2017 QME Course Test Disclaimer: The answers to these questions can be found in the audio recording and in the course handouts and represent the opinion of the speakers. They do not necessarily represent COA’s opinion or policy on the issue. Question Title * 1. Contact Information Full Name and Title * Email Address * Phone Number Question Title * 2. Test Date Date Date Question Title * 3. SB 863 requires Medical Provider Networks (MPNs) to confirm with their network providers that they are willing to continue to participate in the MPN by January 1, 2016. True False Question Title * 4. Carriers/self-insured employers have the exclusive right to choose providers for their MPN. True False Question Title * 5. Liens filed by providers who are criminally charged with Workers’ Compensation fraud, are automatically stayed pending the disposition of the criminal case. True False Question Title * 6. The Division of Workers’ Compensation (DWC) doesn’t require the use of the MTUS Treatment Guidelines and Drug Formulary or any other guidelines for physicians treating Workers’ Compensation cases. True False Question Title * 7. Only the Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME) may examine the injured employee, and prepare and sign the report. This includes: a) taking a complete history, b) reviewing prior medical records, and c) writing the report. True False Question Title * 8. Causation of a disability is NOT a “complexity factor” under the Medical-Legal Fee Schedule. True False Question Title * 9. The QME/AME should ONLY address causation of injury, if injury is denied AND if the parties have requested an AOE/COE evaluation. True False Question Title * 10. An injured worker is entitled to a certified interpreter, if necessary, at defendant’s expense. True False Question Title * 11. For any evaluation performed on or after July 1, 2013, regardless of the date of injury, a QME/AME shall not provide an opinion on any disputed medical treatment issue, but shall provide an opinion about whether the injured worker will need future medical care to cure or relieve the effects of an industrial injury. True False Question Title * 12. QMEs must send in their report within 30 days of the Medical-Legal examination or the parties may request a replacement QME. True False Question Title * 13. Supplementary Reports must be sent in within 30 days of request. Parties may agree to 30 day extension. True False Question Title * 14. A QME can effectively rebut the Combined Values Chart (CVC) by explaining how it was more accurate to use the Whole Person Impairment. True False Question Title * 15. Disability duration is: Time from injury to first day of treatment Time from injury to surgery Time from injury to impairment rating Time from injury until return to work Question Title * 16. Return-to-work is dependent on: Capacity to perform job duties Risk Tolerance All of the above None of the above Question Title * 17. Outcome measures include: Disability duration Impairment Disability All of the above None of the above Question Title * 18. In a Medical-Legal evaluation, what does FACE to FACE time include? Time spent doing diagnostic testing Time the injured worker is waiting to see you Time the QME/AME spends interviewing the injured worker Time spent by staff doing the history Question Title * 19. According to the DWC’s most recent interpretation of the Medical-Legal laws, how does the QME/QME know if Causation is “in dispute?” The applicant tells the physician that the case was admitted or denied The medical records show treatment was provided The Cover letter tell you it is an admitted or denied case All of the above None of the above Question Title * 20. What factors may be considered in performing a Medical-Legal evaluation under the AMA Guides - 5th Edition? Pre-existing injury Pre-existing illness Pre-existing impairment (congenital or development conditions Effect All of the above None of the above Question Title * 21. If there is only one probable cause of injury, the QME/AME should not apportion an injury? True False Question Title * 22. When a QME/AME determines the percent of the total causation, they must consider: a) events of employment, b) past medical history, and c) family conditions. True False Question Title * 23. If a physician opines that 50% of an employee’s back disability is caused by degenerative disc disease, the physician must explain: The nature of the degenerative disc disease How it is causing permanent disability at the time of the evaluation Why it is causing permanent disability at the time of the evaluation How it is responsible for approximately 50% of the disability, and Why it is responsible for approximately 50% of the disability True False Question Title * 24. An exacerbation of an injury is a temporary worsening of a pre-existing condition with an increase in symptoms, signs, disability, and/or impairment. True False Question Title * 25. An aggravation of an injury is a permanent worsening of a pre-existing condition with an increase in symptoms, signs, disability, and/or impairment. True False Question Title * 26. Apportionment is not used as a complexity factor in a Medical-Legal report unless the patient is permanent and stationary. True False Question Title * 27. To avoid problems should the DWC decide to audit the level of your Medical-Legal reports billed, it is advisable to get the parties to agree that the evaluation will be billed as a ML-104 prior to rendering the service. True False Done
