QME Practice Questions with Correct Answers
The law specifies an order of medical evidence standards - what is that order?
1. The guidelines, including the drug formulary adopted by the administrative director
pursuant to section 5307.27 (MTUS)
2. Peer reviewed scientific and medical evidence regarding the effectiveness of the disputed
service.
3. Nationally recognized professional standards
4Expert opinion. Generally accepted standards of medical practice
5.
The employer provides workers compensation benefits regardless of fault.
The employer provides workers compensation benefits regardless of fault.
If the injury is outside of the QME's scope of practice and they have advised and
serviced the parties in writing on what form
QME Findings Summary Form 111
Serve a copy of your report on the Medical Unit of DWC
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 Hand?
Thumb = 40%
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 combination chart start on?
Page 604
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
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 other than the date of the
examination what must be done?
Enter the DATE the Report IS Signed NEXT to or NEAR the Signature on the Report
What does CCR stand for?
The law specifies an order of medical evidence standards - what is that order?
1. The guidelines, including the drug formulary adopted by the administrative director
pursuant to section 5307.27 (MTUS)
2. Peer reviewed scientific and medical evidence regarding the effectiveness of the disputed
service.
3. Nationally recognized professional standards
4Expert opinion. Generally accepted standards of medical practice
5.
The employer provides workers compensation benefits regardless of fault.
The employer provides workers compensation benefits regardless of fault.
If the injury is outside of the QME's scope of practice and they have advised and
serviced the parties in writing on what form
QME Findings Summary Form 111
Serve a copy of your report on the Medical Unit of DWC
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 Hand?
Thumb = 40%
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 combination chart start on?
Page 604
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
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 other than the date of the
examination what must be done?
Enter the DATE the Report IS Signed NEXT to or NEAR the Signature on the Report
What does CCR stand for?
