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QME EXAMS 2024 WITH ACTUAL

CORRECT QUESTIONS AND VERIFIED

DETAILED ANSWERS BY EXPERTS

|FREQUENTLY TESTED QUESTIONS

AND SOLUTIONS |ALREADY GRADED

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The QME/AME is permitted to talk to whom?

A. PTP B. Third party administrator (TPA) C. Defense attorney D. Applicant attorney E. Insurance claims adjuster

A. PTP

When the PTP writes a permanent and stationary report it is not considered a medical-legal report, unless:

A. The worker is not returning to regular work B. The worker is permanent and stationary C. The claim is contested or disputed D. The worker is returning to modified or alternative work E. Future medical care is necessary

C. The claim is contested or disputed

'Physician's office' means a bona fide office facility which is identified by a street address and any other more specific designation such as a suite or room number and which contains the usual and customary equipment for the evaluation and treatment appropriate to the physician's medical specialty or practice. Which does not apply?

A. Post Office Box B. Parking lot C. Home

D. Retail store E. All the above

E. All the above

The injured worker may discontinue the evaluation based on good cause, including:

A. Discriminatory conduct toward the worker based on race or sex B. Discriminatory conduct toward the worker based on religion or sexual preference C. Requests for the worker to submit to unnecessary examination or procedure D. Abusive, hostile or rude behavior toward the worker that demonstrates bias E. All the above

E. All the above

A QME or AME should not:

A. Use a PR-3 (PTP, P&S Report - Permanent Disability Report - Pre 2005 injuries) B. Use a PR-4 (PTP, P&S Report - Permanent Impairment Report - Post 2005 injuries) C. Solicit the worker to become a patient D. Make the patient wait more than an hour to be seen E. All of the above

E. All of the above

The 'QME Appointment Notification Form' should be sent:

A. Within 7 business days after scheduling the patient for the evaluation B. Within 5 business days after scheduling the patient for the evaluation C. Within 1 business day after scheduling the patient for the evaluation D. Within 3 business days after scheduling the patient for the evaluation E. Within 10 business days after scheduling the patient for the evaluation

B. Within 5 business days after scheduling the patient for the evaluation

Which is not true regarding a 2010 injury?

A. You need to serve the original QME report within 30 days after examining the patient B. Follow-Up (ML101) report should be served within 30 days after the exam C. Supplemental (ML106) report should be served within 60 days after records received D. A Follow-Up report (ML101) is done within 9 months of the previous examination E. An AME report is allowed to be served within 45 days after seeing the patient

E. An AME report is allowed to be served within 45 days after seeing the patient

Which of the following statements is not true?

A. An aggravation is a new injury B. An exacerbation or flare up is a temporary increase in symptoms

C. Modified work involves altering the worker's normal work activities D. There is no time limit to receive temporary disability benefits E. Alternate work involves another job/position with the same employer

D. There is no time limit to receive temporary disability benefits

Which of the following statements is not true?

A. Future medical care cannot last more than 2 years B. AOE/COE involves causation of the injury C. Permanent and stationary means that the worker's condition is stable D. First Aid involves one time treatment and any follow-up visit E. An interpreter should be certified, for QME/AME evaluations

A. Future medical care cannot last more than 2 years

Per Labor Code 4600 what medical/hospital treatment is provided by the employer?

A. Medical, chiropractic, surgical and acupuncture care B. Hospital treatment including nursing C. Medicines, medical and surgical supplies D. Crutches, apparatuses, including orthotic and prosthetic devices and services E. All the above

E. All the above

A QME may perform a medical-legal evaluation in which situations below?

A. Panel QME (PQME) in an unrepresented case B. Panel QME in a represented case - strike process - 1 QME left C. Agreed PQME in a represented case - 1 QME agreed to on the panel D. Agreed Medical Evaluation - no panel E. All of the above

E. All of the above

In the California Workers' Compensation System, a physician is:

A. M.D., D.C., D.O. B. D.P.M, Ph.D., D.D.S. C. L.Ac., O.D. D. A, B and C E. M.F.T, P.A., P.T.

D. A, B and C

Which of the below statements are true?

