QME EXAM |100 QUESTIONS| WITH ACTUAL
SOLUTIONS LATEST EXAM UPDATE QUESTIONS
WITH ANSWERS
*Cumulative injury* ...ANS: Results from repetitive trauma
(mental or physical) over a period of time
*Specific injury* ...ANS: Occurs as the result of a single incident or
exposure
2 reasons for termination/suspension of a QME w/o a
hearing ...ANS: (1) Licensing board
suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly
thereafter)
2 requirements for a condition to be considered an injury ...ANS:
(1) Cause disability; or
(2) Result in a need for medical treatment
3 factors to establish in making a causation determination ...ANS:
(1) Presence of pathological conditions and disability
(2) Relevant work exposures
(3) Non-industrial exposures (other causes of disease)
3 requirements when seeking appointment as QME ...ANS: (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)
,ASCORERS STUVIA
3 types of substantive medical disputes resolved by QMEs ...ANS:
(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)
4 basic conditions to establish a workers' compensation
claim ...ANS: (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)
5 major types of causation ...ANS: (1) Direct
(2) Contributing
(3) Acceleration
(4) Precipitation
(5) Aggravation
6 reasons for discipline (suspension/termination) of QMEs after a
hearing ...ANS: (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;
(6) Making material misrepresentations or false statements in an
application for appointment or reappointment as a qualified medical
evaluator.
, ASCORERS STUVIA
7 types of excluded injuries ...ANS: (1) Caused by employee's use
of alcohol or illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
(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
Acceleration ...ANS: Disease process is accelerated by virtue of
work exposure. The date of the onset of the disease is much sooner
than it would have been in the absence of the exposure.
Admissible reports before a WCJ to resolve the issue of
compensability ...ANS: (1) Properly acquired QME
(2) Primary treating physician
Aggravation ...ANS: A medical condition may be present already,
but work exposure makes it worse
Aggravation of a pre-existing, non-industrial condition ...ANS: (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
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