QME Certification Exam
What is the AMA Guides Upper Extremity WPI Maximum 60% Whole Person Impairment
What is the AMA Guides Lower Extremity WPI Maximum 40% Whole Person Impairment
To convert Upper Extremity to WPI what do you do? Multiply UE x 60%
To convert Lower Extremity to WPI what do you do? Multiply LE x 40%
How do you convert a Hand to UE? Multiply Hand by 90%
What are the values of each digit in regard to the Thumb = 40%
Hand? Index and Middle Fingers = 20%
Ring and Little Fingers = 10%
How do you convert a foot to Lower Extremity? Multiply Foot by 70%
In the AMA 5th Edition what page does the Page 604
combination chart start on?
The first number in a DEU Rating represents What? The Chapter Number in the AMA Guides
The Second number in a DEU Rating Represents What? The Part of the Body
The first % in the DEU Rating represents What? The AMA Impairment Rating
The Last set of % in the DEU Rating represents What? The DEU Disability Rating
ACOEM -American College of Occupational and Environmental Medicine.
-A Guideline for EBM
-Treatment Guidelines
Definition of Chronic Pain Lasting 3 or More months from initial onset of pain
Claims Administrator? - Self-administered WC Insurer
- Self administered, Self-insured Employer (WC)
- Self administered, legally uninsured employer (WC)
- Self administered joint powers authority (WC)
- 3rd Party Insurer
- California Insurance Guarantee Association
, QME Certification Exam
Evidence-Based Medicine (EBM) Systematic approach to making clinical decisions which allow the integration of
the best available research evidence with clinical expertise and patient values.
EBM = BARE + CE + PV
Define Functional Improvement 1. Clinically Significant improvement in ADL's (or)
2. Reduction in work restrictions as measured during history and physical exam,
performed and documented as part of the medical evaluation and treatment
(and)
3. Reduction in the Dependency on continued medical treatment
Medical Treatment Care which is reasonably required to Cure or Relieve
Medical Treatment Guidelines Most Current Version of Written recommendations which are systematically
developed by a multidisciplinary process. Reviewed and updated within the
last FIVE (5) years.
Nationally Recognized Peer-reviewed medical journal or
developed, endorsed & disseminated by a national organization with affiliates
based in 2 or more US States and the most current version.
ODG Official Disability Guidelines
Contains EBM tx guidelines
Peer Reviewed Evaluated and Approved PRIOR to Publication by an editorial board of
qualified experts
Scientifically Based Evidence Scientific Literature evaluated and used as a basis to support a
recommendation
Strength of Evidence Establishes relative weight that shall be given to scientifically based evidence
If the QME signs the medical legal report on any date Enter the DATE the Report IS Signed NEXT to or NEAR the Signature on the
other than the date of the examination what must be Report
done?
What does CCR stand for? California Code of Regulations
If the QME finds the IW at P&S what forms should the - Physician's Report of Permanent and Stationary Status
QME complete - Work Capacity (DWC-AD Form 10133.36)
, QME Certification Exam
What does the QME do with the Physicians Report of Serve it on the Claims Administrator along with the Medical Report
Permanent and Stationary Status and Work Capacity
(DWC-AD Form 10133.36)?
If there is a disputed medical issue - outside of the At earliest opportunity and no later than date report is served advise the
evaluator's scope of practice and area of clinical parties - in writing
competency what must be done?
CCR Sections that cover Scope of Practice problems - 4062.1
- 4062.2
If a new injury/illness is claimed involving the same type Same evaluator who reported previously
body part/system and the parties are the same who -if within their scope of practice and clinical competence
would do the evaluation?
What edition of the AMA Guidelines does a QME use? 5th Edition
Description of Frequency? Occasional - 25% of the time
Intermittent - 50% of the time
Frequent - 75% of the time
Constant - 90-100% of the time
Description of Severity? Minimal (mild) - annoyance, non-ratable for PD
Slight - tolerated, causes some interference
Moderate - tolerated, causes Marked interference
Severe - Precludes (prevents) activity
Muscle Grading 5/5 - Full Resistance
4/5 - Some Resistance
3/5 - Gravity only, no resistance
2/5 - movement with gravity eliminated
1/5 - slight contraction with no movement
0/5 - NO contraction
Patellar Reflex Grading 2 = Normal
0 = Absent
4 = Hyperactive
Temporary Disability IW not permanent and stationary, has work restrictions
What is the maximum, separate rating you can give an 3% WPI
IW for Pain?
