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Latest Updated Revision Questions and Answers for HCC QME Exam Complete Rated A.
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Latest Updated Revision Questions and Answers for HCC QME Exam Complete Rated A.
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Latest Updated Revision Questionsand Answers for HCC QME Exam
Complete Rated A.
The MTUS adopted the _____ model as opposed to the biomedical model
to better understand Chronic Pain (CP)?
✔✔Biopsychosocial Model
The MTUS uses _____ to identify IW's with an increased risk for Chronic
Pain (CP) and Delayed Recovery (DR)
✔✔Validated questionaries
The MTUS created the _____ to ensure IW's have access to effective and
appropriate treatment?
✔✔Medical Evidence Evaluation Advisory Committee (MEEAC)
Which DWC unit approves report extensions?
✔✔The medical unit
The "Claims Administrator" is a term referring to who?
✔✔The insurance company and individuals responsible for the claim
A QME of an unrepresented IW, a copy of the report must be sent to which
parties?
✔✔1. IW
2. Local DEU
3. Claims Administrator (insurance company)
,A QME evaluation for compensability (AOE/COE), do not send the QME
report to the_____?
✔✔Local DEU ??? Chat GPT says IW's Employer
If you are an AME agreed on by both attorneys, send your report to which
party(ies)?
✔✔Both attorneys
QME's are required to keep all medical-legal billings for _____ years after
examination?
✔✔3 years
When does a QME use the Diagnosis Related Estimates (DRE) method in
the spine? (4 answers)
✔✔1. Single level (L4/L5)
3. First injury (or repeat injury to a different region -> C3/C4 and L1/L2)
3. Corticospinal damage
4. Injury (as opposed to illness)
When does a QME use the ROM method in the spine? (4 answers)
✔✔1. Multilevel involvement (T3-T5)
2. Re-injury (multiple episodes)
3. Recurrent radiculopathy
4. Illness (as opposed to injury)
,The low-end or high-end of an impairment percentage range in the AMA
Guidelines is determine by_____?
✔✔Activities of Daily Living
The AMA defines Disability as_____?
✔✔An alteration of an individuals capacity to be personal, social, or
occupational demands because of an impairment
Before the 2003 reforms, Disability is defined as_____?
✔✔IW's ability to compete in the open labor market
How long can the employer control care (choose the PTP) if they have an
HCO?
✔✔90-180 days
How long can the employer control care (choose the PTP) if they have an
MPN?
✔✔Life of the claim
How long can the employer control (choose the PTP) care traditionally?
✔✔30 days
How many days does a QME have to submit a non initial PR-2 or PR-4 if
an evaluation is performed?
✔✔20 days
Each party must submit records to QME _____ days before exam?
✔✔20 days
, PR-2 reports without a face-to-face evaluation are due in _____ days
✔✔20 days
IW has _____ days to request IMR after UR denial?
✔✔30 days
How many days do claim administrators have to pay med legal
expenses?
✔✔45 days
When a payment is not made for a med-legal report, the "unreasonably
unpaid" amount can be increased by _____% as a penalty?
✔✔10%
When a payment for treatment is not paid as required, the "unreasonably
unpaid" amount can be increased by _____% as a penalty?
✔✔15%
The employer is required to pay all reasonable charges within _____days?
✔✔60 days
When the PTP determines that the employee's condition is permanent and
stationary, the physician must report within _______________ days from
the date of examination.
✔✔20 days
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