A. Any doctor/acupuncturist who has treated the worker cannot be the QME

B. If a QME becomes a PTP, they can no longer be the QME C. The PTP can talk to the QME D. ML 100 - Missed appointment does not imply that compensation is necessarily owed E. All of the above

E. All of the above

Which of the below statements are false?

A. An injury could have/may have happened/it is possible indicates substantial evidence B. The standard to prove causation is not medical certainty, but a reasonable medical probability C. An injury may be cumulative D. An injury may be specific E. An injury may be specific and cumulative

A. An injury could have/may have happened/it is possible indicates substantial evidence

Benefits available to the injured worker are:

A. Medical treatment B. Temporary disability payments C. Permanent disability payments D. Vocational rehabilitation services E. Death benefits F. All of the above

F. All of the above

Which of the below statements are false?

A. Pre-injury status means the condition has resolved B. Permanent and stationary (P&S) means that the condition will never change C. Discharged as cured means the condition has resolved D. P&S means that residual impairment or disability exists E. Impairment is considered permanent when it has reached MMI

B. Permanent and stationary (P&S) means that the condition will never change

Which reports are admissible at the WCAB?

A. Reports from the PTP B. Reports from the QME or AME C. Secondary treating physician reports D. Consulting reports E. A and B

E. A and B

WPI refers to:

A. Whole Permanent Impairment B. With Partial Impairment C. Without Personal Involvement D. Whole Person Impairment E. Whole Person Injury

D. Whole Person Impairment

100% total disability is presumed to exist in which of the following injuries?

A. Loss of both of the worker's eyes or the sight thereof B. Loss of both of the worker's hands or use thereof C. Practically total paralysis D. A brain injury resulting in incurable mental incapacity or insanity E. All of the above

E. All of the above

Which of the below statements are false?

A. QME panels are picked within geographic region of the worker's home residence B. QMEs are not limited to the number of office locations to evaluate injured workers C. Preference to assigning QME panels is given to unrepresented workers D. QMEs are limited to 10 locations to evaluate injured workers E. A secondary treating physician sends reports to the PTP

B. QMEs are not limited to the number of office locations to evaluate injured workers

In regard to Supplemental Job Displacement Benefits (SJDB), which are true?

A. For injuries before 1-1-13 the voucher amount ranges from $4000 to $10,000 depending upon the permanent disability rating B. For dates of injury on/after 1-1-13 the voucher will be $6000 across the board, regardless of the permanent disability rating C. The voucher will be due 60 days after a treating doctor, AME or QME declares the injured worker permanent and stationary, reports what the worker's work capabilities are and the employer does not offer the worker a job D. If offered, the job must pay no less than 85% of the worker's earnings at the time of the injury, and be expected to last at least 12 months E. All of the Above

E. All of the Above

The SJDB voucher can be used for?

A. Training at a California public school, or other approved provider listed by the state

B. To pay for licensing or certification and testing fees C. Purchase tools required by a training course D. Up to $1000 to purchase a computer and/or $500 in miscellaneous expenses E. Up to $600 for the services of a licensed placement agency or vocational counselor F. All of the Above

F. All of the Above

In cases involving physical injury for 1.1.13 dates of injury and forward, injured workers will not be able to collect additional permanent disability for sleep disorders, sexual dysfunction, or psych injuries that did not directly result from those injuries. QME/AMEs and PTPs will not be able to comment on permanent disability add-ons for which conditions, however, can discuss need for treatment:

A. Sleep disorders B. Sexual dysfunction C. Psychological issues, unless the physical injury is 'catastrophic,' or where the injured worker was the victim of a violent act or a witness to a violent act/crime D. Pain E. Pain medication F. A, B and C

F. A, B and C

In which of the settings below must interpreting services, be provided to an injured worker who does not speak or understand English?

