QME EXAM PREP P2 QUESTIONS WITH
COMPLETE SOLUTIONS
How is the disability rating made? - correct answer--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? - correct answer--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? - correct answer--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? - correct answer--No
What are the limitations to apportionment? - correct answer--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? - correct answer--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? - correct answer--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? - correct answer--A discussion of the mechanism
of injury
What are the 5 main types of workers comp benefits? - correct answer--1) Medical
treatment
2) temporary disability benefits
3) permanent disability benefits
4) death benefits
What is the Boynton Act of 1913? - correct answer--Requires CA employees to have
worker's comp insurance
what is the definition of a medical-legal report? - correct answer--to prove or disprove an
aspect of a contested claim
What is the impairment rating? - correct answer--Rates the degree to which the
impairment decreases a person's ability to perform ADLs, excluding work
What are AOE and COE? - correct answer--AOE: arising out of employment
COE: through the course of employment
What is ex parte communication? - correct answer--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? - correct answer--
Exacerbation: temporary worsening
Aggravation: permanent worsening (new injury)
Define permanent, temporary partial and temporary total disability. - correct answer--
Permanent: irreversible residual of an injury
Temp partial: can work, but earn less than previously
Temp total: cannot work at all
Do psych injuries after termination count as injury? - correct answer--No
Define apportionment - correct answer--Estimate of the % of permanent disability was
caused by work-related injury
What are temporary disability payments? - correct answer--2/3 of average weekly pay,
limited to 104 weeks (2 years)
when are supplemental job displacement benefits offered? - correct answer--if the
employer doesn't offer a RTW (return to work), a voucher can be offered to the IW, but
must be used within 2 years of offer or 5 years from date of injury (DOI)
When are non-psych vs psych injuries compensable? - correct answer--Non-psych: if
1% or more of the injury is industrial
Psych: if >50% is industrial (some exceptions)
What are the known presumptions for worker's comp? - correct answer--1) Firefighters
& peace officers cancer, if known exposures
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