QME EXAM NEWEST ACTUAL EXAM COMPLETE 50 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
When was the 1st work comp act passed? - (ANSWER)1911, seventeen days after the
devistating fire at the triangle shirtwaist company factory in new york took 146 lives
What are the 3 components of the work comp system - (ANSWER)1. No fault
@#$
2. Exclusive remedy %^&*(
o(*&^
3. Assured fixed benefit
%$
No fault - (ANSWER)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.
Exclusive remedy - (ANSWER)less the employer is uninsured, the worker cannot pursue
other forms of recovery from the employer, even if the employer was grossly negligent.
Assured and fixed benefit - (ANSWER)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.
What type of injuries are excluded - (ANSWER)deliberately self-inflicted injuries are
excluded from coverage
What happens if the injury is due to serious misconduct of the employer? - (ANSWER)for
injuries that result from the serious and willful misconduct of the employer, the employee's
compensation is increased by half
, QME EXAM NEWEST ACTUAL EXAM COMPLETE 50 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
What happens if the injury is due to serious misconduct of the employee? - (ANSWER)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
o(*&^
%$
What measures were enacted in 2003 and 2004 - (ANSWER)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.
What measures were enacted in 2013 - (ANSWER)in 2013, measures were enacted that
made wide-ranging changes, which included (1) increasing permanent disability paid to
injured workers and simplifying the permanent disability rating meth-od, (2) resolving
medical treatment disagreements through independent medical review and bill payment
disputes through independent bill review, (3) improving medical provider networks, and (4)
updating the official medical fee schedule and establishing fee schedules for copy
services, in-terpreters, vocational experts, and in-home health care.
Medical unit - (ANSWER)which unit investigates complaints filed against qmes con-cerning
violations of the labor code and regulations as well as other statutes for misconduct com-
mitted in the qme process
What are the key components of compencability - (ANSWER)• how to take a complete
occupational history
• how to define:
O an injury
O first aid
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
When was the 1st work comp act passed? - (ANSWER)1911, seventeen days after the
devistating fire at the triangle shirtwaist company factory in new york took 146 lives
What are the 3 components of the work comp system - (ANSWER)1. No fault
@#$
2. Exclusive remedy %^&*(
o(*&^
3. Assured fixed benefit
%$
No fault - (ANSWER)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.
Exclusive remedy - (ANSWER)less the employer is uninsured, the worker cannot pursue
other forms of recovery from the employer, even if the employer was grossly negligent.
Assured and fixed benefit - (ANSWER)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.
What type of injuries are excluded - (ANSWER)deliberately self-inflicted injuries are
excluded from coverage
What happens if the injury is due to serious misconduct of the employer? - (ANSWER)for
injuries that result from the serious and willful misconduct of the employer, the employee's
compensation is increased by half
, QME EXAM NEWEST ACTUAL EXAM COMPLETE 50 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
What happens if the injury is due to serious misconduct of the employee? - (ANSWER)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
o(*&^
%$
What measures were enacted in 2003 and 2004 - (ANSWER)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.
What measures were enacted in 2013 - (ANSWER)in 2013, measures were enacted that
made wide-ranging changes, which included (1) increasing permanent disability paid to
injured workers and simplifying the permanent disability rating meth-od, (2) resolving
medical treatment disagreements through independent medical review and bill payment
disputes through independent bill review, (3) improving medical provider networks, and (4)
updating the official medical fee schedule and establishing fee schedules for copy
services, in-terpreters, vocational experts, and in-home health care.
Medical unit - (ANSWER)which unit investigates complaints filed against qmes con-cerning
violations of the labor code and regulations as well as other statutes for misconduct com-
mitted in the qme process
What are the key components of compencability - (ANSWER)• how to take a complete
occupational history
• how to define:
O an injury
O first aid