A. A deposition B. Appeals Board hearing C. Medical-legal examination D. Medical treatment appointment E. All the above

E. All the above

Which of the below statements is false regarding depositions?

A. A physician shall be paid a minimum of 1 hour B. A physician shall be reimbursed at a rate of $250 per hour, or $62.50 per each quarter hour, rounded to the nearest quarter hour C. A physician shall be entitled to reasonable and necessary fees spent related to testimony, reasonable preparation and travel time D. A physician cannot expect compensation for reviewing records E. A physician can bill for time spent reviewing their own records in preparation for the deposition 105. Once an AME, Agreed PQME or PQME has issued a comprehensive medical-legal report and a new medical dispute arises, which of the below statements is true?

D. A physician cannot expect compensation for reviewing records

To the extent possible, the parties shall obtain a follow-up or supplemental evaluation from

A. A new evaluator is always used B. Only reports from the PTP are accepted C. A new claim is filed to deal with the new issue D. If not represented, the worker has to get an attorney E. the same evaluator

E. the same evaluator

The QME shall schedule the initial QME appointment at the office location listed on the QME panel; however, which of the below statements is true?

A. The appointment location can be moved to any other office B. The initial appointment location can never be moved; however subsequent evaluations can be done at another office as long as the QME has it listed with the DWC-Medical Unit C. Upon written request D. Only the claims administrator can authorize a move of office locations E. Only a WCAB judge can authorize the move of office locations

B. The initial appointment location can never be moved; however subsequent evaluations can be done at another office as long as the QME has it listed with the DWC-Medical Unit

A PQME or Agreed PQME who cancels a scheduled appointment shall:

A. Reschedule the appointment within 20 calendar days B. Reschedule the appointment within 45 calendar days C. Reschedule the appointment within 15 calendar days D. Reschedule the appointment within 10 calendar days E. Reschedule the appointment within 30 calendar days

E. Reschedule the appointment within 30 calendar days

In the event that no records are received by the QME/AME to prepare and issue a medical-legal report, which of the following statements are true?

A. The QME report must be served within 30 calendar days with or without records B. The QME can wait until the records are received to issue the report C. The QME can contact the treating physician to obtain records D. A, C and E E. The QME should issue a supplemental report when the records are received

D. A, C and E

The evaluator and employee's treating physician may consult as necessary to produce a complete and accurate report. Which statements below are true?

A. The QME/AME evaluator shall note within the report, new or additional information received from

the treating physician B. The QME/AME evaluator needs to name the treating physician in their report C. The treating physician shall remain anonymous D. A and B E. The treating physician can only talk to the QME/AME if the claims administrator agrees

D. A and B

When an injured worker does not speak or understand the English language and an interpreter is used in a medical-legal evaluation, which of the below statements are true?

A. A family member can provide the services B. A staff member, familiar with the worker's language can be used C. A certified interpreter should be used, whenever possible D. The interpreter's name and certification number should be contained in the report E. C and D

E. C and D

Modifiers to the medical-legal billings are designed to further clarify the type of report is being produced and billed. The modifiers are placed with a hyphen after the ML Code. For example an ML 102-94. Which of the below statements are accurate?

A. -92 performed by the PTP B. -93 performed with an interpreter C. -94 performed by an AME or Agreed Panel QME (PQME) D. -95 performed by a panel selected QME E. All the above

E. All the above

Which of the below are examples of 'Types of Causation' found in the Physician's Guide?

A. Direct Causation: The work exposures are directly responsible for the health outcomes B. Contributing Cause: Several factors led to the disease; work exposure is one of these factors C. Acceleration: The disease process is accelerated by virtue of work exposure. The date of onset of the disease is much sooner than would have occurred absent in the absence of the exposure D. Precipitation: The work exposure "precipitates" the manifestation of the illness. For example, an underling tendency or asymptomatic problem was present, but the work exposure causes it to clinically manifest E. Aggravation: A medical condition may be present already, but work exposure makes it worse F. All the above

F. All the above

Each new PTP must complete a Doctor's First Report of Occupational Injury or Illness (Form DLSR 5021) following the initial examination.

