QME testing 13 Flashcards
(15 cards)
You receive a QME panel with a specialty that does not match the injured body part. What should you do?
Notify the DWC Medical Unit and request a replacement panel with an appropriate specialty.
A QME report lacks apportionment despite clear evidence of pre-existing conditions. What’s the consequence?
The report may be deemed inadmissible or incomplete under Labor Code §4663.
On exam day, how should you approach questions with two similar answer choices?
Choose the answer most closely aligned with Labor Code, DWC rules, or AMA 5th Edition standards.
How should you respond to a question referencing an outdated version of the AMA Guides?
Answer based on the AMA Guides 5th Edition, which is the current standard in California.
A patient with prior surgery and new work-related symptoms is being evaluated. What should be documented?
Surgical history, symptom chronology, and a clear apportionment analysis between old and new conditions.
What is the best response when asked for a treatment recommendation as a QME?
Make evidence-based recommendations consistent with MTUS and identify if further evaluation is needed.
How should a QME handle unclear documentation about work restrictions?
Clarify current capabilities, list specific restrictions, and recommend a Functional Capacity Evaluation if needed.
If you’re unsure how to rate a complex impairment on the exam, what’s a safe approach?
Default to using the AMA Guides structure: functional history, physical exam, diagnostic testing, and correct chapter.
What is the best strategy for dealing with lengthy, multi-part exam questions?
Read the last sentence of the question first to understand the goal, then work backward.
What if the injured worker reports severe symptoms but shows no objective findings?
Document the discrepancy and rate based on AMA standards—impairment requires objective support.
How many days does a QME have to reschedule an exam after an initial appointment?
60 calendar days per 8 CCR §41.5.
How long must a QME keep copies of their evaluations and records?
At least 5 years, per DWC rules.
If a party claims ex parte communication, what must the QME do?
Disclose the communication in the report and assess if impartiality has been compromised.
How should you approach a legal scenario question where you’re unfamiliar with the statute?
Use logical reasoning and eliminate clearly incorrect options; prefer answers that protect due process and objectivity.
What is the last thing to check before submitting your QME exam answers?
Ensure all questions are answered, revisit flagged items, and confirm your logic aligns with legal/clinical standards.
