Impairment-Focused QME Reappointment Program

 According to the AMA Guides, 5th Edition, providing an accurate a spinal impairment rating involves utilizing one of two rating methods:  the Range of Motion (ROM) method or the Diagnosis-Related Estimates (DRE) method.  Although these methods appear to be straight-forward to use, we must remember and be aware of many important facts and issues before rating an Applicant for spinal impairment.  In this presentation, we will take an in-depth look at the DRE method as we explore the rationale for its use and many examples as they apply when providing a correct spinal impairment rating. 

 Providing an accurate spinal impairment rating using the Diagnosis-Related Estimate Method can involve more than just throwing an Applicant into a DRE category and calling it a day. There is much more to it than that…  Together, we explore the DRE categories to understand their similarities and differences between the spinal regions.  We also cover several examples of accurate placement of the individual into the appropriate category for spinal impairment rating purposes. 

 Join us as we delve into the nuances of pain impairment assessment and its relationship with functionality. Contrary to popular belief, if pain does not significantly interfere with an individual's ability to carry out common activities of daily living, it may not qualify for a 1%, 2%, or 3% increase in whole person impairment - according to Chapter 18 of the AMA Guides.  Learn how to resolve the dilemmas surrounding pain-related impairment evaluation. Our live video session is designed to empower Qualified Medical Evaluators with the knowledge and tools needed to make accurate and fair assessments. 

 In this Live ZOOMinar sponsored by SullivanonComp, well known and highly respected QME Steve Feinberg M.D. joins us to explain exactly HOW to incorporate alternative impairment ratings into your final conclusions for an accurate description of the examinee's actual impairment, and loss of function for activities of daily living.  Here, we review actual examples of alternative impairment ratings for 1) headaches, 2) upper extremity, and 3) lower extremity and, we explain how to support your opinion for an alternative impairment rating with substantial medical evidence. 

 When it comes to providing an accurate Permanent Impairment opinion - and especially when adding Impairments (versus combining Impairments under the Combined Values Chart), your argument must must must constitute substantial medical evidence.  This is easy to do and in this Live Video, we review how and when you can use simple addition to sum total your examinee's multiple Impairments. 

 Now almost 10 years after the famous Kite decision, it seems as if the Courts have definitively decided on what exactly qualifies as "substantial medical evidence" to support a medical opinion for adding - versus combining - multiple Impairments.    In this Live Video, learn how recent case law reveals a simple 3 step formula that allows you to irrefutably reach the higher Impairment values, and avoid the compressive, reductive effect of the Combined Values Chart (CVC) by adding - versus combining - the Impairments. 

 California Code of Regulations 10682 and the 2016 Physician's Guide give us reference to what must be included in the QME Report.  We also get some direction from the AMA Guides for those cases that involve a Permanent Impairment evaluation.  In Today's session, we begin Session #1 of "The Anatomy of a Good Report" by beginning at the beginning of the Report and going through it section by section to see how the Report is constructed, according to the rules.  In this Session, we review the INTRODUCTION, OPENING STATEMENT, HISTORY, RELEVANT MEDICAL HISTORY, and REVIEW OF RECORDS sections of the Report. 

 This is Session #3 of the topic "The Anatomy of a Good Report."  In this Session, we conclude our review of the high quality QME Report by reviewing CAUSATION, PERMANENT & STATIONARY, PERMANENT IMPAIRMENT, APPORTIONMENT, FUTURE MEDICAL CARE, and WORK STATUS sections of the Report. 

 Black and Hispanic workers suffer frequent industrial injury because these groups are disproportionately represented in high injury risk occupations - such as construction labor.  However, statistics indicate that these groups of injured workers received fewer workers compensation disability benefits than their white colleagues in the same industry for the same severity of injury.  Here we receive two actual workers compensation studies that reveal that racial bias results in inaccurate monetary benefits for minority injured workers. 

 The first domino falls in the war against bias in the medical legal evaluation with the recent passage of SB 788 but then, strangely, it was vetoed by Governor Newsome.  Now, the burden for eliminating bias to prohibit Apportionment to race, religious creed, color, national origin, gender, marital status, sex, sexual identity, or sexual orientation falls squarely on the shoulders of the DWC.  In Todays Live Video, we review the good intentions of SB 788 as well as two actual cases that involved 1) gender discrimination, and 2) national origin discrimination. 

 Recent case law gives us as Qualified Medical Evaluators tremendous authority in rendering opinions and conclusions on our examinees.  History supports even preposterious opinions as long as those opinions qualify as "substantial medical evidence."  Here we briefly review 5 cases that demonstrate the QME's omnipotence, and, how decisions are handled when an opinion is, or is NOT "substantial." 

 QME's CANNOT just throw out opinions and conclusions as if God has spoken.  No - nowadays, there has to be some "substance" behind the opinion.  There have to be relevant facts that support your reasoning.  In today's Live Video, we review 3 actual cases.  In 2 of the cases, the QME failed to qualify his/her opinions as "substantial medical evidence" and, as a result, the WCAB ruled HEAVILY in favor of the defense.  In the 3rd case, the QME got it right and the Applicant came away with a BIG WIN under Almarez/Guzman.