A. True B. False

A. True

Medical treatment is designed to cure or relieve the effects of the industrial injury.

A. True B. False

A. True

If an injured worker's claim is not accepted or denied within 90 days of the worker giving the completed Claim Form (DWC Form 1) to the employer, the claim is presumed to be industrial. And, the claims administrator is liable for up to $10,000 in treatment under the medical treatment guidelines, while considering the claim.

A. True B. False

A. True

Absent a sudden or extraordinary event, a worker most work for an employer for at least 6 months total, to file a psych claim.

A. True B. False

A. True

If the employer is uninsured and fails to have workers' compensation coverage, it is a criminal offense (misdemeanor) punishable by either a fine up to $10,000, or imprisonment in county jail for up to 1 year, or both. Additionally, the state issues penalties up to $100,000 against illegally uninsured employers.

A. True B. False

A. True

If a worker suffers an injury and the employer is uninsured, the employer is responsible for all bills related to the injury or illness.

A. True B. False

A. True

Workers' compensation benefits are the only exclusive remedy for injuries suffered on the job when the employer is properly insured. If the employer is illegally uninsured, the worker can file a civil action

against the employer, in addition to filing a workers' compensation claim.

A. True B. False

A. True

The Uninsured Employers' Benefit Trust Fund (UEBTF), a special unit within the DWC may pay benefits to injured workers who get injured or ill while working for an illegally uninsured employer. The UEBTF pursues reimbursement of their expenditures from the responsible employer through all available avenues, such as filing a lien against their property.

A. True B. False

A. True

A medical provider network (MPN) is a group of healthcare providers set up by the employer's insurance company and approved by the DWC's administrative director to treat workers injured on the job.

A. True B. False

A. True

The 24 visit cap on chiropractic care, physical therapy and occupational therapy, does not apply to dates of injury before 1-1-04.

A. True B. False

A. True

Temporary Disability payments provided to an injured worker for a date of injury on/after 1-19-04 are limited to 104 weeks. For certain injuries, temporary disability shall not last for more than 240 weeks. Those injuries include:

Acute and chronic hepatitis B and C Amputations Severe burns Human immunodeficiency virus (HIV) High-velocity eye injuries Chemical burns to the eyes Pulmonary fibrosis Chronic lung disease.

A. True B. False

A. True

The Labor Code (3600) specifically excludes from compensation 7 types of injuries contained in the Physician's Guide. Those include:

Injuries caused by the employee's use of alcohol or illegal controlled substances (if it can be shown that the injury would not have occurred otherwise) Intentionally self-inflicted injuries Suicide, if willful and deliberate Injuries resulting from altercations, in which the injured employee is the 'initial physical aggressor' Injuries resulting from the employee's commission of a felony, for which the employee has been convicted Injuries resulting from off-duty recreational activities, where participation in the activities does not constitute part of the employee's work related duties, and where the activity is not an expressed or implicit condition of employment Psychiatric injuries claimed after notice of termination/layoff unless certain conditions exist

A. True B. False

A. True

CC&R 9768.10 indicates that IMR doctors can be an MD, DO or DPM.

A. True B. False

A. True

A 'Secondary Physician' is any physician other than the primary treating physician who examines or provides treatment to the employee, but is not primarily responsible for continuing management of the care of the employee.

A. True B. False

A. True

A medical-legal report shall contain a declaration by the physician signing the report, under penalty of perjury, stating, "I declare under penalty of perjury that the information contained in this report and its attachments, if any, is true and correct to the best of my knowledge and belief, except as to information that I have indicated I received from others. As to that information, I declare under penalty of perjury that the information accurately describes the information provided to me and, except as noted herein, that I believe it to be true." The foregoing declaration shall be dated and signed by the reporting physician and shall indicate the county wherein it was signed.

