California QME Exam 2024 - Based on ICAC Course Material! Perfect Study Guide Material for your exam
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Module
Qme
Institution
Qme
California QME Exam 2024 - Based on ICAC Course Material! Perfect Study Guide Material for your exam
California passed first workers compensation act in what year? What event caused this? - ANS 1. 1911
2. Fire at Triangle Shirtwaist Company Factory
Was the first workers compensation act vol...
California QME Exam 2024 - Based on
ICAC Course Material
California passed first workers compensation act in what year? What event caused this?
- ANS 1. 1911
2. Fire at Triangle Shirtwaist Company Factory
Was the first workers compensation act voluntary or mandatory? - ANS Voluntary
A
What year was the Boyton Act passed? What did it require most employers to do? What
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did this act establish? - ANS 1. 1913
2. required most employers to have workers compensation coverage
3. established the State Compensation Insurance Fund (SCIF)
TU
What act replaced the Boyton Act in 1917? What was the new added provision? - ANS
1. Workers' Compensation Insurance and Safety Act
2. "permanent disability must give consideration to diminished ability to compete in the
IS
open labor market"
In what year did the California State Senate allow for subjective factors such as pain
OM
and mental disturbances? - ANS 1951
Federal, Maritime, and Railroad workers are covered under what? - ANS Federal
Work Comp
NA
What 3 things was the workers' compensation system created to pay for? - ANS 1.
Medical treatment
2. Temporary payment for lost wages
3. Permanent disability to compensate for decreased ability to compete in the open
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labor market
What is the Historic Compromise? - ANS 1. Employee gives up the right to pursue
legal action in exchange for benefits.
2. Employer provides benefits, regardless of fault, in exchange for legal protection.
What are the 3 components of the Historic Compromise? - ANS 1. No Fault
2. Exclusive Remedy
3. Assured and Fixed Benefit
, The employer is required to pay for benefits, regardless of fault, as long as the injury is
AOE/COE - ANS "No Fault" component of Historic Compromise
Worker cannot pursue other forms of recovery from the employee, even if the employer
was grossly negligent. (exception: 3rd parties may be sued). - ANS "Exclusive
Remedy" component of Historic Compromise
Workers compensation system established defined benefits which must be paid by the
employer. - ANS "Assured and Fixed Benefit" component of Historic Compromise
A
What are two exceptions to the "No Fault" rule? - ANS 1. Self inflicted injuries are
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excluded from coverage (Labor Code 3600)
2. Injury resulted from failure of the employer to comply with the law or safety and health
regulations or the employee was under 16 years old at time of injury (Labor Code 4551)
TU
When can benefits be reduced by half? When can they be increased by half? - ANS 1.
reduced when injury is result of employee serious and willful misconduct (unless result
is death or permanent disability of 70% or more)
IS
2. increased when injury is result of employer serious and willful misconduct
In 1989 and 1993, measures were enacted to address the QME process including.... -
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ANS 1. Med Legal fee schedule
2. Physician referral
3. QME advertising
4. Compensability of psychiatric and post termination
5. Fraud deterrence
NA
6. Benefit payments for injured workers
In 2003 and 2004, measures were enacted that allowed employers to... - ANS 1.
establish medical provider networks (MPN)
2. Conduct utilization review to ensure that medical care is consistent with evidence
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based guidelines
3. limit the amount of physical therapy and chiropractic
4. increase PD ratings and benefit payments to employees
5. require UR and MTUS guidelines
In 2013, measures were enacted... - ANS 1. increasing PD and simplifying PD rating
method
2. Resolving medical treatment disagreements through IMR and IBR
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