QME Exam Prep p2 Questions With Verified
Answers.
How is the disability rating made? - answerQMEs rate the impairment (NOT DISABILITY),
and then raters use the impairment rating to make a disability rating
What are the two exceptions to using the AMA guides 5th ed. to the evaluation of permanen...
How is the disability rating made? - answer✔QMEs rate the impairment (NOT DISABILITY),
and then raters use the impairment rating to make a disability rating
What are the two exceptions to using the AMA guides 5th ed. to the evaluation of permanent
impairment? - answer✔Psych cases and cases prior to 1/1/2005 (the latter use the 1997 PDRS)
What are the two exceptions to the requirement that QMEs have 1/3 of their time devoted to
direct clinical practice? - answer✔1) if the QME has been an AME at least 8 times in the past
year
2) if the QME is retired or a teaching physician
Can acupuncturists issue opinions on permanent disability? - answer✔No
What are the limitations to apportionment? - answer✔1) Apportionment applies only to
permanent disability and is based on causation
2) only permanent disability is apportioned, never treatment, work restrictions, etc.
What is the signing date for QME reports? - answer✔the date the report is completed, not the
evaluation date. include the county of the report
What are the five major categories of QME disciplinary action? - answer✔1) consistent late
reports
2) lack of availability
3) ex parte communications
4) self-referral
5) reports do not meet DWC minimum standards
What must be included with the HPI? - answer✔A discussion of the mechanism of injury
What are the 5 main types of workers comp benefits? - answer✔1) Medical treatment
2) temporary disability benefits
What is the Boynton Act of 1913? - answer✔Requires CA employees to have worker's comp
insurance
what is the definition of a medical-legal report? - answer✔to prove or disprove an aspect of a
contested claim
What is the impairment rating? - answer✔Rates the degree to which the impairment decreases a
person's ability to perform ADLs, excluding work
What are AOE and COE? - answer✔AOE: arising out of employment
COE: through the course of employment
What is ex parte communication? - answer✔Occurs when a party to a case communicates with
one side only. a QME CANNOT do this (but can speak with the treating MD if questions arise)
What is the difference between exacerbation and aggravation? - answer✔Exacerbation:
temporary worsening
Aggravation: permanent worsening (new injury)
Define permanent, temporary partial and temporary total disability. - answer✔Permanent:
irreversible residual of an injury
Temp partial: can work, but earn less than previously
Temp total: cannot work at all
Do psych injuries after termination count as injury? - answer✔No
Define apportionment - answer✔Estimate of the % of permanent disability was caused by work-
related injury
What are temporary disability payments? - answer✔2/3 of average weekly pay, limited to 104
weeks (2 years)
when are supplemental job displacement benefits offered? - answer✔if the employer doesn't
offer a RTW (return to work), a voucher can be offered to the IW, but must be used within 2
years of offer or 5 years from date of injury (DOI)
When are non-psych vs psych injuries compensable? - answer✔Non-psych: if 1% or more of the
injury is industrial
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