A. True B. False

A. True

A QME who has not paid their recertification fees or let their QME certification lapse, cannot perform a re-evaluation of the patient, however, can perform a supplemental report, where the worker is not examined.

A. True B. False

A. True

A QME may obtain a consultation from any physician as a reasonable and necessary expense.

A. True B. False

B. False

The evaluator and the employee's treating physician(s) may consult as necessary to produce a complete and accurate report.

A. True B. False

A. True

All communications by the parties with the medical-legal evaluator shall be in writing and sent simultaneously to the opposing party when sent to the medical evaluator.

A. True B. False

A. True

Represented parties who have selected an Agreed Medical Evaluator or an Agreed Panel QME shall, as part of their agreement, agree on what information is to be provided to the AME or Agreed PQME.

A. True B. False

A. True

An evaluator shall not request or accept any compensation or thing of value from any source that does or could create a conflict with his or her duties as an evaluator.

A. True B. False

A. True

No physician reporting as an AME or QME shall accept gifts that have a total fair market value in the aggregate of $360 or more, from any single source that handles California workers' compensation matters, in the course of any consecutive 12 months. The sources include, but are not limited to, 1 or more attorneys, physicians, employers, claims administrators, medical or health care or insurance or utilization review business entities.

A. True B. False

A. True

"Primary treating physician' is the physician who is primarily responsible for managing the care of an employee, and who has examined the employee at least once for the purpose of rendering or prescribing treatment and has monitored the effect of the treatment thereafter.

A. True B. False

A. True

"Released from care" means a determination by the PTP that the employee's condition has reached a permanent and stationary status with no need for continuing or future medical treatment.

A. True B. False

A. True

"Permanent and stationary status" is the point when the employee has reached maximal medical improvement, meaning his or her condition is well stabilized, and unlikely to change substantially in the next year with or without medical treatment.

A. True B. False

A. True

"Future medical treatment" is treatment which is anticipated at some time in the future and is reasonably required to cure or relieve the employee from the effects of the injury.

A. True B. False

A. True

"Continuing medical treatment" is occurring or presently planned treatment that is reasonably required to cure or relieve the employee from the effects of the injury.

A. True B. False

A. True

An employee shall have no more than 1 primary treating physician at a time.

A. True B. False

A. True

Secondary treating physicians, physical therapists, and other health care providers to whom the employee is referred shall report to the PTP in the manner required by the PTP.

A. True B. False

A. True

When continuing medical treatment is provided, a progress report (Form PR-2) shall be made no later than 45 days from the last report.

A. True B. False

A. True

The QME or AME evaluates an injured worker, however, there is not enough time to finish the evaluation and the employee is asked to return to the office on another date to complete the process. The 30 days to serve the report on the parties starts on the first day the worker was seen.

A. True B. False

A. True

In unrepresented cases an AME cannot be used.

A. True B. False

A. True

The AMA's 'Guides to the Evaluation of Permanent Impairment', Fifth Edition is used by the State of California, for the purpose of determining Impairment ratings for dates of injury on or after 2005.

A. True B. False

A. True

The term impairment in the Guides refers to permanent impairment.

A. True B. False

A. True

The Guides consider both anatomic and functional loss in evaluating impairment. Which of the below is true?

A. Anatomic loss refers to damage to an organ system or body structure B. Functional loss refers to a change in function for the organ or body system C. Impairment criteria contained in the Guides provides a standardized method for physicians to use to determine medical impairment D. The impairment criteria in the Guides were developed from scientific evidence and from consensus of chapter authors or of medical specialty societies E. All of the above

E. All of the above

The evaluating physician needs to ensure that the examinee understands that the evaluation's purpose is assessment and not medical treatment. However, if new diagnoses are discovered, the physician has a medical obligation to inform the requesting party and the employee about the condition and recommend further assessment.

