Page 1 of 87
EXAMINATION TEST FOR QME NEW
MODIFIED EXAM QUESTIONS WITH
VERIFIED SOLUTIONS CURRENTLY
TESTED AND APPROVED
"Any person who knowingly presents a false or fraudulent claim for the
payment of a loss is guilty of a crime and may be subject to imprisonment in the
state prison for up to ____ years or a fine of up to $50,000 or both -- ANSWER-
five (5) years
Payments to compensate an employee who does not completely recover from an
injury -- ANSWER--PD
"Disability = Impairment + Loss earning capacity + Occupational title + Age" --
ANSWER--Formula for PD
Means approximately 90-100 percent of the time, as a ratable "word of art" --
ANSWER--Constant
For injuries on or after January 1, 1994 and before 01/01/2004 most workers
will be limited to a _____ cap on Vocational Rehabilitation benefits under that
plan -- ANSWER--$16,000
, Page|2
If there are no surviving dependents, the death benefit is paid to -- ANSWER-
Department of Industrial Relations (DIR)
The independent JUDICIAL BODY in California work comp is called --
ANSWER--WCAB
Medical providers who request authorization in writing for a specific course of
treatment for an injured worker must receive a prompt response within ___
working days of receipt of the report not to exceed ____ days -- ANSWER-
response within five (5) working days, not to exceed fourteen (14)
The DWC Unit that rates your panel QME reports -- ANSWER--DEU
Who appoints and monitors Qualified Medical Evaluators, and can suspend or
terminate QME status -- ANSWER--DWC Medical Unit
The employer is required to pay for "medical, surgical, chiropractic and hospital
treatment... which is reasonably required ____ from the effects of the injury --
ANSWER--to cure OR relieve
, Page 3 of 87
The Physician responsible to manage the care of the injured worker --
ANSWER--Primary Treating Physician (PTP)
Who CANNOT be Medical-Legal Evaluating Physician -- ANSWER--Physical
Therapist (PT)
The three Physicians assigned by DWC Medical Unit to do a Med-Legal
evaluation -- ANSWER--Qualified Medical Evaluators (QME)
When the payment for TREATMENT is not made as required, the
"unreasonably unpaid" amount can be increased by a penalty of -- ANSWER--
15%
The injured worker must inform the employer about the injury or illness within
____ of the "date of injury" -- ANSWER--30 days
The employer must furnish the worker with a claim form (DWC-1) within ___
of learning of the injury -- ANSWER--one (1) working day
Treating physician reports and medical-legal evaluations are used to establish --
ANSWER--eligibility for benefits
, Page|4
Unrepresented worker - if the employee does not inform the employer of the
selection within ____ days of the assignment of a panel of qualified medical
evaluators, then the employer may select the physician from the panel --
ANSWER--10
SB-228 reforms of 2003 (Governor Davis) primarily addressed the following
issues -- ANSWER--ACOEM Guidelines - 24 visit limit
For a QME evaluation for compensability only (AOE/COE), DO NOT send the
QME report to the following Part(ies)? -- ANSWER--Local DEU
SB-899 reforms of 2004 (Governor Schwarzenegger) primarily addressed the
following issues? -- ANSWER--AMA Impairment Guides and MPNs
Which of the following is not a term used in California as ratable "word of art"?
-- ANSWER--Often
Who selects the QME -- ANSWER--Patient
In 1913, the Boynton Act -- ANSWER--Required most employers to have
workers' compensation coverage
EXAMINATION TEST FOR QME NEW
MODIFIED EXAM QUESTIONS WITH
VERIFIED SOLUTIONS CURRENTLY
TESTED AND APPROVED
"Any person who knowingly presents a false or fraudulent claim for the
payment of a loss is guilty of a crime and may be subject to imprisonment in the
state prison for up to ____ years or a fine of up to $50,000 or both -- ANSWER-
five (5) years
Payments to compensate an employee who does not completely recover from an
injury -- ANSWER--PD
"Disability = Impairment + Loss earning capacity + Occupational title + Age" --
ANSWER--Formula for PD
Means approximately 90-100 percent of the time, as a ratable "word of art" --
ANSWER--Constant
For injuries on or after January 1, 1994 and before 01/01/2004 most workers
will be limited to a _____ cap on Vocational Rehabilitation benefits under that
plan -- ANSWER--$16,000
, Page|2
If there are no surviving dependents, the death benefit is paid to -- ANSWER-
Department of Industrial Relations (DIR)
The independent JUDICIAL BODY in California work comp is called --
ANSWER--WCAB
Medical providers who request authorization in writing for a specific course of
treatment for an injured worker must receive a prompt response within ___
working days of receipt of the report not to exceed ____ days -- ANSWER-
response within five (5) working days, not to exceed fourteen (14)
The DWC Unit that rates your panel QME reports -- ANSWER--DEU
Who appoints and monitors Qualified Medical Evaluators, and can suspend or
terminate QME status -- ANSWER--DWC Medical Unit
The employer is required to pay for "medical, surgical, chiropractic and hospital
treatment... which is reasonably required ____ from the effects of the injury --
ANSWER--to cure OR relieve
, Page 3 of 87
The Physician responsible to manage the care of the injured worker --
ANSWER--Primary Treating Physician (PTP)
Who CANNOT be Medical-Legal Evaluating Physician -- ANSWER--Physical
Therapist (PT)
The three Physicians assigned by DWC Medical Unit to do a Med-Legal
evaluation -- ANSWER--Qualified Medical Evaluators (QME)
When the payment for TREATMENT is not made as required, the
"unreasonably unpaid" amount can be increased by a penalty of -- ANSWER--
15%
The injured worker must inform the employer about the injury or illness within
____ of the "date of injury" -- ANSWER--30 days
The employer must furnish the worker with a claim form (DWC-1) within ___
of learning of the injury -- ANSWER--one (1) working day
Treating physician reports and medical-legal evaluations are used to establish --
ANSWER--eligibility for benefits
, Page|4
Unrepresented worker - if the employee does not inform the employer of the
selection within ____ days of the assignment of a panel of qualified medical
evaluators, then the employer may select the physician from the panel --
ANSWER--10
SB-228 reforms of 2003 (Governor Davis) primarily addressed the following
issues -- ANSWER--ACOEM Guidelines - 24 visit limit
For a QME evaluation for compensability only (AOE/COE), DO NOT send the
QME report to the following Part(ies)? -- ANSWER--Local DEU
SB-899 reforms of 2004 (Governor Schwarzenegger) primarily addressed the
following issues? -- ANSWER--AMA Impairment Guides and MPNs
Which of the following is not a term used in California as ratable "word of art"?
-- ANSWER--Often
Who selects the QME -- ANSWER--Patient
In 1913, the Boynton Act -- ANSWER--Required most employers to have
workers' compensation coverage
