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QME EXAM QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS 100% CORRECT | NEW UPDATE 2024
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QME EXAM QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS 100% CORRECT | NEW UPDATE 2024
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QME EXAM QUESTIONS AND ANSWERS WITH VERIFIEDSOLUTIONS 100% CORRECT | NEW UPDATE 2024
1911, SEVENTEEN DAYS AFTER THE DEVISTATING FIRE AT THE TRIANGLE SHIRTWAIST COMPANY
FACTORY IN NEW YORK TOOK 146 LIVES - ANSWER when was the 1st work comp act passed?
1. NO FAULT
2. EXCLUSIVE REMEDY
3. ASSURED FIXED BENEFIT - ANSWER WHAT ARE THE 3 COMPONENTS OF THE WORK COMP
SYSTEM
e employer is required to pay benefits no matter who caused the injury, as long as the injury
arose out of or occurred in the course of employment. - ANSWER NO FAULT
less the employer is uninsured, the worker cannot pursue other forms of recovery from the
employer, even if the employer was grossly negligent. - ANSWER EXCLUSIVE REMEDY
The workers' compensation system establishes defined benefits, which must be paid for by the
employer. Workers' compensation awards are typically far less than comparable negligence
awards in a civil suit. For example, although the maximum workers' compensation death benefit
may be far less than the possible award in a civil wrongful death suit, a civil action may take
years to resolve while a death claim can be re-solved in as little as a few months. Additional
recoveries are available to employees for an employer's serious and willful misconduct and
unlawful discrimination (Labor Code § 132a and § 4553). Although group health coverage may
include arbitrary limits on the extent of treatment covered, workers' compensation is a
statutory benefit with no arbitrary limits on the frequency, duration, or extent of services. -
ANSWER ASSURED AND FIXED BENEFIT
deliberately self-inflicted injuries are excluded from coverage - ANSWER WHAT TYPE OF
INJYURIES ARE EXCLUDED
, For injuries that result from the serious and willful misconduct of the employer, the employee's
compensation is increased by half - ANSWER WHAT HAPPENS IF THE INJURY IS DUE TO
SERIOUS MISCONDUCT OF THE EMPLOYER?
For injuries that result from the serious and willful misconduct of the injured employee, benefits
are reduced by half, unless the injury resulted in death or a per-manent disability of 70% or
more; the 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 the time of in-jury - ANSWER
WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS MISCONDUCT OF THE EMPLOYEE?
measures were enacted that allowed employers (1) to establish medical pro-vider networks—
from which injured workers are required to select treating doctors, (2) to conduct utilization
review to ensure that medical care was consistent with evidence-based guidelines, and (3) to
limit the amount of physical therapy and chiropractic treatment. These measures also affect-ed
permanent disability ratings and benefit payments to injured workers. An evidence-based medi-
cal treatment utilization schedule (MTUS), or set of guidelines, was also adopted. - ANSWER
WHAT MEASURES WERE ENACTED IN 2003 AND 2004
In 2013, measures were enacted that made wide-ranging changes, which included (1) increasing
permanent disability paid to injured workers and simplifying the permanent disability rating
meth-od, (2) resolving medical treatment disagreements through independent medical review
and bill payment disputes through independent bill review, (3) improving medical provider
networks, and (4) updating the Official Medical Fee Schedule and establishing fee schedules for
copy services, in-terpreters, vocational experts, and in-home health care. - ANSWER WHAT
MEASURES WERE ENACTED IN 2013
Which unit investigates complaints filed against QMEs con-cerning violations of the Labor Code
and regulations as well as other statutes for misconduct com-mitted in the QME process -
ANSWER MEDICAL UNIT
• How to Take a Complete Occupational History
• How to Define:
o An Injury
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