module 8 part 3

Question 1

Question Answer

Question 2

What is the role of the psychiatric QME vs other QMEs? Psychiatric QMEs specialize in mental health evaluation and are required when psych injury is alleged or needs rating.

Question 3

How is credibility assessed in psych claims? Through consistency of history

Answer 3

mental status exam

Question 4

Are psychological tests required? Not mandatory but can help support diagnosis (e.g.

Answer 4

MMPI-2

Question 5

Mnemonic for psych testing use “TEST” — Tests Enhance Supportive Truth.

Question 6

How should malingering be evaluated? Use validity testing

Answer 6

collateral records

Question 7

What is the importance of timeline analysis? Establishes whether workplace events preceded or exacerbated the disorder versus pre-existing personal issues.

Question 8

Why include social history? Shows baseline stressors

Answer 8

family dynamics

Question 9

How are PTSD claims typically supported? Clear traumatic workplace event

Answer 9

DSM-5 PTSD criteria met

Question 10

Mnemonic for PTSD eval “TRAUMA” — Traumatic event

Answer 10

Re-experiencing

Question 11

What is a common employer defense for PTSD claims? Event not extraordinary (ordinary work stress) or GFPA (lawful personnel action caused distress).

Question 12

How to evaluate depression from injury? Confirm temporal onset

Answer 12

impact of pain/disability

Question 13

What is “psychiatric add-on” after physical injury? A secondary psych claim for PD benefits due to chronic pain/disability from accepted physical injury.

Question 14

What law restricts psych add-on after 2013? SB 863 — limits psych add-on PD for post-1/1/13 dates unless caused by violent act or catastrophic injury.

Question 15

Mnemonic for SB 863 “863 = Less Psych PD.”

Question 16

Catastrophic injury examples for SB 863 exception? Severe burns

Answer 16

amputations

Question 17

Why is SB 863 important for QMEs? Limits PD increase for post-2013 secondary psych claims; QME must know if exception applies.

Question 18

How to document harassment/discrimination claims? Detail specific incidents

Answer 18

frequency

Question 19

What is the “predominant cause” analysis step? Weigh all industrial vs non-industrial causes and determine if work events meet 51% (or 35% violent) threshold.

Question 20

Mnemonic for cause analysis “WANE” — Work vs All Non-Employment.

Question 21

Why are personnel file reviews critical? Document prior performance issues

Answer 21

discipline

Question 22

How to address pre-existing psychiatric history? Identify baseline diagnosis/function and whether work aggravated or created new disability beyond baseline.

Question 23

What is GAF scoring range for PD? 0–100: lower scores = greater impairment; typically 50 or below indicates serious impairment.

Question 24

Why must QME explain GAF score choice? WCAB requires rationale (symptoms

Answer 24

ADL impact

Question 25

How are ADLs tied to psych PD? Greater ADL limitation = higher WPI/PD; must describe self-care

Answer 25

social

Question 26

Mnemonic for ADLs in psych eval “SECS” — Self-care

Answer 26

Employment

Question 27

Why is clear DSM-5 diagnosis necessary? Legal standard requires recognized diagnosis; vague stress or burnout without DSM code won’t qualify.