QME testing 4 Flashcards
(15 cards)
What are the required components of a complete QME medical-legal report?
History of injury, complaints, findings, diagnosis, opinion on causation, apportionment, impairment, work restrictions, treatment recommendations, and declaration of accuracy.
Which regulation outlines the required content for a medical-legal report?
8 CCR §49.
What is the purpose of the declaration of accuracy in a QME report?
To affirm under penalty of perjury that the report is true and complete to the best of the evaluator’s knowledge.
What must a QME include when providing opinions on apportionment?
A percentage breakdown of industrial vs. non-industrial factors and a reasoned medical explanation supporting it.
What must be documented in the ‘history’ section of a QME report?
Mechanism of injury, prior injuries or conditions, medical history, and subjective complaints.
What part of the QME report discusses the patient’s own account of limitations and symptoms?
The subjective complaints section, usually within the history or functional capacity review.
What is the purpose of the ‘review of records’ section in a QME report?
To summarize and acknowledge the documents reviewed and relied upon in forming medical opinions.
When should a QME issue a supplemental report?
If there is new information, clarification is needed, or an error in the original report needs correction.
How should a QME address causation in their report?
By stating whether the injury arose out of and occurred in the course of employment (AOE/COE), and explaining the rationale.
What does the term ‘functional capacity’ refer to in a QME report?
The patient’s ability to perform work-related and daily activities based on clinical findings.
What type of findings must be included in the physical examination section?
Objective findings such as range of motion, strength, neurological signs, and special tests relevant to the case.
What are work restrictions in a QME report based on?
The patient’s limitations due to industrial injury, typically derived from objective and functional findings.
When are future medical care recommendations appropriate in a QME report?
When ongoing care is medically necessary to cure or relieve effects of the injury per Labor Code §4600.
What is the purpose of the ‘discussion’ section in a QME report?
To synthesize clinical findings, literature, and rationale behind opinions on impairment, causation, and apportionment.
How should conflicting medical evidence be addressed in a QME report?
The QME must review and explain why one source is more persuasive or consistent with the evidence.
