QME Exam Prep p2 All Questions and Answers
How is the disability rating made? - ANS 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 impa...
QME Exam Prep p2 All Questions and
Answers
How is the disability rating made? - ANS 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? - ANS Psych cases and cases prior to 1/1/2005 (the latter
A
use the 1997 PDRS)
VI
What are the two exceptions to the requirement that QMEs have 1/3 of their time
devoted to direct clinical practice? - ANS 1) if the QME has been an AME at least 8
times in the past year
TU
2) if the QME is retired or a teaching physician
Can acupuncturists issue opinions on permanent disability? - ANS No
IS
What are the limitations to apportionment? - ANS 1) Apportionment applies only to
permanent disability and is based on causation
2) only permanent disability is apportioned, never treatment, work restrictions, etc.
OM
What is the signing date for QME reports? - ANS 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? - ANS 1) consistent
NA
late reports
2) lack of availability
3) ex parte communications
4) self-referral
JP
5) reports do not meet DWC minimum standards
What must be included with the HPI? - ANS A discussion of the mechanism of injury
What are the 5 main types of workers comp benefits? - ANS 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? - ANS Requires CA employees to have worker's
comp insurance
what is the definition of a medical-legal report? - ANS to prove or disprove an aspect
of a contested claim
What is the impairment rating? - ANS Rates the degree to which the impairment
decreases a person's ability to perform ADLs, excluding work
A
What are AOE and COE? - ANS AOE: arising out of employment
COE: through the course of employment
VI
What is ex parte communication? - ANS Occurs when a party to a case
communicates with one side only. a QME CANNOT do this (but can speak with the
TU
treating MD if questions arise)
What is the difference between exacerbation and aggravation? - ANS Exacerbation:
temporary worsening
IS
Aggravation: permanent worsening (new injury)
Define permanent, temporary partial and temporary total disability. - ANS Permanent:
OM
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? - ANS No
NA
Define apportionment - ANS Estimate of the % of permanent disability was caused by
work-related injury
What are temporary disability payments? - ANS 2/3 of average weekly pay, limited to
JP
104 weeks (2 years)
when are supplemental job displacement benefits offered? - ANS 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? - ANS Non-psych: if 1% or more
of the injury is industrial
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