QME EXAM Actual Exam 2026/2027 Complete Questions
and Correct Detailed Answers | Verified Answers Already
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Section 1: The Qualified Medical Evaluator (QME) Role & Responsibilities
(Questions 1-50)
1. What is the primary role of a Qualified Medical Evaluator (QME) in the
California workers' compensation system?
A) To treat injured workers
B) To provide an objective, unbiased medical-legal opinion on disputed
medical issues
C) To advocate for the injured worker
D) To advocate for the employer/carrier
Answer: B – The QME is a neutral, independent medical evaluator who
provides an objective medical-legal opinion to resolve disputes in the
California workers' compensation system. QMEs do not treat patients (A)
and are not advocates for either party (C, D).
2. Who administers the QME program in California?
A) California Medical Board
B) California Department of Industrial Relations (DIR)
C) Division of Workers' Compensation (DWC) - Medical Unit
D) Workers' Compensation Appeals Board (WCAB)
,Answer: C – The DWC Medical Unit (part of the Division of Workers'
Compensation) administers the QME program, including certification,
regulation, and discipline of QMEs.
3. How often must a QME renew their certification in California?
A) Every year
B) Every 2 years
C) Every 3 years
D) Every 5 years
Answer: B – QME certification must be renewed every 2 years. Renewal
requires completion of continuing education (including ethics) and payment
of renewal fees.
4. Which of the following is a disqualifying factor for QME certification?
A) Being licensed in another state
B) Having a prior malpractice claim
C) Having a felony conviction
D) Having a specialty board certification
Answer: C – A felony conviction is a disqualifying factor for QME
certification. Other disqualifiers include revocation of medical license,
certain misdemeanor convictions (e.g., fraud, dishonesty), and failure to
meet continuing education requirements.
5. What is the "ex parte" communication rule for QMEs?
A) QMEs may communicate with any party at any time
B) QMEs must avoid private communications with one party without the
other party's knowledge or presence
C) QMEs may only communicate with the injured worker
D) QMEs may only communicate with the attorney
,Answer: B – Ex parte communication refers to private communication
between the QME and one party (e.g., the defense attorney) without the
knowledge or presence of the other party. This is strictly prohibited to
maintain neutrality.
6. A QME receives a call from the defense attorney asking to discuss the case
without the applicant attorney present. The QME should:
A) Discuss the case with the attorney
B) Decline to discuss the case and inform the attorney that all
communication must be with both parties or through the DWC
C) Schedule a separate meeting with the applicant attorney first
D) Send a written response instead
Answer: B – Ex parte communication is prohibited. The QME must decline
and inform the attorney that all substantive communication must involve
both parties or occur through proper channels (e.g., DWC).
7. Which of the following is NOT a required component of a QME evaluation
report?
A) History of the injury or illness
B) Review of medical records
C) A treatment plan for the injured worker
D) An analysis of apportionment
Answer: C – The QME report is a medical-legal evaluation to resolve
disputes, not a treatment plan. Treatment is provided by the treating
physician, not the QME. Required components include history, records
review, physical examination, diagnosis, apportionment analysis, and
conclusions.
8. The QME report must be completed and submitted within how many days
after the evaluation?
, A) 15 days
B) 30 days
C) 45 days
D) 60 days
Answer: B – QME reports must be completed and submitted within 30 days
after the evaluation date. Extensions may be granted by the DWC Medical
Unit under certain circumstances.
9. Which of the following is a valid reason for a QME to withdraw from a
case?
A) The QME disagrees with the referring party
B) The QME has a conflict of interest that cannot be resolved
C) The QME is too busy to complete the report on time
D) The QME does not like the patient
Answer: B – A conflict of interest (e.g., prior treating relationship, financial
interest, personal relationship) is a valid reason to withdraw. Disagreement
with a party (A), workload (C), or personal dislike (D) are not valid reasons.
10. What is the maximum fee a QME can charge for an initial comprehensive
evaluation in California?
A) Determined by the QME based on complexity
B) Set by the DWC Medical Unit (subject to annual adjustment)
C) Negotiated between the QME and the referring party
D) Based on the AMA fee schedule
Answer: B – The DWC Medical Unit sets maximum allowable fees for QME
services. QMEs cannot charge more than the established fee schedule.
