QME testing 10 Flashcards
(15 cards)
What is the QME’s obligation when reviewing medical records provided before the evaluation?
Review all records, document them in the report, and indicate how they influenced the medical opinions.
How should a QME handle voluminous or irrelevant records?
Summarize the most relevant materials and explain why others were excluded from detailed discussion.
What is one way to assess the credibility of a patient’s reported symptoms?
Compare subjective complaints to objective findings, consistency with known pathology, and functional limitations.
What are red flags in a treating physician’s report that a QME should critique?
Inconsistent findings, lack of objective support, unclear apportionment, or reliance on non-medical opinions.
What is a key indicator that a prior report may be inadequate or incomplete?
Failure to address causation, apportionment, impairment rating, or missing a required section under 8 CCR §49.
When should a QME perform a full chart review during re-evaluation?
When new information has been submitted, or if prior reports are incomplete or under dispute.
What should be included in a QME’s medical record review summary?
Source, date, provider, content relevance, and impact on diagnosis or opinion.
What is a high-yield study strategy for the QME exam?
Use spaced repetition flashcards, focus on California Labor Code, QME regulations, and AMA Guides protocols.
Which practice tests are most useful for preparing for the QME exam?
Those based on DWC regulations, sample QME scenarios, and medical-legal report critique questions.
What is the best way to ensure familiarity with AMA Guides impairment calculations?
Work through real case examples using the Guides, particularly Chapters 14–17 and 15 for spine.
What is one strategy for writing an efficient and compliant QME report?
Use a structured template aligned with 8 CCR §49 and AMA Guide protocols to ensure all components are addressed.
What role does medical literature play in QME reports?
It may support opinions, especially in complex cases, but must be cited appropriately and used to clarify—not replace—clinical findings.
How can a QME avoid bias in report writing?
Stick to objective data, avoid attorney influence, and clearly state the basis for all opinions.
What is a best practice when preparing for QME oral or scenario-based test questions?
Practice explaining causation, apportionment, and impairment scenarios clearly and concisely.
What is one common cause for IMR overturning a denial despite a QME’s opinion?
Failure to link treatment recommendations to MTUS or lack of adequate clinical justification.
