module 6 part 5

Question 1

How does work restrictions history support apportionment?

Answer 1

Prior documented restrictions show pre-existing impairment contributing to current PD.

Question 2

What is vocational apportionment?

Answer 2

Evaluating how much pre-existing limitations affected earning capacity before the work injury.

Question 3

Mnemonic for vocational apportionment

Answer 3

“JOB” — Job limits, Old restrictions, Baseline earnings.

Question 4

When is vocational apportionment useful?

Answer 4

When a worker had documented job limits or reduced earnings from prior conditions before current injury.

Question 5

Can QME apportion to prior non-industrial settlement?

Answer 5

Yes — if records show PD from that settlement affects current impairment.

Question 6

Why review old imaging?

Answer 6

Confirms degenerative changes or prior trauma existed before current injury to support apportionment.

Question 7

How should QME document mechanism of aggravation?

Answer 7

Describe exactly how work activities worsened or accelerated the pre-existing condition.

Question 8

Example: Prior ACL tear + new knee twist.

Answer 8

QME might apportion 40% to pre-existing ACL injury, 60% to new work trauma.

Question 9

Why must QME avoid conclusory language?

Answer 9

Phrases like “likely non-industrial” without explanation are insufficient and legally weak.

Question 10

Mnemonic for avoiding conclusory reports

Answer 10

“SHOW” — Show How & Why.

Question 11

Can QME apportion to symptom flare-ups?

Answer 11

No — temporary symptom increase without permanent impairment isn’t apportionable.

Question 12

What is combination injury?

Answer 12

Two or more injuries blend to create single impairment; QME must still try to separate % if possible.

Question 13

What if combination can’t be separated?

Answer 13

WCAB may treat as 100% industrial if physician can’t reasonably divide PD.

Question 14

Why is timeline of care critical?

Answer 14

Shows pre-existing impairment level before new injury and aids in assigning % apportionment.

Question 15

How to handle post-termination claims?

Answer 15

Determine if PD existed before termination; still apportion if pre-existing.

Question 16

Mnemonic for timeline analysis

Answer 16

“DATE” — Documentation, Activities, Treatment, Events.

Question 17

When can QME apportion to personal activities?

Answer 17

If documented non-work activity (e.g., sports injury) directly caused part of the impairment.

Question 18

Can lifestyle factors like obesity be apportioned?

Answer 18

Yes — if medically documented as contributing to PD (e.g., weight-bearing joint damage).

Question 19

Pitfall: apportioning to BMI alone.

Answer 19

Invalid — must link obesity to actual pathology contributing to PD.

Question 20

Why must QME explain natural disease progression?

Answer 20

Needed to justify non-industrial % and avoid speculation.

Question 21

Example: Lumbar degeneration expected to worsen 10%/yr.

Answer 21

QME can apportion if shows current PD partly from pre-injury degeneration documented by imaging.

Question 22

Can QME apportion to psychiatric pre-disposition?

Answer 22

Only if there’s a pre-existing psychiatric diagnosis impacting current PD.

Question 23

Why describe objective vs subjective findings?

Answer 23

Supports credibility of apportionment and avoids overreliance on patient complaints.

Question 24

Mnemonic for strong evidence base

Answer 24

“ROSIE” — Records, Objective signs, Studies, Imaging, Exam.

Question 25

What if apportionment differs between experts?

Answer 25

WCAB weighs reasoning; the most thorough, well-supported opinion is usually adopted.

Question 26

Why include work duty analysis?

Answer 26

Connects or disconnects industrial activities to current impairment, supporting % allocation.