Exam (elaborations)
QME EXAM QUESTIONS AND ANSWERS 2024
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QME EXAM QUESTIONS AND ANSWERS 2024
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QME EXAM 2024ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
Parties receiving service of the QME Appointment Notification Form -
ANSWERS-Employee (+ representative)
Employer/claims administrator (+ representative)
QUESTION 2
Trigger to send medical records and other information to the QME - ANSWERS-
Receipt of the QME Appointment Notification Form
QUESTION 3
Causes for issuance of a replacement panel - ANSWERS-(1) Failure to serve the
QME Appointment Notification Form;
(2) Disclosure of COI by an evaluator after an appointment has been made;
(3) Necessity for subsequent examination by a QME in a different specialty (due to
limitations in scope of practice or clinical competency)
(4) QME doesn't practice in the requested specialty
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PAGE 1
, QME EXAM 2024
(5) QME cannot schedule an appointment within 60 days of the initial request of
the appointment
(6) Injured worker changes address since initial request for a panel but before
initial appointment
(7) Two or more members of a QME panel are from the same group practice
(8) QME is unavailabile
(9) QME who previously reported on the case is unavailable
(10) QME is currently, or has been, the treating physician of the worker for the
injury currently under dispute
(11) Claims administrator/employer agrees that a new panel be issued based upon
the geographic area of the worker's employment
(12) Untimely filing of report by QME
(13) QME doesn't cancel an appointment in a timely manner
(14) QME panel was issued more than 24 months prior to the request for the
replacement panel and none of the QMEs have examined the worker
(15) Qualifed and competent QME refuses to provide an evaluation or written
statement explaining why he/she is not qualified or competent to address one or
more issues in dispute in the case
(16) Administrative Director orders an additional QME evaluation
QUESTION 4
Responsibility for arranging for and paying an interpreter for the QME exam -
ANSWERS-Employer
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PAGE 2
, QME EXAM 2024
QUESTION 5
Information which may be provided to the QME by any party - ANSWERS-(1) All
records prepared/maintained by treating physician(s)
(2) Other medical records, relevant to the determination of the medical issue in
dispute
(3) Letter outlining medical determination of the primary treating physician or the
compensability issue requested to address in the evaluation
(4) If concerning a dispute over a UR decision, a copy of the treating physician's
report and the claim administrator's decision to approve, delay, deny or modify the
disputed treatment
(5) Non-medical records relevant to determination of medical issue(s) in dispute
QUESTION 6
Time frame for service of info on an opposing party that a party proposes to
provide to the selected QME - ANSWERS-20 days before the info is provided to
the evaluator
QUESTION 7
Time frame to object to sending of non-medical records to the selected QME -
ANSWERS-Within 10 days
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