A. True B. False

A. True

The final impairment rating should be rounded to the nearest whole number?

A. True B. False

A. True

For dates of injury before 2005, Subjective Factors of Disability are used to determine intensity and frequency of symptoms/complaints. Which of the below statements are true concerning the frequency of symptoms?

A. Constant pain occurs 100% of the time B. Constant pain occurs approximately 90 to 100% of the time C. Frequent pain occurs approximately 75% of the time D. Intermittent pain occurs approximately 50% of the time

E. Occasional pain occurs approximately 25% of the time F. B, C, D and E

F. B, C, D and E

For dates of injury before 2005, Subjective Factors of Disability are used to determine intensity and frequency of symptoms/complaints. Which of the below statements are true concerning the intensity of symptoms?

A. Severe pain, would preclude the activity precipitating the pain B. Moderate pain can be tolerated, but would cause a marked handicap in the performance of the activity precipitating the pain C. Slight pain can be tolerated but would cause some handicap in the performance of the activity precipitating the pain D. Minimal (or mild) pain would constitute an annoyance, but would cause no handicap in the performance of a particular activity and is non ratable E. All of the above

E. All of the above

Permanent Disability reports for musculoskeletal injuries for dates of injury before 2005 take into consideration for rating purposes, which of the following?

A. Subjective Factors of Disability B. Objective Factors of Disability C. Work Preclusions or Restrictions D. All of the above

D. All of the above

Permanent Disability reports for psych injuries for dates of injury before 2005 take into consideration Psychiatric Disability Protocols for Work Functions 1 through 8.

A. True B. False

A. True

When a worker is injured and plans to file a claim, which of the following should happen to move the case forward?

A. The worker completes a Workers' Compensation Claim Form (DWC 1) questions 1 -8 and the employer contributes to this form, questions 9- B. The employer needs to complete an Employer's Report of Occupational Injury or Illness (Form 5020) C. The PTP completes a Doctor's First Report (DFR) of Occupational Injury or Illness (Form 5021) D. All of the above

D. All of the above

While serving as a QME/AME it is not permitted to solicit an injured worker to become your patient. However, if the worker asks you to assume a role as a treating physician, and you accept, you cannot be the QME/AME in the future.

A. True B. False

A. True

A QME must use good clinical judgment in applying the AMA Guides and may utilize any chapter, table or method that most accurately reflects the injured worker's impairment within, "The four corners" of the Guides. (The Guzman Court of Appeals Decision)

A. True B. False

A. True

For psychiatric injuries, impairment is not decided by the AMA Guides, but the Global Assessment of Function (GAF) Scores.

A. True B. False

A. True

A permanent disability/impairment evaluation report cannot be completed if the injured worker's condition is not permanent and stationary/maximum medical improvement. The rating of impairment and apportionment requires P&S/MMI.

A. True B. False

A. True

Which statements below are true?

A. A permanent disability report is for a date of injury before 2005 B. A permanent impairment report (AMA) is for a date of injury from 2005 and forward C. Ratings are adjusted for age and occupation D. All the above

D. All the above

A 1 to 3% add-on rating for pain can only be added if there is a ratable impairment.

A. True B. False

A. True

Temporary disability payments cease when the worker returns to work, or is P&S.

A. True B. False

A. True

An AME cannot be used in an unrepresented case.

A. True B. False

A. True

A QME must see the worker within 60 days of the request for an appointment.

A. True B. False

A. True

A QME may see the patient after 60 days by agreement of the scheduling party, however, not beyond 90 days.

A. True B. False

A. True

The QME Appointment Notification Form (Form 110) shall be submitted within 5 business days.

A. True B. False

A. True

An oral cancellation of a QME appointment must be followed by a written confirmation.

A. True B. False

A. True

All communications with a QME must be in writing.

A. True B. False

A. True

QMEs do not resolve treatment disputes; the IMR process resolves them.

