QME Exam California Qualified Medical Evaluator (DWC
Medical Unit) | AMA Guides 5th Edition UP-TO-DATE
EXAM QUESTIONS AND 100% ACCURATE
SOLUTIONS | VERIFIED ANSWERS - INSTANT
PDF DOWNLOAD.
Domain 1: AMA Guides 5th Edition – Impairment Rating
Question 1
According to the AMA Guides 5th Edition, impairment is defined as:
A) A loss of earning capacity due to injury
B) A significant deviation, loss, or loss of use of a body function or structure
C) A medical condition that prevents return to any work
D) A functional limitation requiring permanent accommodations
Correct Answer: B
Explanation: The AMA Guides 5th Edition defines impairment as a significant deviation,
loss, or loss of use of a body function or structure . This is distinct from disability, which
refers to the impact of impairment on the ability to perform activities of daily living or
work.
Question 2
The preferred method for rating upper extremity impairment under the AMA Guides 5th
Edition is:
,A) Range of motion model
B) Diagnosis-based estimates
C) Neurological deficit scoring
D) Grip strength dynamometry
Correct Answer: B
*Explanation: The AMA Guides 5th Edition emphasizes diagnosis-based impairment
(DBI) over range of motion for upper extremities due to higher reliability and validity .
The DBI method focuses on the underlying diagnosis rather than functional testing
alone. *
Question 3
The DRE (Diagnosis-Related Estimate) method is primarily used for rating:
A) Upper extremity joints
B) Spinal impairment
C) Psychiatric conditions
D) Skin disorders
Correct Answer: B
Explanation: DRE categories I through VIII are the primary method for rating cervical,
thoracic, and lumbar spinal impairment under the AMA Guides 5th Edition . Each category
corresponds to specific clinical findings and severity levels.
Question 4
A patient with lumbar DRE Category II (minor impairment) receives what whole person
impairment (WPI) range?
A) 0-2%
B) 5-8%
C) 10-15%
D) 20-25%
Correct Answer: B
,*Explanation: DRE Lumbar Category II (clinical history and examination findings with no
significant radiculopathy) yields a whole person impairment range of 5-8% . Category I
is 0% (no significant clinical findings). *
Question 5
Which spinal DRE Category requires findings of radiculopathy with objective neurologic
signs?
A) Category II
B) Category III
C) Category IV
D) Category V
Correct Answer: B
Explanation: DRE Category III requires findings of radiculopathy with objective neurologic
signs, including reflex loss, sensory changes, or muscle atrophy . Category II involves injury
without radiculopathy.
Question 6
A patient has 15% upper extremity impairment. The whole person impairment is:
A) 6%
B) 9%
C) 15%
D) 25%
Correct Answer: B
*Explanation: The upper extremity to whole person conversion factor under AMA Guides
5th Edition is 0.6 (60%). 15% × 0.6 = 9% WPI . This conversion is found in Table 15-9,
Chapter 15. *
Question 7
Lower extremity impairment is converted to whole person impairment using what
factor?
, A) 0.2 (20%)
B) 0.4 (40%)
C) 0.6 (60%)
D) 1.0 (100%)
Correct Answer: B
*Explanation: AMA Guides 5th Edition Table 17-3 specifies that lower extremity
impairment percentage multiplied by 0.4 equals whole person impairment . For
example, 20% LE impairment = 8% WPI. *
Question 8
Hand impairment is converted to upper extremity impairment using:
A) Direct 1:1 mapping
B) Table 15-8 (hand to UE conversion)
C) Grip strength only
D) Number of digits involved
Correct Answer: B
*Explanation: Table 15-8 provides conversion factors from hand impairment to upper
extremity impairment . For example, 10% hand impairment converts to approximately
9% UE impairment. *
Question 9
Thumb impairment carries what percentage of total hand function according to AMA
Guides 5th Edition?
