and its outcome
Risk Factors - ANS Conditions increasing the likelihood of harm or injury
Unlawful Discrimination - ANS Illegitimate differentiation leading to unfair treatment
QME Selection Process - ANS Procedure for choosing a Qualified Medical Evaluator
Examination Process - ANS Steps involved in medical evaluations by QMEs
Conflict of Interest Disclosure - ANS Revealing any personal interests that may affect
judgment
Ethical Obligations of the QME - ANS Moral duties and responsibilities of the medical
evaluator
Evaluation Protocols - ANS Set rules and procedures for medical assessments
Qualified Medical Evaluator (QME) - ANS Physician appointed to resolve disputes in
workers' compensation cases
Labor Code section 139.2 - ANS Enacted in 1991, authorizes the QME program and sets
evaluation laws
Guide
What info is not essential to determine industrial aggravation of chronic pre-existing medical
condition? - ANS An understanding of industrial risk factors for the condition.
QME Review of Medical Records - ANS Review all the records and summarize all
information relevant to disputed issues.
Worker injured june 24, 2008; his vocational rehab benefits - ANS Are replaced by a
supplemental job displacement benefit
QME Advertising under labor code: - ANS Permitted to advertise services in a legal journal
Date of Injury (DOI) for Cumulative Injury - ANS The date when the employee first realizes
the work-related disability
Employer's must pay for Medical Treatment of any non-industrial condition that prevents: -
ANS full implementation of necessary care for the industrial injury.
Prophylactic Work Restrictions - ANS safeguard the injured worker from further harm.
Reporting Cause of Disability in med-legal report: - ANS Mandated to be direct and definite
QME History of Injury: - ANS Inquire about the immediate events following the injury
Compensable Injury Definition as per Labor Code - ANS Includes any work-related
aggravation of a pre-existing physical or mental condition
In med-legal eval written in Nov 2004, lab and diagnostic test results or findings are _____
factors - ANS Objective
AMA Guidelines for Impairment Rating, for persistent pain add 3% for the pain when: - ANS
Any case involving excessive pain not already included in the impairment rating.
State-Established Protocols for QME Evaluations in 2004: - ANS psychiatry, pulmonary,
cardiac, neuromusculoskeletal, and immunological evaluations.
Face to Face Time Definition - ANS Includes the time spent by the physician in history-taking
and physical examination.
, Content of Medical-Legal Report - ANS Should include a specific or differential diagnosis.
Mandatory Inclusion in Report - ANS The declaration in its entirety
QME or AME Evaluation is performed if the employer or employee: - ANS disagrees with the
treating physician's disability evaluation.
QME Accreditation - ANS Process for QME approval under Labor Code section 139.2
Permanent Disability Determination - ANS Assessment of lasting impairment affecting work
capacity
Substantial Evidence - ANS Sufficient proof to support a claim or decision
Rating by Analogy - ANS Assigning disability rating based on similar cases
Industrial Cancer - ANS Work-related cancer due to occupational exposure
Apportionment Determinations - ANS Allocation of disability causes in a claim
Causation - ANS Establishing the link between an event and its outcome
Risk Factors - ANS Conditions increasing the likelihood of harm or injury
Unlawful Discrimination - ANS Illegitimate differentiation leading to unfair treatment
QME Selection Process - ANS Procedure for choosing a Qualified Medical Evaluator
Examination Process - ANS Steps involved in medical evaluations by QMEs
Conflict of Interest Disclosure - ANS Revealing any personal interests that may affect
judgment
Ethical Obligations of the QME - ANS Moral duties and responsibilities of the medical
evaluator
Evaluation Protocols - ANS Set rules and procedures for medical assessments
Qualified Medical Evaluator (QME) - ANS Physician appointed to resolve disputes in
workers' compensation cases
Labor Code section 139.2 - ANS Enacted in 1991, authorizes the QME program and sets
evaluation laws
