Top 5 Articles of 2016

From how to use an inclinometer correctly to understanding why a panel QME gets involved in a work injury, read up on the best workers’ compensation content of the past year.

  1. What’s A QME?
  2. Muscle Atrophy
  3.  Exacerbation vs. Aggravation
  4. Activities of Daily Living
  5. How to use an Inclinometer

Do you have a workers’ compensation topic you’d like to see covered? Email us and we’ll put our best people on it!

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Automated Impairment Rating: The Science Behind RateFast

RateFast automates the impairment rating process, giving providers and injured workers the ability to generate accurate analyses of occupational injuries based on the AMA Guides to Impairment Rating.

But how is it done?

Listen to the podcast or keep reading to discover how CPA Josh Moore applies knowledge from accounting to the development of the RateFast impairment rating system.

Continue reading Automated Impairment Rating: The Science Behind RateFast

Playing the Game of Chicken in Workers’ Comp

The price that grocery stores pay for chicken is based on a particular index. This Washington Post article reveals how our entire nation agrees to pay the price of chicken based on this index. The newsworthy claim of the article is that if we really look at the open market, the stores are paying a price for chicken that is completely arbitrary, rather than the correct or natural price of chicken.

This is problematic not only for the consumer but for the industry as a whole.

As fascinating as this is, why are we discussing this on our workers’ compensation blog? What are the implications of this concept for work comp in California? Read on to find out.


Chicken” by Thomas Vlerick is licensed under CC BY 2.0


Continue reading Playing the Game of Chicken in Workers’ Comp

The Art of the Qualified Medical Exam

A QME is a medical professional who is credentialed by the state to perform qualified medical examinations required for certain workers’ compensation cases. For a more detailed look at what a QME is, take a look at this article.

Recently on the RateFast Work Comp Report podcast we interviewed Dr. Nissen about being a Qualified Medical Examiner (QME). Dr. Nissen discussed what he called “the art of the QME”—a skillset that involves using creativity and critical thinking to overcome several unique challenges.

A few of these challenges are described below.

Understanding the American Medical Association Guide to Impairment Rating and Evaluation.

Using the huge tome commonly known as the AMA Guides demands a depth-of-knowledge that few physicians take the time to develop. In order to serve as an effective impartial examiner, the QME is responsible for knowing the Guides back-to-front. This knowledge directly informs all other aspects of QME’s work with the claim, from performing the physical exam to determining impairment.

Assessing previous medical charts.

Medical charts for a single patient are often hundreds of pages long, and the ability to review them for relevant information takes practice, insight, and real-time analysis.

Performing an accurate physical evaluation.

The QME evaluates the patient according to the Guides, reviewing all thirty-four activities of daily living, and taking repeated measurements depending on the type of injury. A correct evaluation requires extensive knowledge of the Guides and rigorous attention to detail.

Creating a precise and correct impairment rating.

All of the relevant medical charts and all new information generated by the QME’s physical exam must be collected into the QME’s report. This data must be accurate; after all, the QME’s role is to bring objectivity to the claim, so reproducibility of results is key.


Dr. Nissen argues that in order for QME reports to truly benefit injured workers, physicians need a system for collecting consistent data. Accurate and meaningful data results in less legation, and ultimately the speedy close of the workers’ compensation claim.

Fortunately, such a system has been developed. RateFast is a total workers’ compensation solution that helps providers perform perfect exams, document patient medical histories, format and organize reports, and determine impairment ratings according to the AMA Guides. We urge medical providers, QMEs, and anyone who is interested in improving workers’ compensation to join RateFast for free.

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How Telemedicine Benefits Injured Workers

This is a post for medical providers, employers, and employees who are interested in understanding how telemedicine can improve workers’ compensation in California.

Doctor working on a digital tablet

When it comes to workers’ compensation, who benefits from telemedicine? The short answer: everybody. But the gains will be immediately apparent to the injured worker.

First, let’s think about how an injured worker currently experiences the workers’ compensation process.
Continue reading How Telemedicine Benefits Injured Workers

The Eagle Has Landed. Its name is RateFast!

