Glossary of chronology sample terms
Answer in brief: short definitions of the terms the samples use, grouped by where you meet them. Each one says what the term means in a chronology, not its full legal or clinical meaning.
Limits: Every sample here is synthetic: no real patient, invented names and invented page numbers. Rules quoted for QME and Social Security work come from the cited regulation, read 2026-11-12; they are not legal advice, and facts about other sample libraries come from each publisher's page on that date.
Terms about samples
- Synthetic file
- An invented record file: made-up patient, providers, dates and page numbers. Every sample on this site is built on one. No real record was used or de-identified.
- Annotation
- A numbered note under a sample table that explains why a row was written the way it was. Annotations are about method; they are never part of the chronology itself.
- Pin cite
- A citation to the exact page or page range that holds a fact, as opposed to a citation to a whole document. Every row in the samples carries one.
- Records-reviewed list
- A list of every source in the file with its page range and page count, plus what was set aside. In California QME work it supports the page count the physician verifies.
Terms for exam and claim work
- IME
- Independent medical examination: an exam and records review by a physician who is not treating the person, requested by an insurer, employer or other party.
- QME
- Qualified medical evaluator: a physician certified by the California Division of Workers' Compensation to perform medical-legal evaluations in disputed claims.
- Referral question
- A question the requesting party asks the examiner to answer, such as causation or need for further care. The IME sample tags every row to 1 or more of them.
- Apportionment
- In California comp, the physician's finding of what approximate share of permanent disability came from the work injury and what from other factors (Labor Code 4663). The QME sample tags rows the evaluator may weigh.
- MMI
- Maximum medical improvement: the point at which a condition is not expected to change much with further treatment. California uses "permanent and stationary" for a similar point.
- Work status
- What a treating record says about work on a date: off work, modified duty with listed restrictions, full duty, or permanent restrictions.
- BAA
- Business associate agreement: the HIPAA contract a vendor signs before handling protected health information for a covered entity or its business associate.
Terms for disability work
- Alleged onset date
- The date a Social Security claimant says the disability began. The disability sample counts months from it on every row.
- RFC
- Residual functional capacity: the most a person can still do despite their limits, as assessed in a Social Security claim. Medical source statements and exam findings feed into it.
Terms for review and planning work
- Late entry
- A note signed or filed well after the event it describes. The med mal sample shows both the event time and the signing time.
- Future care item
- A service, supply, device, medication or visit a life care plan projects. The life care plan sample ties each one to the note that recommends it.