QME exam-with 100% verified solutions 2024-2025, Exams of Advanced Education

Download QME exam-with 100% verified solutions 2024-2025 and more Exams Advanced Education in PDF only on Docsity! QME exam-with 100% verified solutions 2024-2025 1. Workers' Compensation laws in California originated with the _______________ which was passed in ________________. Boynton Act; 1913 2. The "Grand Bargain" of the workers compensation system involves employers agreeing to pay assured and fixed benefits for industrial injuries and workers agreeing to: Not sue their employer in civil court for an industrial injury. 3. The five basic categories of workers' compensation benefits are called: Medical Treatment, Temporary Disability Benefits, Permanent Disability Benefits, Death Benefits, Supplemental Job Displacement Benefits. 4. Temporary Disability Benefits are paid at the rate of _____________ and are usually limited by a ______________ time cap. 2/3 of average "weekly" wages; 2 year 5. Supplemental Job Displacement Benefits are available where: The date of injury is AFTER "1/1/13" and the employer does not offer Return-to-Work. 6. A(n) _____________ report, written by an AME, QME, or AQME, does not involve a face-to-face evaluation of an Applicant. Supplemental 7. In the workers' compensation system, "Injury" is defined as: Incident or exposure that causes disability or need for medical treatment. Where a prior injury (be it industrial or non-industrial) is "exacerbated," it means ______________; Where a prior injury (be it industrial or non- industrial) is "aggravated," it means ________________. There is a temporary increase in symptoms but then a return to baseline causing no additional Permanent Disability (PD); There is an increase in symptoms with an increase in PD, and it is considered a new injury. 9. Non-compensable injuries include those caused by intoxication, injuries that are self-inflicted, injuries resulting from incidents where Applicant is an initial aggressor, injuries sustained while committing a crime, death by suicide, injuries caused by off-duty recreational activities not required by employment, and __________: Post-termination psychiatric injuries. 10. Non-psychological injuries are considered compensable if ________ of the injury was industrially caused; Subject to a few exceptions, psychological injuries are considered compensable if ______ of the injury was industrially caused . 20. Under Labor Code 4628, a report must Disclose the date and location at which the evaluation took place. 21. Which of the following is included in Regulation 10606 as 1 of 15 items that every QME report should include? Treatment indicated, including past, continuing, and future medical care 22. QME reports may be read and utilized by: Insurance companies/adjuster; workers' compensation attorneys; non-workers' compensation attorneys involved in 3rd party cases; Judges; other QMEs/AMEs; treating physicians. 23. For dates of injury later than _________, either side may request a panel QME or may, but need not, attempt to get __________________. 1/1/05; an AME 24. Which of the following is qualified to serve as a QME but may not opine on permanent disability? Acupuncturist 25. May a QME provide medical treatment within the workers' compensation system? Yes. A QME may perform treatment services within the workers' comp system and may treat the same individual for whom the physician has done a QME evaluation if the injured worker requests such treatment. 26. Under California Civil Code 56.10, a physician may disclose medical information where it is Relevant to a legal claim where the injured worker has placed his or her medical history in issue. 27. Defense and Applicant sides must each serve ________________ to the other party at least 20 days prior to the date of the QME evaluation. All the records they plan on providing to the QME 28. Under the regulations, "nonsubstantial matters" like scheduling issues do not constitute ex parte communications for _________ but there is no such rule that applies to ______________. AMEs; QMEs 29. In CA workers' compensation cases, all medical decisions must be based on the _______________ standard, which requires medical evidence from a physician. Substantial Medical Evidence 30. Under Escobedo, a medical opinion must be predicated on _____________; must not be speculative; must be based on pertinent facts, adequate exam, and history; and must set forth the reasoning in support of its conclusions. Reasonable Medical Probability 31. The measure for Reasonable Medical Probability is "More likely than not." 32. Under Labor Code 4628, a QME report must include: The name and qualifications of each person who performed any non-clerical services in connection with the report (for example, diagnostic studies). 33. Where there is failure to comply with the requirements of Labor Code 4628, The report is inadmissible; There is no liability for med-legal expenses incurred in connection with the report; There is a possible civil penalty up to $1,000; There is possible QME disciplinary action; and There is possible contempt per WCAB judicial powers. Causation of permanent disability or impairment. 43. If an applicant has received a prior award of permanent disability: ????? ????? It shall be conclusively presumed that the prior permanent disability exists at the time of any subsequent industrial injury. 44. A(n)___________ must be served within 5 business days from setting a QME evaluation date. Appointment Notification Form 45. Only ____________________ may cancel a QME evaluation due to failure to receive medical record in advance. Psychologists and Psychiatrists 46. Where an evaluator fills out a Notice of Unavailability for periods of unavailability longer than 14 days, the evaluator may Be denied subsequent reappointment if his or her period of unavailability exceeds 90 total days in one year. 47. A QME certificate must be: Displayed in a conspicuous manner at the applicable office location at all times during the period of QME appointment at that location. 48. The direct examination of a medical witness: Will not be received at trial in CA workers' comp cases except upon a showing of good cause. 49. A request for extension of time to serve a report must be filed At least 5 days prior to the due date. 50. The required Labor Code § 4628 disclosure at the end of every report: Is made under penalty of perjury.