module 9 part 5

Question 2

What is the apportionment rule for presumptive injuries?

Answer 2

Presumption affects causation, but PD apportionment to non-industrial factors is still required if supported.

Question 3

Mnemonic for apportionment

Answer 3

“PRESUME CAUSE, STILL SPLIT PD.”

Question 4

Why must QME document pre-existing conditions under presumption?

Answer 4

To allow valid apportionment even if causation is presumed.

Question 5

Can lifestyle risks lower PD?

Answer 5

Yes — smoking, obesity, family history may reduce permanent disability portion even under presumption.

Question 6

How does presumption affect TD?

Answer 6

If presumption applies, TD is usually granted unless employer proves non-industrial cause of disability.

Question 7

Why do presumptions reduce litigation time?

Answer 7

They shift the burden, so employers often settle sooner if rebuttal is weak.

Question 8

What is the 90-day denial rule?

Answer 8

If employer fails to deny claim within 90 days, injury is presumed accepted.

Question 9

Does 90-day rule apply to psych?

Answer 9

Yes, if employer misses deadline, claim presumed compensable (unless clear fraud).

Question 10

Mnemonic for 90-day rule

Answer 10

“90 = AUTO OK.”

Question 11

How are seasonal/volunteer firefighters treated?

Answer 11

Many presumption statutes extend to volunteer/reserve firefighters if they meet service criteria.

Question 12

What is the occupational disease presumption?

Answer 12

Some diseases (e.g., lung, cancer) presumed from chronic exposures tied to job class.

Question 13

Can presumptions be rebutted with epidemiology?

Answer 13

Yes — employers sometimes use population studies to argue no increased risk in job.

Question 14

Why is individual medical history stronger?

Answer 14

Specific risk factors (smoking, genetics) often outweigh population stats in rebuttal.

Question 15

What is the dual employment issue?

Answer 15

If employee works 2 jobs, presumption applies only to qualifying job (e.g., firefighting).

Question 16

Why should QME know dual job info?

Answer 16

Needed to assign causation/PD to correct employer and exposure.

Question 17

Are presumptions portable between agencies?

Answer 17

Generally yes — if worker changes departments but stays in qualifying role, service time may stack.

Question 18

What is the cumulative service rule?

Answer 18

Service time in similar qualifying roles can add up to meet minimum employment requirement.

Question 19

Mnemonic for service

Answer 19

“STACK TIME.”

Question 20

Why must QME confirm exact employment dates?

Answer 20

Determines if statutory service/time windows are met.

Question 21

How do presumptions interact with MMI?

Answer 21

Presumption helps prove work-causation, but MMI still required for PD rating.

Question 22

Can a presumption be lost?

Answer 22

Yes — if worker fails to meet filing deadlines or doesn’t prove qualifying employment.

Question 23

How do statutes define “injury date” for presumptions?

Answer 23

Usually date of disability or first treatment, not first exposure.

Question 24

Mnemonic for injury date

Answer 24

“DIS DATE.”

Question 25

Why do statutes specify “last day worked”?

Answer 25

Used to count post-employment presumption windows (e.g., cancer 10 yrs after last day).

Question 26

Can employer surveillance rebut presumption?

Answer 26

Only if it provides strong evidence of **non-industrial cause** or fraud.

Question 27

How do presumptions affect subrogation?

Answer 27

Employer may still pursue third-party recovery if outside party caused exposure.

Question 28

Why are presumptions updated frequently?

Answer 28

New science/policy (e.g., COVID) and lobbying by safety groups expand coverage.

Question 29

QME’s best practice when unsure about presumption?

Answer 29

State uncertainty, describe facts, and **cite statute** for judge/DEU to decide.