11. A QME is asked to provide a "supplemental report." What is the purpose
of this report?
and Correct Detailed Answers | Verified Answers Already
Graded A+ Brand New Version Complete California
Qualified Medical Evaluator Exam Prep with QME Practice
Test Pass Guaranteed - A+ Graded
Section 1: The Qualified Medical Evaluator (QME) Role & Responsibilities
(Questions 1-50)
1. What is the primary role of a Qualified Medical Evaluator (QME) in the
California workers' compensation system?
A) To treat injured workers
B) To provide an objective, unbiased medical-legal opinion on disputed
medical issues
C) To advocate for the injured worker
D) To advocate for the employer/carrier
Answer: B – The QME is a neutral, independent medical evaluator who
provides an objective medical-legal opinion to resolve disputes in the
California workers' compensation system. QMEs do not treat patients (A)
and are not advocates for either party (C, D).
2. Who administers the QME program in California?
A) California Medical Board
B) California Department of Industrial Relations (DIR)
C) Division of Workers' Compensation (DWC) - Medical Unit
D) Workers' Compensation Appeals Board (WCAB)
,Answer: C – The DWC Medical Unit (part of the Division of Workers'
Compensation) administers the QME program, including certification,
regulation, and discipline of QMEs.
3. How often must a QME renew their certification in California?
A) Every year
B) Every 2 years
C) Every 3 years
D) Every 5 years
Answer: B – QME certification must be renewed every 2 years. Renewal
requires completion of continuing education (including ethics) and payment
of renewal fees.
4. Which of the following is a disqualifying factor for QME certification?
A) Being licensed in another state
B) Having a prior malpractice claim
C) Having a felony conviction
D) Having a specialty board certification
Answer: C – A felony conviction is a disqualifying factor for QME
certification. Other disqualifiers include revocation of medical license,
certain misdemeanor convictions (e.g., fraud, dishonesty), and failure to
meet continuing education requirements.
5. What is the "ex parte" communication rule for QMEs?
A) QMEs may communicate with any party at any time
B) QMEs must avoid private communications with one party without the
other party's knowledge or presence
C) QMEs may only communicate with the injured worker
D) QMEs may only communicate with the attorney
,Answer: B – Ex parte communication refers to private communication
between the QME and one party (e.g., the defense attorney) without the
knowledge or presence of the other party. This is strictly prohibited to
maintain neutrality.
6. A QME receives a call from the defense attorney asking to discuss the case
without the applicant attorney present. The QME should:
A) Discuss the case with the attorney
B) Decline to discuss the case and inform the attorney that all
communication must be with both parties or through the DWC
C) Schedule a separate meeting with the applicant attorney first
D) Send a written response instead
Answer: B – Ex parte communication is prohibited. The QME must decline
and inform the attorney that all substantive communication must involve
both parties or occur through proper channels (e.g., DWC).
7. Which of the following is NOT a required component of a QME evaluation
report?
A) History of the injury or illness
B) Review of medical records
C) A treatment plan for the injured worker
D) An analysis of apportionment
Answer: C – The QME report is a medical-legal evaluation to resolve
disputes, not a treatment plan. Treatment is provided by the treating
physician, not the QME. Required components include history, records
review, physical examination, diagnosis, apportionment analysis, and
conclusions.
8. The QME report must be completed and submitted within how many days
after the evaluation?
, A) 15 days
B) 30 days
C) 45 days
D) 60 days
Answer: B – QME reports must be completed and submitted within 30 days
after the evaluation date. Extensions may be granted by the DWC Medical
Unit under certain circumstances.
9. Which of the following is a valid reason for a QME to withdraw from a
case?
A) The QME disagrees with the referring party
B) The QME has a conflict of interest that cannot be resolved
C) The QME is too busy to complete the report on time
D) The QME does not like the patient
Answer: B – A conflict of interest (e.g., prior treating relationship, financial
interest, personal relationship) is a valid reason to withdraw. Disagreement
with a party (A), workload (C), or personal dislike (D) are not valid reasons.
10. What is the maximum fee a QME can charge for an initial comprehensive
evaluation in California?
A) Determined by the QME based on complexity
B) Set by the DWC Medical Unit (subject to annual adjustment)
C) Negotiated between the QME and the referring party
D) Based on the AMA fee schedule
Answer: B – The DWC Medical Unit sets maximum allowable fees for QME
services. QMEs cannot charge more than the established fee schedule.
11. A QME is asked to provide a "supplemental report." What is the purpose
of this report?
