QME EXAM NEWEST 2024-2025
ACTUAL EXAM 430 QUESTIONS
AND CORRECT VERIFIED
ANSWERS. ALREADY GRADED A+
1. The law specifies an order of medical evidence standards - what is that
order?: 1. The guidelines, including the drug formulary adopted by the
administrative director pursuant to section 5307.27 (MTUS)
2. Peer reviewed scientific and medical evidence regarding the effectiveness
of the disputed service.
3. Nationally recognized professional standards
4Expert opinion. Generally accepted standards of medical
practice 5.
2. The employer provides workers compensation benefits regardless of
fault.: The employer provides workers compensation benefits regardless
of fault.
3. If the injury is outside of the QME's scope of practice and they have
advised and serviced the parties in writing on what form: QME
Findings Summary Form 111
Serve a copy of your report on the Medical Unit of DWC
4. What is the AMA Guides Upper Extremity WPI Maximum: 60%
Whole Person
Impairment
,5. What is the AMA Guides Lower Extremity WPI Maximum: 40%
Whole Person Impairment
6. To convert Upper Extremity to WPI what do you do?: Multiply UE x
60%
7. To convert Lower Extremity to WPI what do you do?: Multiply LE x
40%
8. How do you convert a Hand to UE?: Multiply Hand by 90%
9. What are the values of each digit in regard to the Hand?: Thumb =
40%
Index and Middle Fingers = 20%
Ring and Little Fingers = 10%
10. How do you convert a foot to Lower Extremity?: Multiply Foot by 70%
11. In the AMA 5th Edition what page does the combination chart start
on?: Page 604
12. The first number in a DEU Rating represents What?: The Chapter
Number in the AMA Guides
13. The Second number in a DEU Rating Represents What?: The Part of
the Body
14. The first % in the DEU Rating represents What?: The AMA
Impairment Rating 15. The Last set of % in the DEU Rating represents
What?: The DEU Disability Rating
16. ACOEM: -American College of Occupational and Environmental
Medicine. -A Guideline for EBM
-Treatment Guidelines
17. Definition of Chronic Pain: Lasting 3 or More months from initial onset
of pain
,18. Claims Administrator?: - Self-administered WC Insurer
- Self administered, Self-insured Employer (WC)
- Self administered, legally uninsured employer (WC)
- Self administered joint powers authority (WC)
- 3rd Party Insurer
- California Insurance Guarantee Association
19. Evidence-Based Medicine (EBM): Systematic approach to making
clinical decisions which allow the integration of the best available research
evidence with clinical expertise and patient values.
EBM = BARE + CE + PV
20. Define Functional Improvement: 1. Clinically Significant
improvement in ADL's (or)
2. Reduction in work restrictions as measured during history and physical
exam, performed and documented as part of the medical evaluation and
treatment (and)
3. Reduction in the Dependency on continued medical treatment
21. Medical Treatment: Care which is reasonably required to Cure or Relieve
22. Medical Treatment Guidelines: Most Current Version of Written
recommendations which are systematically developed by a
multidisciplinary process. Reviewed and updated within the last FIVE (5)
years.
23. Nationally Recognized: Peer-reviewed medical journal or developed,
endorsed & disseminated by a national organization with affiliates based
in 2 or more US States and the most current version.
24. ODG: Official Disability Guidelines
Contains EBM tx guidelines
, 25. Peer Reviewed: Evaluated and Approved PRIOR to Publication by an
editorial board of qualified experts
26. Scientifically Based Evidence: Scientific Literature evaluated and used
as a basis to support a recommendation
27. Strength of Evidence: Establishes relative weight that shall be given to
scientifically based evidence
28. If the QME signs the medical legal report on any date other than the
date of the examination what must be done?: Enter the DATE the
Report IS Signed
NEXT to or NEAR the Signature on the Report
29. What does CCR stand for?: California Code of Regulations
30. If the QME finds the IW at P&S what forms should the QME
complete: - Physician's Report of Permanent and Stationary Status
- Work Capacity (DWC-AD Form 10133.36)
31 What does the QME do with the Physicians Report of Permanent and
Stationary Status and Work Capacity (DWC-AD Form 10133.36)?:
Serve it on the Claims Administrator along with the Medical Report
32. If there is a disputed medical issue - outside of the evaluator's scope of
practice and area of clinical competency what must be done?: At
earliest opportunity and no later than date report is served advise the parties
- in writing
33. CCR Sections that cover Scope of Practice problems: - 4062.1 - 4062.2
34. If a new injury/illness is claimed involving the same type body
part/system and the parties are the same who would do the
evaluation?: Same evaluator who reported previously
-if within their scope of practice and clinical competence
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