QME Competency Exam Prep Guide questions with correct answers

QME Competency Exam Prep Guide
questions with correct answers

Who holds authority to appoint physicians as QME evaluators? - ANSWER: ➡ Administrative
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Director (AD) (LC 139.2)
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What is the term of appointment as QME evaluator? - ANSWER: ➡ 2 years (LC 139.2)
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What are the 3 requirements when seeking appointment as QME? - ANSWER: ➡ (1) Pass the
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QME competency exam; (2) Complete a 12-hour course in disability eval report writing; (3)
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Devote at least 1/3rd of total practice time to providing direct medical treatment (or have
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served as a AME on 8+ occasions in past 12 mos prior to application)
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What are the 2 reasons for termination/suspension of a QME without a hearing? - ANSWER:
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➡ (1) Licensing board suspends/revokes/terminates license to practice; (2) Failure to pay
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required fee (upon appointment and yearly thereafter)
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What are the 6 reasons for discipline (suspension/termination) of QMEs after a hearing? -
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ANSWER: ➡ (1) Violation of material statutory or administrative duty; (2) Failure to follow
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medical procedures or qualifications; (3) Failure to comply with the timeframe standards;
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(4) Failure to meet licensing/certification requirements; (5) Preparation of medical-legal
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evaluations that fail to meet the minimum standards for those reports as established by the
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administrative director or the appeals board; (6) Making material misrepresentations or
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false statements in an application for appointment or reappointment as a qualified medical
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evaluator.
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What are the 3 types of substantive medical disputes resolved by QMEs? - ANSWER: ➡ (1)
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Compensability of the claim; (2) Permanent disability; (3) 'Catch-all' (temporary disability,
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work restrictions, new and further disabilities after permanent disability (deterioration of
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original injury), compensability of new body part added to claim)
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, What is the definition of 'injury' in compensability claims? - ANSWER: ➡ (1) An injury or
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disease arising out of employment; (2) A 'derivative' injury caused by treatment of an injury
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arising out of employment; (3) Any reaction to or side effect from preventative health care
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the employer provides
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Time frame in which either party in unrepresented cases may object to a medication
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determination by the treating physician - ANSWER: ➡ 30 days, in writing
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Time limit for unrepresented injured worker to submit request for a QME panel after
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receiving form from employer - ANSWER: ➡ 10 days
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Time frame after which unrepresented worker has the right to obtain an evaluation from any
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QME within a reasonable geographic area - ANSWER: ➡ After 20 days, if request for QME
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panel is not issued
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Time frame in which an injured worker is required to select a physician from the QME panel,
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make an appointment for the exam and inform the claims administrator of the selection and
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appointment - ANSWER: ➡ Within 10 days after the panel is issued
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Rights of the claim administrator in selecting the QME and arranging the appointment -
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ANSWER: ➡ If injured worker does not inform the claims administrator of the selection or
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date of appointment
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Time frame in represented cases during which each party may strike one name from the
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QME panel - ANSWER: ➡ 10 days after the assignment of the panel
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Time frame in which selected QME must schedule an appointment to see the injured worker -
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ANSWER: ➡ Within 60 days of a request for an appointment (up to 90 days)
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Time frame to submit the QME Appointment Notification Form - ANSWER: ➡ Within 5
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business days of making the appointment
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