What is the AMA Guides Upper Extremity WPI Maximum 60% Whole Person Impairment
What is the AMA Guides Lower Extremity WPI Maximum 40% Whole Person Impairment
To convert Upper Extremity to WPI what do you do? Multiply UE x 60%
To convert Lower Extremity to WPI what do you do? Multiply LE x 40%
How do you convert a Hand to UE? Multiply Hand by 90%
What are the values of each digit in regard to the Thumb = 40%
Hand? Index and Middle Fingers = 20%
Ring and Little Fingers = 10%
How do you convert a foot to Lower Extremity? Multiply Foot by 70%
In the AMA 5th Edition what page does the Page 604
combination chart start on?
The first number in a DEU Rating represents What? The Chapter Number in the AMA Guides
The Second number in a DEU Rating Represents What? The Part of the Body
The first % in the DEU Rating represents What? The AMA Impairment Rating
The Last set of % in the DEU Rating represents What? The DEU Disability Rating
ACOEM -American College of Occupational and Environmental Medicine.
-A Guideline for EBM
-Treatment Guidelines
Definition of Chronic Pain Lasting 3 or More months from initial onset of pain
Claims Administrator? - Self-administered WC Insurer
- Self administered, Self-insured Employer (WC)
- Self administered, legally uninsured employer (WC)
- Self administered joint powers authority (WC)
- 3rd Party Insurer
- California Insurance Guarantee Association
, QME Certification Exam
Evidence-Based Medicine (EBM) Systematic approach to making clinical decisions which allow the integration of
the best available research evidence with clinical expertise and patient values.
EBM = BARE + CE + PV
Define Functional Improvement 1. Clinically Significant improvement in ADL's (or)
2. Reduction in work restrictions as measured during history and physical exam,
performed and documented as part of the medical evaluation and treatment
(and)
3. Reduction in the Dependency on continued medical treatment
Medical Treatment Care which is reasonably required to Cure or Relieve
Medical Treatment Guidelines Most Current Version of Written recommendations which are systematically
developed by a multidisciplinary process. Reviewed and updated within the
last FIVE (5) years.
Nationally Recognized Peer-reviewed medical journal or
developed, endorsed & disseminated by a national organization with affiliates
based in 2 or more US States and the most current version.
ODG Official Disability Guidelines
Contains EBM tx guidelines
Peer Reviewed Evaluated and Approved PRIOR to Publication by an editorial board of
qualified experts
Scientifically Based Evidence Scientific Literature evaluated and used as a basis to support a
recommendation
Strength of Evidence Establishes relative weight that shall be given to scientifically based evidence
If the QME signs the medical legal report on any date Enter the DATE the Report IS Signed NEXT to or NEAR the Signature on the
other than the date of the examination what must be Report
done?
What does CCR stand for? California Code of Regulations
If the QME finds the IW at P&S what forms should the - Physician's Report of Permanent and Stationary Status
QME complete - Work Capacity (DWC-AD Form 10133.36)
, QME Certification Exam
What does the QME do with the Physicians Report of Serve it on the Claims Administrator along with the Medical Report
Permanent and Stationary Status and Work Capacity
(DWC-AD Form 10133.36)?
If there is a disputed medical issue - outside of the At earliest opportunity and no later than date report is served advise the
evaluator's scope of practice and area of clinical parties - in writing
competency what must be done?
CCR Sections that cover Scope of Practice problems - 4062.1
- 4062.2
If a new injury/illness is claimed involving the same type Same evaluator who reported previously
body part/system and the parties are the same who -if within their scope of practice and clinical competence
would do the evaluation?
What edition of the AMA Guidelines does a QME use? 5th Edition
Description of Frequency? Occasional - 25% of the time
Intermittent - 50% of the time
Frequent - 75% of the time
Constant - 90-100% of the time
Description of Severity? Minimal (mild) - annoyance, non-ratable for PD
Slight - tolerated, causes some interference
Moderate - tolerated, causes Marked interference
Severe - Precludes (prevents) activity
Muscle Grading 5/5 - Full Resistance
4/5 - Some Resistance
3/5 - Gravity only, no resistance
2/5 - movement with gravity eliminated
1/5 - slight contraction with no movement
0/5 - NO contraction
Patellar Reflex Grading 2 = Normal
0 = Absent
4 = Hyperactive
Temporary Disability IW not permanent and stationary, has work restrictions
What is the maximum, separate rating you can give an 3% WPI
IW for Pain?
