Disclaimer: The answers to these questions can be found in the audio recording, in the course handouts, and represent the opinion of the speakers.  They do not necessarily represent COA’s opinion or policy on the issue.

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1. Contact Information (Required.)

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2. Test Date (Required.)

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3. The Division of Workers' Compensation has updated Medical-Legal Fee Schedule effective April 1, 2021.   (Required.)

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4. The updated Medical-Legal Fee Schedule will still be based on the AMA Guides 5th Edition. (Required.)

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5. All parties sending records to a QME/AME are required to send along a Declaration which indicates the number of pages sent. (Required.)

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6. If the QME/AME does not receive the Declaration with the records, they are to act as if the records were not received. (Required.)

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7. If the QME/AME reviews the records without the Declaration, the payor likely will not pay for the review of records. (Required.)

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8. Once the Declaration is received and if the QME/AME has already sent in their report, they may bill a Supplemental Report for the review of records.  A request for the Supplemental Report from the payor is also needed. (Required.)

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9. Common Mistakes Doctors Make in Their Reports
The Escobedo decision has been around since 2004 and only applies to apportionment. (Required.)

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10. The treating physician and QME must address the same issues in their reports (Medical-Legal Report or PR-4) because the judge can rely on either report - whichever they believe is more comprehensive. (Required.)

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11. QMEs must disclose in their report who actually evaluated the patient including if a computer assisted in the evaluation. (Required.)

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12. Active and Passive range of motion are both valid. (Required.)

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13. The Combined Values chart in the AMA Guides is based on scientific data. (Required.)

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14. Orthopaedic surgeons only need to understand and use the musculoskeletal chapters of the AMA Guides.  The other chapters are not important in an orthopaedic evaluation. (Required.)

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15. An Almarez-Guzman analysis allows the QME to determine the final impairment of the injured worker regardless of the impairment assigned by the AMA Guides. (Required.)

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16. It is important for the QME to tell the judge in your report what is "normal" according to the AMA Guide when compared to your findings on the patient that you are evaluating.  You cannot assume the judge will know. (Required.)

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17. An Almarez-Guzman analysis requires the evaluating physician to first calculate the impairment assigned by the standard and customary use of the AMA Guides and then assign an alternative impairment if that is more accurate to the injured worker. (Required.)

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18. Contributory Causation.
The employer is only liable for the percentage of permanent disability directly caused by the injury. (Required.)

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19. QMEs/AMEs can either address causation or apportionment in their reports.  They do not have to address both. (Required.)

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20. Contributory causation can include factors related to heredity, disease, and medical conditions. (Required.)

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21. It is important to remember that the AMA Guides does not include any notion of cumulative trauma. (Required.)

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22. The defense and applicant attorneys both have the responsibility of proving or disapproving apportionment. (Required.)

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23. When apportioning an injury, which of the situations should be considered? (Required.)

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24. In your evaluation report, it is not important to discuss how the injury caused a permanent disability. (Required.)

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25. It is important to include a discussion in your report of when a risk factor becomes causative of disability. (Required.)

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26. In order for the evaluation report to be complete, the QME/AME must include a rationale for the conclusions in their report. (Required.)

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27. Chronic pain is a subjective phenomenon, often associated with confounding behavioral, characterological, cultural, personality and psychological issues.     (Required.)

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28. Chronic pain can be abolished by cutting out the offending lesion in most cases. (Required.)

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29. The AMA Guides Fifth Edition Defines Impairment “a loss, loss of use, or derangement of any body part, organ system, or organ function." (Required.)

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30. Disability usually results from an impairment that results in a functional loss of ability to perform activities of daily living or complex activities such as work. (Required.)

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31. Myofascial Pain Syndrome and Fibromyalgia can be rated using a standard approach to the AMA Guides Edition. (Required.)

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32. The evaluating physician is tasked with providing the most accurate impairment rating. (Required.)

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33. Synergy suggests that when two body parts are injured and their combined loss of ADLs may be greater than the sum of their separate effects, which of the following is not true. (Required.)

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34. In the case of Kite v Athens Administrators, two hip impairments were: (Required.)

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35. In the case of Kite v Athens Administrators, two hip impairments were: (Required.)

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36. Guidelines are now available to enhance telemedical evaluations of shoulder, spine, and ankle injuries.  But not hips or knees. (Required.)

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37. Despite being new, televideo exams have been validated with modifications so patients can help examine themselves. (Required.)

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38. Adverse Childhood Experiences (ACES) are associated in adults with the onset of chronic pain. (Required.)

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39. ACE patients are very compliant with their doctor's treatment recommendations. (Required.)

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