QME EXAM NEWEST 2024-2025
ACTUAL EXAM 100 QUESTIONS
AND CORRECT VERIFIED
ANSWERS. ALREADY GRADED A+
1. Holds authority to appoint physicians as QME evaluators:
Administrative Director (AD) (LC 139.2)
2. Term of appointment as QME evaluator: 2 years (LC 139.2)
3. 3 requirements when seeking appointment as QME: (1) Pass the QME
competency exam;
(2) Complete a 12-hour course in disability eval report writing;
(3) Devote at least 1/3rd of total practice time to providing direct medical
treatment
(or have served as a AME on 8+ occasions in past 12 mos prior to
application)
4. 2 reasons for termination/suspension of a QME w/o a hearing: (1)
Licensing board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
5. 6 reasons for discipline (suspension/termination) of qmes after a
hearing: (1) Violation of material statutory or administrative duty;
(2) Failure to follow medical procedures or qualifications;
(3) Failure to comply with the timeframe standards;
(4) Failure to meet licensing/certification requirements;
,(5) Preparation of medical-legal evaluations that fail to meet the minimum
standards for those reports as established by the administrative director or
the appeals board; (6) Making material misrepresentations or false
statements in an application for appointment or reappointment as a
qualified medical evaluator.
6. 3 types of substantive medical disputes resolved by qmes: (1)
Compensability of the claim;
(2) Permanent disability;
(3) "Catch-all" (temporary disability, work restrictions, new and further
disabilities after permanent disability (detereoration of original injury),
compensability of new body part added to claim)
7. Definition of *injury* in compensability claims: (1) An injury or disease
arising out of employment;
(2) A *derivative* injury caused by treatment of an injury arising out of
employment; (3) Any reaction to or side effect from preventative health care
the employer provides to health care workers
8. *Specific injury*: Occurs as the result of a single incident or exposure
9. *Cumulative injury*: Results from repetitive trauma (mental or physical)
over a period of time
10. 2 requirements for a condition to be considered an injury: (1) Cause
disability; or
(2) Result in a need for medical treatment
11. Occupational disease: Disease that in whole or part is caused by work
12. 7 types of excluded injuries: (1) Caused by employee's use of alcohol or
illegal controlled substances;
(2) Intentionally self-inflicted injuries;
, (3) Suicide;
(4) Resulting from altercations, in which the injured employee is the *initial
physical aggressor*;
(5) Resulting from the employee's commission of a felony, for which the
employee has been convicted (including "wobbly felonies," which are
crimes that may be prosecuted as misdemeanors or felonies)
(6) Resulting from off-duty recreational activities, in which participation in
the activities does not constitute part of the employee's work-related
duties and the activity is not an expressed or implicit condition of
employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless
certain conditions exist
13. 4 basic conditions to establish a workers' compensation claim: (1)
*Injury*
(physiological or psychological harm);
(2) Employment relationship;
(3) Injury caused by the employment (This is also referred to as arising out of
employment [AOE].);
(4) Occurred in the course of the employment (COE)
14. Aggravation of a pre-existing, non-industrial condition: (1) Causes a
temporary or permanent increase in disability; (2) Creates a new need for
medical treatment; or
(3) Requires a change in the existing course of treatment
15. Symptoms that don't constitute a new injury: *Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the
current employment
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