module 7 part 2

Question 1

What is Maximum Medical Improvement (MMI)?

Answer 1

The point where a condition is stable and unlikely to change substantially with further treatment; required before PD/WPI rating.

Question 2

Mnemonic for MMI

Answer 2

“Stable = Rateable.”

Question 3

Why must PD be rated only after MMI?

Answer 3

Before MMI, impairment may still change, making any rating inaccurate.

Question 4

What is the Disability Evaluation Unit (DEU)?

Answer 4

A division of the DWC that reviews QME reports and calculates official PD ratings.

Question 5

Can the WCAB judge adjust PD ratings?

Answer 5

Yes, judges can accept or adjust ratings based on evidence if DEU rating is disputed.

Question 6

What are body part codes in rating?

Answer 6

Numeric codes used by DEU to classify injured body regions for conversion.

Question 7

Mnemonic for body part coding

Answer 7

“CODES” — Categorize, Organize, Define, Evaluate, Schedule.

Question 8

What is loss of pre-injury earning capacity?

Answer 8

A key principle behind PD ratings — impairment is tied to expected loss of earnings.

Question 9

How is bilateral impairment handled?

Answer 9

Combine WPI for both sides using the Combined Values Chart (CVC) before conversion to PD.

Question 10

Mnemonic for bilateral calculation

Answer 10

“BOTH” — Both sides combine first.

Question 11

What is the Combined Values Chart (CVC)?

Answer 11

AMA Guides tool to combine multiple impairments without simply adding percentages.

Question 12

Example: 10% WPI hand + 10% WPI arm.

Answer 12

Combined ≈ 19% WPI (not 20%), then convert to PD.

Question 13

What is add-on for pain limit?

Answer 13

Up to 3% WPI per AMA Guides if pain increases functional loss.

Question 14

What are Almaraz/Guzman cases?

Answer 14

Case law allowing physicians to use alternative AMA Guides chapters/methods if strict Guides rating is inaccurate.

Question 15

Mnemonic for Almaraz/Guzman

Answer 15

“AG = Alternative Guides.”

Question 16

What must QME explain when using Almaraz/Guzman?

Answer 16

Why the standard AMA Guides rating is inaccurate and how alternative method better reflects impairment.

Question 17

What is a rebuttal rating?

Answer 17

A challenge to standard rating based on evidence that DFEC or AMA Guides doesn’t reflect actual disability.

Question 18

Can QMEs adjust DFEC factor?

Answer 18

No — DFEC is statutory; QME only provides WPI and medical evidence.

Question 19

How are psychiatric PD ratings handled?

Answer 19

Use GAF (Global Assessment of Functioning) per CA guides and convert to WPI then PD.

Question 20

Mnemonic for psych rating

Answer 20

“GAF → WPI → PD.”

Question 21

What is PD indemnity?

Answer 21

Monetary compensation paid for industrially caused permanent disability after rating is finalized.

Question 22

Why is accuracy critical in WPI reporting?

Answer 22

Small errors can significantly change PD %, affecting monetary award and legal disputes.

Question 23

Can subjective complaints alone justify WPI?

Answer 23

No — must be supported by objective findings or clearly explained under AMA Guides criteria.

Question 24

What are standard vs adjusted PD again?

Answer 24

Standard PD = WPI × DFEC; Adjusted PD = adds age/occupation modifiers.

Question 25

What is the 2005 PDRS occupational group number?

Answer 25

A number assigned to each job type to reflect its physical demands; used to adjust PD.

Question 26

Mnemonic for occupational adjustment

Answer 26

“JOB#” — Job number drives PD shift.