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QME EXAM NEWEST ACTUAL EXAM ALL 200 QUESTIONS AND CORRECT DETAILED SOLUTIONS
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QME EXAM NEWEST ACTUAL EXAM ALL 200 QUESTIONS AND CORRECT DETAILED SOLUTIONS
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Page 1 of 35QME EXAM NEWEST ACTUAL EXAM ALL
200 QUESTIONS AND CORRECT DETAILED
SOLUTIONS
QUESTION: Holds authority to appoint physicians as QME evaluators - ANSWER-
Administrative Director (AD) (LC 139.2)
QUESTION: Term of appointment as QME evaluator - ANSWER-2 years (LC 139.2)
QUESTION: 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)
QUESTION: 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)
QUESTION: 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;
Success!
, Page 2 of 35
(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.
QUESTION: 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)
QUESTION: 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
QUESTION: *Specific injury* - ANSWER-Occurs as the result of a single incident or exposure
Success!
, Page 3 of 35
QUESTION: *Cumulative injury* - ANSWER-Results from repetitive trauma (mental or
physical) over a period of time
QUESTION: 2 requirements for a condition to be considered an injury - ANSWER-(1) Cause
disability; or
(2) Result in a need for medical treatment
QUESTION: Occupational disease - ANSWER-Disease that in whole or part is caused by work
QUESTION: 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;
(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
Success!
, Page 4 of 35
QUESTION: 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)
QUESTION: 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
QUESTION: 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
QUESTION: Date of injury (DOI)-specific injury - ANSWER-Date on which the incident or
exposure occurred
QUESTION: 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
Success!
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