A. True B. False

A. True

A QME shall advise the injured worker before the examination that he/she is entitled to ask the evaluator questions.

A. True B. False

A. True

A preponderance of the evidence means, "Such evidence as, when weighed with that opposed to it, has more convincing force and the greater probability of truth."

A. True B. False

A. True

The injured worker has the burden of proof to show by a preponderance of the evidence that the injury was work related.

A. True B. False

A. True

To constitute substantial medical evidence, a medical opinion must be predicated on reasonable medical probability.

A. True B. False

A. True

QME reports shall be kept for 5 years from the date of each evaluation report.

A. True B. False

A. True

A medical opinion is not substantial evidence if it is based on an inadequate medical history or examination, incorrect legal theories, facts no longer germane to the case, speculation, surmise, and conjecture or guessing.

A. True B. False

A. True

If an interpreter is used in a case, their name and certification number should be listed in the report.

A. True B. False

A. True

Which of the statements below are true about doctors wanting to become QMEs?

A. Chiropractors are required to take a 44 Hour California Workers Compensation Evaluation Course or have completed a 300 hour postgraduate specialty program B. A psychologist must have at least 5 years postdoctoral experience in the treatment of emotional or mental disorders C. All physicians must have completed at least a 12 Hour Disability Evaluation Report Writing Program prior to appointment as a QME (Except DCs - 44 Hour Course includes Report Writing) D. Must pass the QME Competency Examination E. All of the above

E. All of the above

The State of California uses the most current edition of the AMA Guides to determine impairment.

A. True B. False - Only the Fifth Edition

B. False - Only the Fifth Edition

The AMA Guides - Fifth Edition are only used for dates of injury 1-1-05 and forward.

A. True B. False

A. True

A QME/AME may only use 1 chapter of the AMA Guides to provide an impairment rating.

A. True B. False - Can use any chapter in the book that is applicable to the injured worker's condition(s) to provide the most accurate rating

B. False - Can use any chapter in the book that is applicable to the injured worker's condition(s) to provide the most accurate rating

A physician must be a QME to perform medical-legal evaluations and reports.

A. True B. False - PTPs and AMEs do not have to be a QME to write a medical-legal report

B. False - PTPs and AMEs do not have to be a QME to write a medical-legal report

An AME must be a QME.

A. True B. False

B. False

Which reports are accepted at the WCAB?

A. PTP B. Secondary physician reports, adopted by the PTP C. QME D. AME E. All the above

E. All the above

A QME must have 6 hours a year, or 12 hours every 2 years of QME continuing education to qualify for reappointment.

A. True B. False

A. True

A QME who has treated the injured worker, must disqualify them self if their name appears on the QME panel list.

A. True B. False

A. True

Any QME who has not paid the QME reappointment fee within 2 years of the due date must retake the QME Competency Examination and pass it prior to regaining or obtaining QME active status.

A. True B. False

A. True

The DWC - Medical Unit is responsible for providing panel QME lists.

A. True B. False

A. True

Medical-legal testimony means expert testimony provided by a physician at a deposition or WCAB hearing.

A. True B. False

A. True

Medical research does NOT include reading or reading about the AMA Guides, Treatment Guidelines (i.e. MTUS/ACOEM etc.), the Labor Code, Regulations or other legal materials.

A. True B. False

A. True

An interpreter shall be provided if the injured worker does not proficiently speak or understand the English language.

A. True B. False

A. True

Medical-legal (ML 100 - 106) billing modifiers include.

A. -92 Performed by a PTP B. -93 Interpreter needed at the time of the examination (10% more - ML 102 & ML 103) C. -94 Performed by an AME (25% more) D. -95 Performed by a panel QME E. All the above

E. All the above

A comprehensive medical evaluation and report prepared by the PTP when there are no contested or disputed issues is not considered a medical-legal expense and is billed under the Official Medical Fee Schedule (OMFS) and not the Official Medical-Legal Fee Schedule (OMLFS).

