QME REVIEWED EXAM QUESTIONS WITH
VERIFIED ANSWERS [GUARANTEED 100%
GRADE A+]
Holds authority to appoint physicians as QME evaluators - Correct Answers -Administrative
Director (AD) (LC 139.2)
Term of appointment as QME evaluator - Correct Answers -2 years (LC 139.2)
3 requirements when seeking appointment as QME - Correct Answers -(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)
2 reasons for termination/suspension of a QME w/o a hearing - Correct Answers -(1) Licensing
board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
6 reasons for discipline (suspension/termination) of QMEs after a hearing - Correct Answers -(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.
,3 types of substantive medical disputes resolved by QMEs - Correct Answers -(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)
Definition of *injury* in compensability claims - Correct Answers -(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
*Specific injury* - Correct Answers -Occurs as the result of a single incident or exposure
*Cumulative injury* - Correct Answers -Results from repetitive trauma (mental or physical) over
a period of time
2 requirements for a condition to be considered an injury - Correct Answers -(1) Cause disability;
or
(2) Result in a need for medical treatment
Occupational disease - Correct Answers -Disease that in whole or part is caused by work
7 types of excluded injuries - Correct Answers -(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
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
VERIFIED ANSWERS [GUARANTEED 100%
GRADE A+]
Holds authority to appoint physicians as QME evaluators - Correct Answers -Administrative
Director (AD) (LC 139.2)
Term of appointment as QME evaluator - Correct Answers -2 years (LC 139.2)
3 requirements when seeking appointment as QME - Correct Answers -(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)
2 reasons for termination/suspension of a QME w/o a hearing - Correct Answers -(1) Licensing
board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
6 reasons for discipline (suspension/termination) of QMEs after a hearing - Correct Answers -(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.
,3 types of substantive medical disputes resolved by QMEs - Correct Answers -(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)
Definition of *injury* in compensability claims - Correct Answers -(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
*Specific injury* - Correct Answers -Occurs as the result of a single incident or exposure
*Cumulative injury* - Correct Answers -Results from repetitive trauma (mental or physical) over
a period of time
2 requirements for a condition to be considered an injury - Correct Answers -(1) Cause disability;
or
(2) Result in a need for medical treatment
Occupational disease - Correct Answers -Disease that in whole or part is caused by work
7 types of excluded injuries - Correct Answers -(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
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
