Module3_Flashcards_Part2

Question 1

Front

Answer 1

Back

Question 2

What is the physician declaration required in all medical-legal reports?

Answer 2

A signed statement that the report is true, correct, and prepared in compliance with DWC regulations.

Question 3

What must the QME disclose about conflicts of interest?

Answer 3

Any financial, personal, or professional ties to parties that could bias the evaluation.

Question 4

What happens if a QME fails to disclose a conflict of interest?

Answer 4

Possible report invalidation and disciplinary action, including decertification.

Question 5

When must QME reports address return-to-work ability?

Answer 5

Always when injury may affect the worker’s ability to perform job duties.

Question 6

What is the time frame to object to the QME specialty?

Answer 6

10 days after receiving the panel list if represented; ASAP if unrepresented.

Question 7

What are common reasons for QME panel replacement?

Answer 7

Incorrect specialty, conflict of interest, QME unavailable within 60/90 days.

Question 8

What is the Panel QME strike process?

Answer 8

Each party may strike one doctor from the 3-name panel before selection.

Question 9

Who issues replacement QME panels?

Answer 9

The DWC Medical Unit.

Question 10

What is considered substantial cause under CA Labor Code 4663?

Answer 10

Work must contribute at least 35–40% to the disability or need for treatment.

Question 11

What must a QME include when recommending job retraining?

Answer 11

Whether permanent restrictions prevent return to prior job and require retraining.

Question 12

What are the penalties for late or inadequate QME reports?

Answer 12

Payment denial, DWC discipline, or decertification.

Question 13

How must QME serve their reports?

Answer 13

Send copies to all parties and DWC within required time limits.

Question 14

What is the timeline to deliver medical records to QME?

Answer 14

At least 20 days before the exam for represented parties.

Question 15

When may a QME request additional testing?

Answer 15

If medically necessary to form an accurate impairment opinion.

Question 16

What is the role of vocational experts in PD rating disputes?

Answer 16

They evaluate employability and earning capacity based on QME findings.

Question 17

What is the DEU rating formula?

Answer 17

Combines WPI%, age, occupation, and modifiers to calculate permanent disability %.

Question 18

What is the difference between apportionment and causation in reports?

Answer 18

Apportionment divides disability among causes; causation decides if work caused condition.

Question 19

What is an addendum vs. supplemental report?

Answer 19

Addendum = clarifies own prior report; Supplemental = responds to party request/new info.

Question 20

How must interpreters be handled in QME exams?

Answer 20

Must be certified/qualified; insurer usually pays for their services.

Question 21

What should QME do if interpreter is inaccurate?

Answer 21

Note it in report and request a qualified interpreter if needed.

Question 22

What is the rule on video/audio recording QME exams?

Answer 22

Generally prohibited without agreement or court order.

Question 23

What is the time frame for serving the QME report after exam?

Answer 23

30 days unless an approved extension is granted.

Question 24

What info must be included about job tasks?

Answer 24

Pre-injury duties, physical/mental demands, and ability to return to them.

Question 25

When must a QME comment on future medical care?

Answer 25

Whenever condition likely needs ongoing or preventive treatment.

Question 26

Who pays for copy services and record transmission to QME?

Answer 26

The employer/insurer as part of claim cost.

Question 27

When can a party depose a QME?

Answer 27

After the report issues, parties may depose for clarification under oath.

Question 28

What is required in QME physical exam documentation?

Answer 28

Objective measurements, reproducibility, and consistency with reported complaints.

Question 29

What happens if QME is unavailable >90 days?

Answer 29

Parties can request panel replacement.

Question 30

Who can review adequacy of QME reports?

Answer 30

Judges and the DWC Medical Unit.