QME EXAM NEWEST ACTUAL EXAM COMPLETE 350
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW VERSION!!
4 basic conditions to establish a workers' compensation claim - CORRECT ANSWERS-(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)
Aggravation of a pre-existing, non-industrial condition - CORRECT ANSWERS-(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
Symptoms that don't constitute a new injury - CORRECT ANSWERS-*Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the current employment
Date of injury (DOI)-specific injury - CORRECT ANSWERS-Date on which the incident or
exposure occurred
Date of injury (DOI)-cumulative injury - CORRECT ANSWERS-Date when the employee first
suffered disability from the exposure, and either knew, or should have known, that the disability was
caused by present or previous employment
Items determined by the DOI - CORRECT ANSWERS-(1) Statute of limitations for particular
procedures within the workers' compensation system;
(2) Regulations that will apply to the worker's injury;
(3) Compensation rate for the worker's injury;
(4) Employers who are liable for the claim.
,Reasonable medical probability - CORRECT ANSWERS-Standard by which QME uses
combination of existing medical and scientific knowledge and the occupational and medical history of
the individual worker to conclude whether the work exposure contributed to the injury
Evidentiary standard of causation/contribution in compensability disputes - CORRECT
ANSWERS-Preponderance of the evidence (51%; more likely than not)
3 factors to establish in making a causation determination - CORRECT ANSWERS-(1) Presence
of pathological conditions and disability
(2) Relevant work exposures
(3) Non-industrial exposures (other causes of disease)
5 major types of causation - CORRECT ANSWERS-(1) Direct
(2) Contributing
(3) Acceleration
(4) Precipitation
(5) Aggravation
Direct causation - CORRECT ANSWERS-Work exposures are directly responsible for the health
outcomes
Contributing causation - CORRECT ANSWERS-Several factors led to the disease; work
exposure is one of these factors
Acceleration - CORRECT ANSWERS-Disease process is accelerated by virtue of work exposure.
The date of the onset of the disease is much sooner than it would have been in the absence of the
exposure.
Precipitation - CORRECT ANSWERS-Work exposure *precipitates* the manifestation of the
illness. For example, an underlying tendency or asymptomatic problem was present, but the work
exposure causes it to clinically manifest.
, Aggravation - CORRECT ANSWERS-A medical condition may be present already, but work
exposure makes it worse
Principle of "taking employees as you find them" - CORRECT ANSWERS-The employer cannot
avoid liability for an occupational injury by claiming that the injury would not have happened if the
worker had been in a different physical
or emotional condition before the accident.
Criteria for compensation of psychiatric injuries - CORRECT ANSWERS-(1) Diagnosed mental
disorder;
(2) Causes disability or need for medical treatment; and
(3) Employee can demonstrate that events of employment were *predominant cause* of the injury
Limits for claims of psychiatric injury - CORRECT ANSWERS-(1) *Actual events of
employment* were the *predominant cause* (> 50%) among all combined causes of the psychiatric
injury (except if the injury is a derivative of an underlying physical injury)
(2) If the injury resulted from a violent act or from direct exposure to a significant violent act, the actual
events of employment must have been a *substantial cause* of the injury (contributed >= 35% of the
causation from all sources combined)
(3) Employee was employed by employer >= 6 months (not continuously), unless the injury was caused
by a sudden and extraordinary employment condition
(4) Injury was not substantially (>=35%) caused by "lawful, nondiscriminatory, good faith personnel
actions" (e.g., being passed over for promotion or being transferred to another department)
(5) Claim can not be filed after notification of termination or layoff
Perception is not disability - CORRECT ANSWERS-Disability is not based on how much stress
*should* have been felt by employee, but rather how much stress *is* felt by an individual worker
reacting uniquely to the work environment
Stress must have proximately caused the injury
Proximate cause - CORRECT ANSWERS-Causal connection between injury and employment
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW VERSION!!
4 basic conditions to establish a workers' compensation claim - CORRECT ANSWERS-(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)
Aggravation of a pre-existing, non-industrial condition - CORRECT ANSWERS-(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
Symptoms that don't constitute a new injury - CORRECT ANSWERS-*Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the current employment
Date of injury (DOI)-specific injury - CORRECT ANSWERS-Date on which the incident or
exposure occurred
Date of injury (DOI)-cumulative injury - CORRECT ANSWERS-Date when the employee first
suffered disability from the exposure, and either knew, or should have known, that the disability was
caused by present or previous employment
Items determined by the DOI - CORRECT ANSWERS-(1) Statute of limitations for particular
procedures within the workers' compensation system;
(2) Regulations that will apply to the worker's injury;
(3) Compensation rate for the worker's injury;
(4) Employers who are liable for the claim.
,Reasonable medical probability - CORRECT ANSWERS-Standard by which QME uses
combination of existing medical and scientific knowledge and the occupational and medical history of
the individual worker to conclude whether the work exposure contributed to the injury
Evidentiary standard of causation/contribution in compensability disputes - CORRECT
ANSWERS-Preponderance of the evidence (51%; more likely than not)
3 factors to establish in making a causation determination - CORRECT ANSWERS-(1) Presence
of pathological conditions and disability
(2) Relevant work exposures
(3) Non-industrial exposures (other causes of disease)
5 major types of causation - CORRECT ANSWERS-(1) Direct
(2) Contributing
(3) Acceleration
(4) Precipitation
(5) Aggravation
Direct causation - CORRECT ANSWERS-Work exposures are directly responsible for the health
outcomes
Contributing causation - CORRECT ANSWERS-Several factors led to the disease; work
exposure is one of these factors
Acceleration - CORRECT ANSWERS-Disease process is accelerated by virtue of work exposure.
The date of the onset of the disease is much sooner than it would have been in the absence of the
exposure.
Precipitation - CORRECT ANSWERS-Work exposure *precipitates* the manifestation of the
illness. For example, an underlying tendency or asymptomatic problem was present, but the work
exposure causes it to clinically manifest.
, Aggravation - CORRECT ANSWERS-A medical condition may be present already, but work
exposure makes it worse
Principle of "taking employees as you find them" - CORRECT ANSWERS-The employer cannot
avoid liability for an occupational injury by claiming that the injury would not have happened if the
worker had been in a different physical
or emotional condition before the accident.
Criteria for compensation of psychiatric injuries - CORRECT ANSWERS-(1) Diagnosed mental
disorder;
(2) Causes disability or need for medical treatment; and
(3) Employee can demonstrate that events of employment were *predominant cause* of the injury
Limits for claims of psychiatric injury - CORRECT ANSWERS-(1) *Actual events of
employment* were the *predominant cause* (> 50%) among all combined causes of the psychiatric
injury (except if the injury is a derivative of an underlying physical injury)
(2) If the injury resulted from a violent act or from direct exposure to a significant violent act, the actual
events of employment must have been a *substantial cause* of the injury (contributed >= 35% of the
causation from all sources combined)
(3) Employee was employed by employer >= 6 months (not continuously), unless the injury was caused
by a sudden and extraordinary employment condition
(4) Injury was not substantially (>=35%) caused by "lawful, nondiscriminatory, good faith personnel
actions" (e.g., being passed over for promotion or being transferred to another department)
(5) Claim can not be filed after notification of termination or layoff
Perception is not disability - CORRECT ANSWERS-Disability is not based on how much stress
*should* have been felt by employee, but rather how much stress *is* felt by an individual worker
reacting uniquely to the work environment
Stress must have proximately caused the injury
Proximate cause - CORRECT ANSWERS-Causal connection between injury and employment
