QME Competency Exam Prep Guide Questions And Answers Graded A+
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Course
QME Competency
Institution
QME Competency
Rights of the claim administrator in selecting the QME and arranging the appointment - If injured
worker does not inform the claims administrator of the selection or date of appointment
What are some examples of good cause for periods of unavailability longer than 90 days? -
Sabbaticals, death/s...
QME Competency Exam Prep Guide
Rights of the claim administrator in selecting the QME and arranging the appointment - If injured
worker does not inform the claims administrator of the selection or date of appointment
What are some examples of good cause for periods of unavailability longer than 90 days? -
Sabbaticals, death/serious illness of immediate family member
Decider of disputes about whether a COI may affect the integrity and impartiality of the evaluation or
supplemental reports - WCALJ assigned to the case
Who should the reports be served to for unrepresented workers? - Injured worker, claims
administrator/employer.
Face - to - face time - Only time evaluator is present with an injured worker, taking a history,
performing a physical exam or discussing the worker's medical condition with the worker
Good cause for discontinuing a comprehensive medical - legal evaluation by a QME - (1) Injured
worker/representative uses abusive language towards the evaluator/evaluator's staff;
(2) Injured worker/representative deliberately attempts to disrupt the operation of the evaluator's office
in any way;
(3) Injured worker is intoxicated or under the influence of any medication which impairs the injured
worker's ability to participate in the evaluation/process.
Good cause for discontinuing the evaluation by an injured worker - (1) Discriminatory conduct,
based on race, sex, national origin, religion or sexual preference;
(2) Abuse, hostile or rude behavior, including behavior demonstrating a bias against injured workers;
(3) Requests that the worker submit to an unnecessary exam or procedure.
Minimum face - to - face time requirements for uncomplicated evaluations - 20 minutes for
neuromusculoskeletal evaluations
Options of represented workers after disclosure of COI by evaluator - (1) Waive the COI
, (2) Replace the evaluator's name on the panel (if COI discovered before any names have been stricken)
(3) Request a new panel (if COI discovered after appt made)
Parties receiving service of the QME Appointment Notification Form - Employee (+ representative)
AND Employer/claims administrator (+ representative)
Required exam disclosures - (1) Injured worker may ask the evaluator and evaluator shall
promptly answer questions about any matter concerning the evaluation process;
(2) Injured worker may discontinue the evaluation based on *good cause*;
(3) Disclosure of probationary status, if required as a condition of probation.
Time frame after which unrepresented worker has the right to obtain an evaluation from any QME
within a reasonable geographic area - After 20 days, if request for QME panel is not issued
Time frame in represented cases during which each party may strike one name from the QME panel -
10 days after the assignment of the panel
Time frame in which an injured worker is required to select a physician from the QME panel, make an
appointment for the exam and inform the claims administrator of the selection and appointment -
Within 10 days after the panel is issued
Time frame in which either party in unrepresented cases may object to a medication determination by
the treating physician - 30 days, in writing
Time frame in which selected QME must schedule an appointment to see the injured worker -
Within 60 days of a request for an appointment (up to 90 days)
Time frame to submit the QME Appointment Notification Form - Within 5 business days of making
the appointment
Time limit for unrepresented injured worker to submit request for a QME panel after receiving form from
employer - 10 days
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