QME MICHELLE EXAM NEWEST 2024-2025
ACTUAL EXAM 180 QUESTIONS AND
CORRECT VERIFIED ANSWERS. ALREADY
GRADED A+
1. When did California pass its first workers' compensation act?: 1911
2. What event in 1911 lead to workers' compensation act to be passed?:
17 days after FIRE at Triangle Shirtwaist Company Factory in NYC
3. How many lives did the Triangle Shirtwaist Company factory fire
claim?: 146
4. The provision of workers' compensation coverage remained voluntary
for employers after the fire. What Act required most employers to have
workers' compensation coverage?: Boynton Act (1913)
5. What is the Boynton Act (1913)?: - Required most employers to have
workers' compensation coverage
- Established state compensation insurance fund (which opened its doors in
1914)
6. What year did the Boynton Act pass?: 1913
7. What replaced the Boynton Act in 1917?: - Workers' Compensation
Insurance
- Safety Act
,8. When did the Workers' compensation insurance (WCI) and Safety
Act (SA) replace the Boynton Act?: 1917
9. What provision did the WCI + SA add?: When rating permanent
disability, "consideration be given to the diminished ability of such an injured
employee to compete in the open labor market"
10. When did CA state senate decided the new language, "imposed the
obligation to make due allowances for obvious physical impairments and
due allowance for such disabling subjective factors such as pain,
discomfort, psychiatric or mental disturbances, provided the subjective
factors be considered to be of permanent nature: 1951
11. What three employees are part of separate workers compensation
system/not part of CA system?: 1) Federal employees
2) Maritime employees
3) Railroad employees
12. What employees are part of workers compensation systems in
CA?: All employees including - Farm workers
- Most domestic and household employees
- Some State prison inmates
13. Historic Compromise has what three components?: 1) No Fault
2) Exclusive Remedy
3) Assured and fixed benefit
,14. What is "Historic compromise": The employer provides workers
compensation benefits regardless of fault, in exchange for protection against
civil action by the employee
15. Historic Compromise - Define: NO FAULT: The 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
16. Historic Compromise - Define: EXCLUSIVE REMEDY: Unless the
employer is uninsured, the workers cannot pursue other forms of recovery
from the employer, even if the employer was grossly negligent.
*If a third party is contributed to an injury or death (work related car
accident), the third party may be sued
17. Historic Compromise - Define: Assured and fixed benefit: - Defined
benefits must be paid for by the employer
- Workers compensation awards are far less than comparable negligence
awards in
A civil suit
- Max workers compensation death benefit may be far less than possible
award in civil wrongful death suit
18. Workers compensation is a __________ with no arbitrary limits on
the frequency, duration, or extent of services: Statutory benefit
19. The "no fault" rule has exceptions:: Deliberately self-inflicted
injuries are excluded from coverage
20. For injuries that result from serious and willful misconduct of the
injured EMPLOYEE, benefits are *reduced* by ___________ unless the
injury resulted in death or permeant disability of _____% or more.: half
, 70%
21. Exceptions to the "no fault" rule:: 1) The injury resulted from failure
of the employer to comply with the law or safely and health regulations.
2) The employee was under 16 years old at the time of injury
22. For injuries that result from serious and willful misconduct of the
EMPLOY-
ER, the employee's compensation is ______________: increased by half
23. True or false: Serious and willful misconduct is generally difficult to
prove, so these penalties are rarely imposed: True
24. In _____ and _____, measures were enacted to address the QME
process, a fee schedule for medical legal examinations, physician
referral, advertising, the compensability of psychiatric and post-
termination claims, fraud deterrence, and benefit payments for
injured workers.: 1989 1993
25. In 2003 and 2004, measures were enacted that allowed employers to::
1. Establish medical provider networks (injured workers are required to
select treating docs)
2. Conduct utilization review to ensure medical care was
consistent with evidence-based guidelines
3. Limit amount of physical therapy and chiropractic
treatment26. MTUS:: Evidence-based
Medical treatment utilization schedule
27. When was MTUS adopted? (Medical treatment utilization
schedule): 2003 and 2004
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