Lungs/Respiratory QME Evaluation Guide
Pulmonary evaluations in workers' compensation address occupational asthma, COPD from toxic exposures, pneumoconioses (silicosis, asbestosis), and hypersensitivity pneumonitis. These claims are common in construction, mining, firefighting, and manufacturing. Evaluations rely heavily on pulmonary function testing and exposure history documentation.
0-65% WPI
Typical Impairment
$3,000-$5,000
QME Fee Range
#11
Frequency Rank
Evaluation Methods
- Pulmonary function testing (spirometry, DLCO)
- Chest imaging review
- Arterial blood gas analysis
- Exposure history assessment
- Exercise tolerance testing
Common Conditions
Chemical bronchitis
Mild intermittent asthma, uncomplicated
Pneumoconiosis due to asbestos and other mineral fibers
Pneumoconiosis due to other dust containing silica (silicosis)
Hypersensitivity pneumonitis due to unspecified organic dust
Specialties That Evaluate This Region
Related Body Parts
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Find Lungs/Respiratory Specialists →Frequently Asked Questions
How is the lungs/respiratory evaluated in a QME examination?
A QME evaluation of the lungs/respiratory follows the Chapter 5 — The Pulmonary System of the AMA Guides 5th Edition. Common evaluation methods include Pulmonary function testing (spirometry, DLCO), Chest imaging review, Arterial blood gas analysis. The physician assesses objective findings, reviews medical records, and determines permanent impairment using standardized criteria.
What impairment rating can I expect for a lungs/respiratory injury?
Typical whole person impairment ratings for lungs/respiratory injuries in California workers' compensation range from 0-65% WPI. The exact rating depends on objective findings, diagnosis severity, treatment history, and whether the DRE or ROM method is used.
What does a QME evaluation cost for lungs/respiratory injuries?
QME evaluation fees for lungs/respiratory injuries in California typically range from $3,000-$5,000 (2026 OMFS rates). Fees are set by the Division of Workers' Compensation fee schedule and may vary based on case complexity and whether supplemental reports are needed.
What conditions commonly affect the lungs/respiratory?
Common workers' compensation conditions involving the lungs/respiratory include Chemical bronchitis, Mild intermittent asthma, uncomplicated, Pneumoconiosis due to asbestos and other mineral fibers. These conditions are typically evaluated by Pulmonology or Occupational Medicine physicians.