QME EXAM NEWEST ACTUAL EXAM
COMPLETE 200 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
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Holds authority to appoint physicians as QME evaluators - Answer-
Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator - Answer- 2 years (LC 139.2)
3 requirements when seeking appointment as QME - Answer- (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 - Answer- (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 -
Answer- (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;
, QME EXAM NEWEST ACTUAL EXAM
(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 - Answer- (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 - Answer- (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 to health care workers
*Specific injury* - Answer- Occurs as the result of a single incident or exposure
*Cumulative injury* - Answer- Results from repetitive trauma (mental or physical)
over a period of time
2 requirements for a condition to be considered an injury - Answer- (1) Cause
disability; or
(2) Result in a need for medical treatment
Occupational disease - Answer- Disease that in whole or part is caused by work
7 types of excluded injuries - Answer- (1) Caused by employee's use of alcohol or
illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
, QME EXAM NEWEST ACTUAL EXAM
(4) Resulting from altercations, in which the injured employee is the *initial physical
aggressor*;
(5) Resulting from the employee's commission of a felony, for which the employee
has been convicted (including "wobbly felonies," which are crimes that may be
prosecuted as misdemeanors or felonies)
(6) Resulting from off-duty recreational activities, in which participation in the
activities does not constitute part of the employee's work-related duties and the
activity is not an expressed or implicit condition of employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless certain
conditions exist
4 basic conditions to establish a workers' compensation claim - Answer- (1)
*Injury* (physiological or psychological harm);
(2) Employment relationship;
(3) Injury caused by the employment (This is also referred to as arising out of
employment [AOE].);
(4) Occurred in the course of the employment (COE)
Aggravation of a pre-existing, non-industrial condition - Answer- (1) Causes a
temporary or permanent increase in disability;
(2) Creates a new need for medical treatment; or
(3) Requires a change in the existing course of treatment
Symptoms that don't constitute a new injury - Answer- *Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the current
employment
Date of injury (DOI)-specific injury - Answer- Date on which the incident or
exposure occurred
Date of injury (DOI)-cumulative injury - Answer- Date when the employee first
suffered disability from the exposure, and either knew, or should have known, that
the disability was caused by present or previous employment