A. True B. False

A. True

Request for Authorization (RFA) is used to request treatment in a work comp claim.

A. True B. False

A. True

If a new diagnosis/condition is discovered during an evaluation, unrelated to the work comp claim, the evaluator has an obligation to inform the involved parties and recommend further medical assessment.

A. True B. False

A. True

In the AMA Guides, in situations where impairment ratings are not provided for a particular condition, an analogy to a similar condition should be provided.

A. True B. False

A. True

To add up to 3% whole person impairment for pain (Chapter 18), no formal assessment of painrelated impairment is required.

A. True B. False

A. True

The QME/AME physician needs to ensure that the injured worker/patient/examinee understands that that the evaluation's purpose is medical assessment, not medical treatment.

A. True B. False

A. True

A permanent impairment rating should not be provided until the patient is permanent and stationary/MMI.

A. True B. False

A. True

The 8 ADLs listed in Table 1-2 on page 4 of the Guides should be considered when establishing an impairment rating.

A. True B. False

A. True

An impairment rating should be rounded to the nearest whole number.

A. True B. False

A. True

Up to 3% whole person impairment may be increased for the effects of treatment or lack of treatment (medication). Pages 20 and 600, AMA Guides.

A. True B. False

A. True

In any case where an acupuncturist has been selected by the injured worker from a 3 member panel and an issue of disability is in dispute, the acupuncturist shall request a consult from another QME. The acupuncturist shall evaluate all other issues as required for a complete evaluation.

A. True B. False

A. True

Workers' Compensation laws in California originated with the _____ which was passed in ____

A. Almaraz Act

1905 B. Boynton Act

1913 C. Blackledge Act

1910 D. Guzman Act 1924

B. Boynton Act

1913

The "Grand Bargain" of the workers compensation system involves employers agreeing to pay assured and fixed benefits for industrial injuries and workers agreeing to: a. A. reduction in pay to cover the cost of workers' compensation insurance. B. Accept lower industrial safety oversight by the state. C. Not sue their employer in civil court for an industrial injury. D. Exempt Importer/Exporter companies from liability for industrial injury.

D. Exempt Importer/Exporter companies from liability for industrial injury.

The five basic categories of workers' compensation benefits are called:

A. Medical Treatment, Permanent Disability Benefits, Death Benefit, Supplemental Job Displacement Benefits, Stay-at-Home Stipend. B. Therapeutic Costs Voucher, Temporary Disability Benefits, Permanent Disability Benefits, Death Benefits, Supplemental Job Displacement Benefits. C. Medical Treatment, Temporary Disability Benefits, Permanent Disability Benefits, Death Benefits, Supplemental Job Displacement Benefits. D. Medical Treatment, Temporary Disability Benefits, Permanent Disability Benefits, Death Benefits, Intermediate Benefits, Supplemental Job Displacement Benefits.

C. Medical Treatment, Temporary Disability Benefits, Permanent Disability Benefits, Death Benefits, Supplemental Job Displacement Benefits.

Temporary Disability Benefits are paid at the rate of ____ and are usually limited by a ____ time cap.

A. 2/3 of average weekly wages

2 year B. 90% of average weekly wages

2 year C. 2 /3 of yearly earnings

1 year D. ½ the Bosco rate

Seven years

A. 2/3 of average weekly wages

2 year

Supplemental Job Displacement Benefits are available where:

A. Vocational Rehabilitation costs are deemed unreasonable. B. The date of injury is before 1/1/13 and the employer does not offer Return-to

Work. C. The injured worker passes the a Job Proficiency Test. D. The date of injury is after 1/1/13 and the employer does not offer Return-to-Work~D. The date of injury is after 1/1/13 and the employer does not offer Return-to-Work

Which report, written by an AME, QME, or AQME, does not involve a face-to-face evaluation of an Applicant?

A. Initial (aka "Comprehensive") B. Re-evaluation (aka "Follow-up")