Answers7
How is the disability rating made? - ANSWERS-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? - ANSWERS-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? - ANSWERS-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? - ANSWERS-No
What are the limitations to apportionment? - ANSWERS-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? - ANSWERS-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? - ANSWERS-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? - ANSWERS-A discussion of the mechanism of injury
What are the 5 main types of workers comp benefits? - ANSWERS-1) Medical treatment
2) temporary disability benefits
3) permanent disability benefits
4) death benefits
5) supplemental job displacement benefits (SJDB)
What is the Boynton Act of 1913? - ANSWERS-Requires CA employees to have worker's comp
insurance
what is the definition of a medical-legal report? - ANSWERS-to prove or disprove an aspect of a
contested claim
What is the impairment rating? - ANSWERS-Rates the degree to which the impairment
decreases a person's ability to perform ADLs, excluding work
What are AOE and COE? - ANSWERS-AOE: arising out of employment
COE: through the course of employment
What is ex parte communication? - ANSWERS-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? - ANSWERS-Exacerbation:
temporary worsening