What does 0% WPI really mean?  

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Whether you’re a medical provider, an injured worker, a claims adjuster, or an attorney, this article is relevant to you if you’ve encountered a 0% whole person impairment rating in a California PR-4 or QME report.

If you receive a report—or are writing a report—with 0% WPI (whole person impairment), this number should raise some flags.

Why?

Because, when it comes to the AMA Guides and impairment rating, a 0% WPI is a very special number.

If a report claims that a patient has 0% impairment, then it needs to meet some specific requirements. If it doesn’t meet those requirements, then the number is inaccurate—and as we all know, an inaccurate impairment rating can lead to unnecessary delay, litigation, and expense for all stakeholders.

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3 Critical Questions to Ask About your Qualified Medical Exam

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This is article is meant for injured workers’, medical providers, qualified medical examiners (QMEs), insurance adjusters, and other stakeholders in a California workers’ compensation claim.

When a medical condition has reached Maximal Medical Improvement (MMI), the QME (Qualified Medical Examiner) is required to perform an impairment rating exam.

The impairment exam consists of a series of detailed questions and measurements defined by California law and the American Medical Association (AMA) Guides, 5th Edition.

An accurate and correct impairment exam leads to faster settlement and delivery of benefits, whereas an incorrect exam leads to delay, confusion, and or costly litigation.

As a stakeholder in the system, here are three simple questions you should ask in order to determine the accuracy of your orthopedic medical exam.

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