California workers’  compensation care delivery technology history was made by a partnership between Alchemy Logic System Inc., dba RateFast (Santa Rosa, CA) and KuraMD (Roseville, CA).

Santa Rosa, CA, October 11, 2016 at 4:38 p.m.pst

Dr. John Alchemy, MD, QME successfully connected to an injured worker for a PR-2 visit using the HIPAA secure environment of KuraMD telemedicine platform. A complete history and physical exam was performed, followed by the creation of a legally compliant PR-2 report and an MRI request for authorization (RFA) written on using only the Apple iPhone 6+ device. The iPhone was being simultaneously charged by a 2013 Tesla Model S 85 Kwh battery. This landmark event is the first documented instance of 100% mobile delivery of care to an injured worker.

Dr. Alchemy was later quoted saying, “I just never gave up hope. RateFast has already disrupted the category of workers’ compensation report writing and injury mapping. Now with KuraMD that delivery channel is totally mobile. Effective delivery of work comp care in California has just been turned on 24/7, anywhere, anytime-and it’s in your pocket now.”

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Is incomplete data affecting the accuracy of your impairment rating?

This article is for medical providers, insurance adjusters, attorneys, and injured workers who want to understand common causes of inaccurate impairment ratings.

Correct impairment ratings save time and money for all stakeholders; they result in correct apportionment for subsequent claims, and allow predictable trends and costs for data analysis and work risk assessment. Of course, the inverse is also true: inaccurate impairment ratings cause claims to consume the time and resources of everybody involved.

One of the best things you can do to check the accuracy of an impairment rating is to make sure that you’re working with a complete data set. In other words, make sure that the provider—or whoever is doing the impairment rating—has all the necessary information.

A complete data set supports an accurate rating, which decreases the risk that the rating will be contested, which means a faster, easier workers compensation claim for all parties.

So why don’t all workers’ compensation claims have complete data? Here are three common circumstances that lead to incomplete data sets:

  1. Sometimes the required information is not obvious. This is especially common in cases involving the spine with patient symptoms such as radiculopathy.
  2. The importance of some data about the injury isn’t always clear to medical providers, so they don’t ask the necessary questions or take the necessary measurements. For example, if an employee has injured her left shoulder, then the provider might not ask detailed questions about the pre-existing history of the right shoulder. However, for upper extremity injuries, the history of the uninjured side of the body can actually affect the impairment rating of the injured body part.
  3. A stakeholder might omit data in order to intentionally increase or decrease the impairment rating. This is considered fraud by the state of California, which you can read more about here.

Let’s look at an example. A twenty-year-old old delivery driver has a back injury. When she reaches maximal medical improvement, a provider examines her. She is pain free and takes no medication, has no problems with her activities of daily living, and takes no medications. It seems as though her injury has not impacted the employee at all, and so the provider concludes that there are no ratable findings. The provider skips the medical history and assigns the patient a 0% whole person impairment. Is this correct?

No. The rating assessment was incomplete. If the provider had taken the full history, then they might have discovered that the patient had L3 dermatomal sensory loss directly after the injury, with imaging showing a concordant herniated disk at that level. Although there were no ratable findings at the time of the final exam, the AMA Guides 5th edition mandates a 5% whole person impairment because she had radiculopathy, even though it is now gone (Category II, Table 15-3, Page 384).

However, only providers who are intimately familiar with the AMA Guides will check for radiculopathy.

In summary, incomplete data are more common than you think. For this reason, we recommend using a tool such as RateFast to ensure that all the relevant questions are answered. Get your free account today.

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How to Update Your Credit Card in RateFast

Update for 2021: RateFast Express is an even easier alternative to the wonderful RateFast software. We write your workers’ comp impairment reports for you. Try RateFast Express today!

This post is for RateFast users who want to update their credit card information on RateFast. This article assumes that you already have an account with RateFast. Last updated September 12th, 2016. 

If you get a new credit card or if your old credit card expires, you will need to re-enter your credit card into RateFast.

Continue reading How to Update Your Credit Card in RateFast