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;
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