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Exam (elaborations)

QME exam Questions and Answers 100% Pass

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QME exam Questions and Answers 100% Pass Holds authority to appoint physicians as QME evaluators - Administrative Director (AD) (LC 139.2) Term of appointment as QME evaluator - 2 years (LC 139.2) 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) 2 reasons for termination/suspension of a QME w/o a hearing - (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 - (1) Violation of material statutory or administrative duty; Copyright ©EMILLECT 2024. ALL RIGHTS RESERVED. Page 2/27 (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. 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 (detereoration of original injury), compensability of new body part added to claim) Definition of *injury* in compensability claims - (1) An injury or disease arising out of employment; Copyright ©EMILLECT 2024. ALL RIGHTS RESERVED. Page 3/27 (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* - Occurs as the result of a single incident or exposure *Cumulative injury* - Results from repetitive trauma (mental or physical) over a period of time 2 requirements for a condition to be considered an injury - (1) Cause disability; or (2) Result in a need for medical treatment Occupational disease - Disease that in whole or part is caused by work 7 types of excluded injuries - (1) Caused by employee's use of alcohol or illegal controlled substances; (2) Intentionally self-inflicted injuries;

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Uploaded on
November 26, 2024
Number of pages
27
Written in
2024/2025
Type
Exam (elaborations)
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QME exam Questions and Answers 100% Pass


Holds authority to appoint physicians as QME evaluators -

✔✔Administrative Director (AD) (LC 139.2)


Term of appointment as QME evaluator - ✔✔2 years (LC 139.2)


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)


2 reasons for termination/suspension of a QME w/o a hearing - ✔✔(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 -

✔✔(1) Violation of material statutory or administrative duty;

Copyright ©EMILLECT 2024. ALL RIGHTS RESERVED. Page 1/27

,(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.


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 (detereoration of original injury),

compensability of new body part added to claim)


Definition of *injury* in compensability claims - ✔✔(1) An injury or disease

arising out of employment;
Copyright ©EMILLECT 2024. ALL RIGHTS RESERVED. Page 2/27

, (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* - ✔✔Occurs as the result of a single incident or exposure


*Cumulative injury* - ✔✔Results from repetitive trauma (mental or

physical) over a period of time


2 requirements for a condition to be considered an injury - ✔✔(1) Cause

disability; or


(2) Result in a need for medical treatment


Occupational disease - ✔✔Disease that in whole or part is caused by work


7 types of excluded injuries - ✔✔(1) Caused by employee's use of alcohol or

illegal controlled substances;


(2) Intentionally self-inflicted injuries;


(3) Suicide;




Copyright ©EMILLECT 2024. ALL RIGHTS RESERVED. Page 3/27

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