module 6 part 6

Question 1

How should QME handle multiple body parts?

Answer 1

Analyze and apportion each body part separately; don’t lump unrelated regions together.

Question 2

Mnemonic for multi-part apportionment

Answer 2

“MAP” — Multiple Areas, Percentages each.

Question 3

What if prior impairment was rated under old schedule?

Answer 3

Still consider it; explain functional overlap and convert if needed for clarity.

Question 4

Can QME apportion to hereditary disorders?

Answer 4

Yes, if disorder is active and contributes to PD; not if only family history without impairment.

Question 5

Example: Scoliosis present pre-injury.

Answer 5

QME may apportion % to scoliosis if imaging and functional limits existed before work injury.

Question 6

Why cite literature or guidelines?

Answer 6

Strengthens medical reasoning and supports defensibility in litigation.

Question 7

Mnemonic for literature use

Answer 7

“CITE” — Cite, Interpret, Tie to evidence, Explain impact.

Question 8

When to issue supplemental report?

Answer 8

If new records or test results alter apportionment opinion; QME should update with reasoning.

Question 9

What is apportionment to pathology vs disability?

Answer 9

Must apportion to disability (functional loss), not just presence of disease without impairment.

Question 10

Pitfall: apportioning to imaging only.

Answer 10

Invalid if no functional impairment; radiographic changes alone don’t justify % PD.

Question 11

Why clarify industrial vs non-industrial pathology?

Answer 11

Prevents confusion and supports accurate % assignment for each contributing factor.

Question 12

Can QME apportion to illegal activity (e.g., drug abuse)?

Answer 12

Yes, if medically documented as contributing to PD (e.g., liver disease from substance use).

Question 13

Mnemonic for final report checklist

Answer 13

“CLEAR MAP” — Causation, Logic, Evidence, Apportion %, Records, Multiple areas, Apply percentages.

Question 14

How to discuss medical probability?

Answer 14

State opinion is within reasonable medical probability; required legal standard.

Question 15

What if patient disagrees with apportionment?

Answer 15

QME explains rationale; WCAB ultimately decides weight of evidence.

Question 16

How can QME defend against cross-exam?

Answer 16

Stick to documented facts, cite records/imaging, explain methodology clearly.

Question 17

Example: Hip OA + work injury.

Answer 17

QME might assign 50% to long-standing OA, 50% to industrial trauma if both contribute to PD.

Question 18

Why describe job physical demands?

Answer 18

Connects or disconnects work tasks to current PD and supports allocation.

Question 19

Can future surgeries affect apportionment?

Answer 19

No — apportionment is based on current PD at MMI, not speculative future changes.

Question 20

Mnemonic for apportionment precision

Answer 20

“SMART” — Specific, Measurable, Apportion %, Rationale, Tied to evidence.

Question 21

How does apportionment affect PD benefit calculation?

Answer 21

Reduces the industrial % used to compute monetary benefits; worker is paid only for industrial portion.

Question 22

What if QME fails to apportion when indicated?

Answer 22

WCAB may assume 100% industrial and award full PD against employer.

Question 23

Can apportionment be zero?

Answer 23

Yes, if no credible non-industrial contribution is found.

Question 24

What should QME say when prior % unknown?

Answer 24

Provide best estimate with rationale: “In my medical opinion, 30% is due to prior degeneration…” etc.

Question 25

Why should QME summarize key evidence?

Answer 25

Helps WCAB and attorneys follow logic and accept % allocation without challenge.

Question 26

Mnemonic for overall apportionment mastery

Answer 26

“APPLY” — Assess history, Pathology, Percentages, Link logic, Yield clear report.