A) 20%
B) 30%
C) 40%
D) 50%
Correct Answer: C
*Explanation: Under AMA Guides 5th Edition Table 15-7, the thumb accounts for 40% of
total hand function . The index finger is 20%, middle finger 20%, ring finger 10%, and
little finger 10%. *
Medical Unit) | AMA Guides 5th Edition UP-TO-DATE
EXAM QUESTIONS AND 100% ACCURATE
SOLUTIONS | VERIFIED ANSWERS - INSTANT
PDF DOWNLOAD.
Domain 1: AMA Guides 5th Edition – Impairment Rating
Question 1
According to the AMA Guides 5th Edition, impairment is defined as:
A) A loss of earning capacity due to injury
B) A significant deviation, loss, or loss of use of a body function or structure
C) A medical condition that prevents return to any work
D) A functional limitation requiring permanent accommodations
Correct Answer: B
Explanation: The AMA Guides 5th Edition defines impairment as a significant deviation,
loss, or loss of use of a body function or structure . This is distinct from disability, which
refers to the impact of impairment on the ability to perform activities of daily living or
work.
Question 2
The preferred method for rating upper extremity impairment under the AMA Guides 5th
Edition is:
,A) Range of motion model
B) Diagnosis-based estimates
C) Neurological deficit scoring
D) Grip strength dynamometry
Correct Answer: B
*Explanation: The AMA Guides 5th Edition emphasizes diagnosis-based impairment
(DBI) over range of motion for upper extremities due to higher reliability and validity .
The DBI method focuses on the underlying diagnosis rather than functional testing
alone. *
Question 3
The DRE (Diagnosis-Related Estimate) method is primarily used for rating:
A) Upper extremity joints
B) Spinal impairment
C) Psychiatric conditions
D) Skin disorders
Correct Answer: B
Explanation: DRE categories I through VIII are the primary method for rating cervical,
thoracic, and lumbar spinal impairment under the AMA Guides 5th Edition . Each category
corresponds to specific clinical findings and severity levels.
Question 4
A patient with lumbar DRE Category II (minor impairment) receives what whole person
impairment (WPI) range?
A) 0-2%
B) 5-8%
C) 10-15%
D) 20-25%
Correct Answer: B
,*Explanation: DRE Lumbar Category II (clinical history and examination findings with no
significant radiculopathy) yields a whole person impairment range of 5-8% . Category I
is 0% (no significant clinical findings). *
Question 5
Which spinal DRE Category requires findings of radiculopathy with objective neurologic
signs?
A) Category II
B) Category III
C) Category IV
D) Category V
Correct Answer: B
Explanation: DRE Category III requires findings of radiculopathy with objective neurologic
signs, including reflex loss, sensory changes, or muscle atrophy . Category II involves injury
without radiculopathy.
Question 6
A patient has 15% upper extremity impairment. The whole person impairment is:
A) 6%
B) 9%
C) 15%
D) 25%
Correct Answer: B
*Explanation: The upper extremity to whole person conversion factor under AMA Guides
5th Edition is 0.6 (60%). 15% × 0.6 = 9% WPI . This conversion is found in Table 15-9,
Chapter 15. *
Question 7
Lower extremity impairment is converted to whole person impairment using what
factor?
, A) 0.2 (20%)
B) 0.4 (40%)
C) 0.6 (60%)
D) 1.0 (100%)
Correct Answer: B
*Explanation: AMA Guides 5th Edition Table 17-3 specifies that lower extremity
impairment percentage multiplied by 0.4 equals whole person impairment . For
example, 20% LE impairment = 8% WPI. *
Question 8
Hand impairment is converted to upper extremity impairment using:
A) Direct 1:1 mapping
B) Table 15-8 (hand to UE conversion)
C) Grip strength only
D) Number of digits involved
Correct Answer: B
*Explanation: Table 15-8 provides conversion factors from hand impairment to upper
extremity impairment . For example, 10% hand impairment converts to approximately
9% UE impairment. *
Question 9
Thumb impairment carries what percentage of total hand function according to AMA
Guides 5th Edition?
A) 20%
B) 30%
C) 40%
D) 50%
Correct Answer: C
*Explanation: Under AMA Guides 5th Edition Table 15-7, the thumb accounts for 40% of
total hand function . The index finger is 20%, middle finger 20%, ring finger 10%, and
little finger 10%. *
