Q1: How is the disability rating determined?
A1: Qualified Medical Evaluators (QMEs) rate the impairment (not the disability) first, and then this
impairment rating is used to derive the final disability rating.
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Q2: What are the two exceptions to using the AMA Guides 5th Edition for evaluating permanent
impairment?
A2: The two exceptions are:
1. Cases that involve psychological conditions.
2. Cases that occurred before January 1, 2005, which utilize the 1997 Permanent Disability Rating
Schedule (PDRS).
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Q3: What are the exceptions to the requirement that QMEs dedicate one-third of their time to direct
clinical practice?
A3: The exceptions are:
1. If the QME has served as an Agreed Medical Evaluator (AME) at least 8 times in the previous year.
2. If the QME is a retired physician or a teaching physician.
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Q4: Can acupuncturists issue opinions regarding permanent disability?
A4: No, acupuncturists are not permitted to issue opinions on permanent disability.
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, Q5: What are the limitations associated with apportionment?
A5: The limitations include:
1. Apportionment is applicable only to permanent disability and is based on causation.
2. Apportionment only pertains to permanent disability and not to treatment, work restrictions, etc.
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Q6: What constitutes the signing date for QME reports?
A6: The signing date for QME reports is the date when the report is completed, not the date of the
evaluation. The report must also include the county where it was generated.
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Q7: What are the five major categories of disciplinary action that can be taken against a QME?
A7: The five major categories include:
1. Consistent late submission of reports.
2. Lack of availability for consultations.
3. Ex parte communications.
4. Self-referral practices.
5. Reports that do not meet the minimum standards set by the Department of Workers' Compensation
(DWC).
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Q8: What must be included with the History of Present Illness (HPI)?
A8: The HPI must include a discussion of the mechanism of injury.
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