QME EXAM NEWEST 2024
UPDATED QUESTIONS WITH
VERIFIED ANSWERS ALREADY
GRADED
Holds authority to appoint physicians as QME evaluators - CORRECT
ANSWER>>>>Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator - CORRECT ANSWER>>>>2 years (LC 139.2)
3 requirements when seeking appointment as QME - CORRECT 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)
2 reasons for termination/suspension of a QME w/o a hearing - CORRECT
ANSWER>>>>(1) Licensing board suspends/revokes/terminates license to
practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
6 reasons for discipline (suspension/termination) of QMEs after a hearing - CORRECT
ANSWER>>>>(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.
3 types of substantive medical disputes resolved by QMEs - CORRECT
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)
Definition of *injury* in compensability claims - CORRECT 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
*Specific injury* - CORRECT ANSWER>>>>Occurs as the result of a single incident
or exposure
*Cumulative injury* - CORRECT ANSWER>>>>Results from repetitive trauma
(mental or physical) over a period of time
2 requirements for a condition to be considered an injury - CORRECT
ANSWER>>>>(1) Cause disability; or
(2) Result in a need for medical treatment
Occupational disease - CORRECT ANSWER>>>>Disease that in whole or part is
caused by work
7 types of excluded injuries - CORRECT 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
4 basic conditions to establish a workers' compensation claim - CORRECT
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)
Aggravation of a pre-existing, non-industrial condition - CORRECT 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
, Symptoms that don't constitute a new injury - CORRECT ANSWER>>>>*Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the
current employment
Date of injury (DOI)-specific injury - CORRECT ANSWER>>>>Date on which the
incident or exposure occurred
Date of injury (DOI)-cumulative injury - CORRECT 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
Items determined by the DOI - CORRECT ANSWER>>>>(1) Statute of limitations for
particular procedures within the workers' compensation system;
(2) Regulations that will apply to the worker's injury;
(3) Compensation rate for the worker's injury;
(4) Employers who are liable for the claim.
Reasonable medical probability - CORRECT ANSWER>>>>Standard by which QME
uses combination of existing medical and scientific knowledge and the
occupational and medical history of the individual worker to conclude whether
the work exposure contributed to the injury
Evidentiary standard of causation/contribution in compensability disputes - CORRECT
ANSWER>>>>Preponderance of the evidence (51%; more likely than not)
3 factors to establish in making a causation determination - CORRECT
ANSWER>>>>(1) Presence of pathological conditions and disability
(2) Relevant work exposures
(3) Non-industrial exposures (other causes of disease)
5 major types of causation - CORRECT ANSWER>>>>(1) Direct
(2) Contributing
(3) Acceleration
(4) Precipitation
(5) Aggravation
Direct causation - CORRECT ANSWER>>>>Work exposures are directly
responsible for the health outcomes
Contributing causation - CORRECT ANSWER>>>>Several factors led to the disease;
work exposure is one of these factors
Acceleration - CORRECT ANSWER>>>>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.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller profwhite. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $24.99. You're not tied to anything after your purchase.
