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QME EXAM 2026/2027 ORIGINAL PRACTICE
SET: 200 QUESTIONS WITH ANSWERS &
RATIONALES
CALIFORNIA QUALIFIED MEDICAL
EVALUATOR | DWC MEDICAL UNIT | AMA
GUIDES 5TH EDITION
## DOMAIN 1: AMA GUIDES 5TH EDITION – IMPAIRMENT
RATING (Questions 1–40)
---
**1.** According to the AMA Guides 5th, impairment is defined as:
A) A loss of earning capacity due to injury
B) A deviation from normal health and function
C) A medical condition that prevents return to any work
D) A functional limitation requiring permanent accommodations
**Answer:** B
**Rationale:** AMA Guides 5th defines impairment as a significant
deviation, loss, or loss of use of a body function or structure, not loss of
earnings (which is disability). Page reference: Chapter 1, p. 2.
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---
**2.** The preferred method for rating upper extremity impairment is:
A) Diagnosis-based estimates
B) Range of motion model
C) Neurological deficit scoring
D) Grip strength dynamometry
**Answer:** A
**Rationale:** AMA Guides 5th emphasizes diagnosis-based
impairment (DBI) over ROM for upper extremities due to higher
reliability and validity. Chapter 15, p. 438.
---
**3.** A patient has a Grade 2 modifier for pain in a region already
rated. This will:
A) Double the impairment rating
B) Add 1% to 3% whole person impairment
C) Add 0% to 3% whole person impairment based on severity
D) Be ignored unless surgery occurred
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**Answer:** C
**Rationale:** Pain modifiers in Chapter 18 allow 0–3% WPI based on
documented pain frequency and intensity. Grade 2 = moderate pain,
typically +1-2% WPI.
---
**4.** The Combined Values Chart (CVC) is used to:
A) Convert hand impairment to whole person
B) Add multiple impairment ratings non-linearly
C) Subtract prior impairment from current
D) Calculate apportionment percentages
**Answer:** B
**Rationale:** CVC combines multiple WPI values using the formula A
+ B(1-A), accounting for decreasing marginal impact. Chapter 1, p. 13.
---
**5.** Lower extremity impairment is converted to whole person
impairment using a factor of:
A) 1.0 (no conversion needed)
B) 0.4 (40% of lower extremity value)
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C) 0.6 (60% of lower extremity value)
D) Varies by joint
**Answer:** B
**Rationale:** AMA Guides 5th Table 17-3: LE impairment % × 0.4 =
WPI. Example: 20% LE impairment = 8% WPI.
---
**6.** A patient has 15% upper extremity impairment. The whole
person impairment is:
A) 6%
B) 9%
C) 15%
D) 25%
**Answer:** B
**Rationale:** UE to WPI conversion factor is 0.6. 15% × 0.6 = 9%
WPI. Chapter 15, Table 15-9.
---
QME EXAM 2026/2027 ORIGINAL PRACTICE
SET: 200 QUESTIONS WITH ANSWERS &
RATIONALES
CALIFORNIA QUALIFIED MEDICAL
EVALUATOR | DWC MEDICAL UNIT | AMA
GUIDES 5TH EDITION
## DOMAIN 1: AMA GUIDES 5TH EDITION – IMPAIRMENT
RATING (Questions 1–40)
---
**1.** According to the AMA Guides 5th, impairment is defined as:
A) A loss of earning capacity due to injury
B) A deviation from normal health and function
C) A medical condition that prevents return to any work
D) A functional limitation requiring permanent accommodations
**Answer:** B
**Rationale:** AMA Guides 5th defines impairment as a significant
deviation, loss, or loss of use of a body function or structure, not loss of
earnings (which is disability). Page reference: Chapter 1, p. 2.
,2|Page
---
**2.** The preferred method for rating upper extremity impairment is:
A) Diagnosis-based estimates
B) Range of motion model
C) Neurological deficit scoring
D) Grip strength dynamometry
**Answer:** A
**Rationale:** AMA Guides 5th emphasizes diagnosis-based
impairment (DBI) over ROM for upper extremities due to higher
reliability and validity. Chapter 15, p. 438.
---
**3.** A patient has a Grade 2 modifier for pain in a region already
rated. This will:
A) Double the impairment rating
B) Add 1% to 3% whole person impairment
C) Add 0% to 3% whole person impairment based on severity
D) Be ignored unless surgery occurred
,3|Page
**Answer:** C
**Rationale:** Pain modifiers in Chapter 18 allow 0–3% WPI based on
documented pain frequency and intensity. Grade 2 = moderate pain,
typically +1-2% WPI.
---
**4.** The Combined Values Chart (CVC) is used to:
A) Convert hand impairment to whole person
B) Add multiple impairment ratings non-linearly
C) Subtract prior impairment from current
D) Calculate apportionment percentages
**Answer:** B
**Rationale:** CVC combines multiple WPI values using the formula A
+ B(1-A), accounting for decreasing marginal impact. Chapter 1, p. 13.
---
**5.** Lower extremity impairment is converted to whole person
impairment using a factor of:
A) 1.0 (no conversion needed)
B) 0.4 (40% of lower extremity value)
, 4|Page
C) 0.6 (60% of lower extremity value)
D) Varies by joint
**Answer:** B
**Rationale:** AMA Guides 5th Table 17-3: LE impairment % × 0.4 =
WPI. Example: 20% LE impairment = 8% WPI.
---
**6.** A patient has 15% upper extremity impairment. The whole
person impairment is:
A) 6%
B) 9%
C) 15%
D) 25%
**Answer:** B
**Rationale:** UE to WPI conversion factor is 0.6. 15% × 0.6 = 9%
WPI. Chapter 15, Table 15-9.
---
