module 6 part 2

Question 1

What is functional apportionment?

Answer 1

Dividing disability based on actual loss of function caused by different factors (e.g., work injury vs arthritis).

Question 2

When is functional apportionment useful?

Answer 2

When prior medical records show measurable pre-injury functional limits or work restrictions.

Question 3

Mnemonic for functional apportionment

Answer 3

“FLEA” — Functional limits, Evidence, Apportion %.

Question 4

How should QME address aggravation vs acceleration?

Answer 4

Aggravation = worsening severity; Acceleration = faster progression. Both can justify partial non-industrial apportionment.

Question 5

Can a QME apportion to future degeneration?

Answer 5

No — must be based on current, known pathology or disability, not predictions.

Question 6

Example: OA in knee worsened by work.

Answer 6

If OA already present and work hastened it, QME can apportion % to OA vs work trauma.

Question 7

Why must apportionment be expressed in %?

Answer 7

The WCAB requires a numerical percentage to apply to PD calculations; vague terms like “minor” or “significant” aren’t acceptable.

Question 8

Mnemonic for expressing percentages

Answer 8

“PEN” — Percentages Every time Numerically.

Question 9

How can QME support % estimates?

Answer 9

Use imaging, medical history, prior awards, objective findings, and literature if needed.

Question 10

What if QME believes prior injury fully healed?

Answer 10

Then no apportionment — only current work injury counts if prior condition resolved with no residual impairment.

Question 11

What is apportionment to natural aging?

Answer 11

Assigning % of PD to age-related degeneration if supported by imaging/history; cannot be speculative.

Question 12

Pitfall: apportioning to normal aging w/o evidence.

Answer 12

Invalid; must have imaging or objective findings showing degeneration contributed to PD.

Question 13

What is merger in apportionment?

Answer 13

When two injuries combine so completely that they cannot be separated; often treated as fully industrial if inseparable.

Question 14

How does merger affect PD?

Answer 14

PD may be assigned fully to the current industrial injury if prior factors can’t be reasonably separated.

Question 15

Mnemonic for merger decision

Answer 15

“MERGE” — Medical evidence reveals grouping effects.

Question 16

When should QME request more records?

Answer 16

If prior treatment or injuries are suspected but documentation is missing; prevents unsupported apportionment.

Question 17

How to apportion when prior PD rating unknown?

Answer 17

Base on objective findings and probable residuals; explain reasoning clearly even without exact % from past award.

Question 18

What is the Eggshell Skull Rule’s limit?

Answer 18

Worker vulnerability doesn’t eliminate apportionment if underlying condition contributes to PD.

Question 19

Can psychosocial stress be apportioned?

Answer 19

Only if tied to documented non-industrial psychiatric disorder contributing to disability.

Question 20

Why use literature references?

Answer 20

Supports medical probability and helps defend apportionment percentages in litigation.

Question 21

Mnemonic for strong apportionment report

Answer 21

“CLEAR” — Causation explained, Logic, Evidence, Apportion %, Records cited.

Question 22

How to handle prior cumulative trauma claims?

Answer 22

Separate out contribution from prior cumulative exposure vs current job; explain with timeline and duties.

Question 23

Can QME apportion to obesity?

Answer 23

Yes, if documented obesity directly contributes to impairment (e.g., weight-bearing joint degeneration).

Question 24

Pitfall: apportioning to risk factors like family history.

Answer 24

Invalid — family history alone doesn’t prove pathology or disability contribution.

Question 25

Why describe mechanism of injury in apportionment?

Answer 25

Links work duties to PD and clarifies why part is industrial vs other causes.