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QME Exam Questions and Verified Answers 2025.
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QME Exam Questions and Verified Answers 2025.
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1QME Exam Questions and Verified Answers 2025
1911, SEVENTEEN DAYS AFTER THE DEVISTATING FIRE AT THE TRIANGLE SHIRTWAIST COMPANY
FACTORY IN NEW YORK TOOK 146 LIVES - correct answer when was the 1st work comp act passed?
1. NO FAULT
2. EXCLUSIVE REMEDY
3. ASSURED FIXED BENEFIT - correct 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. - correct 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. - correct 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. - correct answer ASSURED AND FIXED BENEFIT
deliberately self-inflicted injuries are excluded from coverage - correct 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 - correct answer WHAT HAPPENS IF THE INJURY IS DUE TO SERIOUS
MISCONDUCT OF THE EMPLOYER?
, 2
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 - correct 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. - correct 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. - correct 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 - correct answer
MEDICAL UNIT
• How to Take a Complete Occupational History
• How to Define:
o An Injury
o First Aid
• Aggravation
• Recurrence
• Arising Out of Employment (AOE)
• Occurring in the Course of Employment (COE)
• Causation
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