QUALIFIED MEDICAL EVALUATOR (QME) EXAM
PREP | SELF TEST 1 – 300 VERIFIED PRACTICE
QUESTIONS & ANSWERS WITH DETAILED
EXPLANATIONS | INSTANT PDF DOWNLOAD
• This QME Exam Prep Self Test contains verified practice questions with detailed
explanations designed to simulate the real California QME examination experience.
• Study by reading each question carefully, selecting your answer before checking
the highlighted correct option and EXPERT RATIONALE below it.
QUALIFIED MEDICAL EVALUATOR (QME) EXAM PREP 2025 SELF TEST 1 –
PRACTICE QUESTIONS & ANSWERS WITH DETAILED EXPLANATIONS
1. Under California Labor Code, who is authorized to perform a Qualified
Medical Evaluation for an injured worker represented by an attorney?
A. Any licensed physician selected by the employer
B. A primary treating physician chosen by the employee
C. A panel Qualified Medical Evaluator selected from a DWC panel
D. An Agreed Medical Evaluator selected by both parties
E. A physician appointed directly by the Workers' Compensation Appeals Board
CORRECT ANSWER: D. An Agreed Medical Evaluator selected by both
parties
EXPERT RATIONALE: When an injured worker is represented by an attorney, the parties
may agree on an Agreed Medical Evaluator (AME). If they cannot agree, a panel QME is
requested from the DWC Medical Unit. The AME process is the preferred method when
representation exists.
2. What is the primary role of a Qualified Medical Evaluator in the California
workers' compensation system?
,A. To provide ongoing medical treatment to the injured worker
B. To determine the employer's liability for workplace injuries
C. To resolve disputes regarding medical issues including causation and permanent
disability
D. To approve or deny surgery requests made by the treating physician
E. To represent the injured worker's interests at hearings
CORRECT ANSWER: C. To resolve disputes regarding medical issues
including causation and permanent disability
EXPERT RATIONALE: The QME's primary role is to provide an independent medical
opinion that resolves disputed medical issues such as causation, extent of injury, and
permanent disability. They do not provide treatment or legal representation.
3. Which regulatory body oversees the QME program in California?
A. California Department of Public Health
B. California Medical Board
C. Division of Workers' Compensation Medical Unit
D. California Department of Industrial Relations
E. State Compensation Insurance Fund
CORRECT ANSWER: C. Division of Workers' Compensation Medical Unit
EXPERT RATIONALE: The DWC Medical Unit within the Department of Industrial
Relations administers the QME program, including certification, panel appointments,
and oversight of QME conduct and reporting.
4. How often must a QME renew their certification in California?
A. Every year
B. Every two years
,C. Every three years
D. Every four years
E. Every five years
CORRECT ANSWER: B. Every two years
EXPERT RATIONALE: QME certification must be renewed every two years. Renewal
requires completion of continuing education hours specific to workers' compensation
and compliance with DWC Medical Unit requirements.
5. Under the AMA Guides 5th Edition, what does "apportionment" refer to in a
permanent disability evaluation?
A. Division of medical costs between employer and employee
B. Distribution of permanent disability between prior and current industrial injuries
or non-industrial causes
C. Allocation of treatment responsibility among multiple treating physicians
D. The percentage of fault assigned to the employer
E. The splitting of temporary disability benefits over time
CORRECT ANSWER: B. Distribution of permanent disability between prior
and current industrial injuries or non-industrial causes
EXPERT RATIONALE: Apportionment refers to the process of determining what portion
of permanent disability is caused by the current industrial injury versus pre-existing
conditions or prior injuries. California Labor Code Section 4663 requires physicians to
address apportionment in their reports.
6. What is the maximum number of hours a QME may spend on a
comprehensive medical-legal evaluation before billing for additional time?
A. 2 hours
B. 3 hours
, C. 4 hours
D. 5 hours
E. 6 hours
CORRECT ANSWER: C. 4 hours
EXPERT RATIONALE: The DWC fee schedule allows QMEs to bill for up to 4 hours for a
comprehensive medical-legal evaluation (ML-200 code). Additional time beyond this
threshold requires documentation and separate billing codes.
7. Which edition of the AMA Guides is required for rating permanent disability
in California workers' compensation cases?
A. Third Edition
B. Fourth Edition
C. Fifth Edition
D. Sixth Edition
E. Any edition approved by the treating physician
CORRECT ANSWER: C. Fifth Edition
EXPERT RATIONALE: California Labor Code Section 4660 mandates the use of the AMA
Guides to the Evaluation of Permanent Impairment, Fifth Edition, for rating permanent
disability in workers' compensation cases.
8. What is the timeframe within which a QME must complete and serve a
comprehensive medical-legal report after the examination?
A. 15 days
B. 20 days
C. 30 days
D. 45 days
PREP | SELF TEST 1 – 300 VERIFIED PRACTICE
QUESTIONS & ANSWERS WITH DETAILED
EXPLANATIONS | INSTANT PDF DOWNLOAD
• This QME Exam Prep Self Test contains verified practice questions with detailed
explanations designed to simulate the real California QME examination experience.
• Study by reading each question carefully, selecting your answer before checking
the highlighted correct option and EXPERT RATIONALE below it.
QUALIFIED MEDICAL EVALUATOR (QME) EXAM PREP 2025 SELF TEST 1 –
PRACTICE QUESTIONS & ANSWERS WITH DETAILED EXPLANATIONS
1. Under California Labor Code, who is authorized to perform a Qualified
Medical Evaluation for an injured worker represented by an attorney?
A. Any licensed physician selected by the employer
B. A primary treating physician chosen by the employee
C. A panel Qualified Medical Evaluator selected from a DWC panel
D. An Agreed Medical Evaluator selected by both parties
E. A physician appointed directly by the Workers' Compensation Appeals Board
CORRECT ANSWER: D. An Agreed Medical Evaluator selected by both
parties
EXPERT RATIONALE: When an injured worker is represented by an attorney, the parties
may agree on an Agreed Medical Evaluator (AME). If they cannot agree, a panel QME is
requested from the DWC Medical Unit. The AME process is the preferred method when
representation exists.
2. What is the primary role of a Qualified Medical Evaluator in the California
workers' compensation system?
,A. To provide ongoing medical treatment to the injured worker
B. To determine the employer's liability for workplace injuries
C. To resolve disputes regarding medical issues including causation and permanent
disability
D. To approve or deny surgery requests made by the treating physician
E. To represent the injured worker's interests at hearings
CORRECT ANSWER: C. To resolve disputes regarding medical issues
including causation and permanent disability
EXPERT RATIONALE: The QME's primary role is to provide an independent medical
opinion that resolves disputed medical issues such as causation, extent of injury, and
permanent disability. They do not provide treatment or legal representation.
3. Which regulatory body oversees the QME program in California?
A. California Department of Public Health
B. California Medical Board
C. Division of Workers' Compensation Medical Unit
D. California Department of Industrial Relations
E. State Compensation Insurance Fund
CORRECT ANSWER: C. Division of Workers' Compensation Medical Unit
EXPERT RATIONALE: The DWC Medical Unit within the Department of Industrial
Relations administers the QME program, including certification, panel appointments,
and oversight of QME conduct and reporting.
4. How often must a QME renew their certification in California?
A. Every year
B. Every two years
,C. Every three years
D. Every four years
E. Every five years
CORRECT ANSWER: B. Every two years
EXPERT RATIONALE: QME certification must be renewed every two years. Renewal
requires completion of continuing education hours specific to workers' compensation
and compliance with DWC Medical Unit requirements.
5. Under the AMA Guides 5th Edition, what does "apportionment" refer to in a
permanent disability evaluation?
A. Division of medical costs between employer and employee
B. Distribution of permanent disability between prior and current industrial injuries
or non-industrial causes
C. Allocation of treatment responsibility among multiple treating physicians
D. The percentage of fault assigned to the employer
E. The splitting of temporary disability benefits over time
CORRECT ANSWER: B. Distribution of permanent disability between prior
and current industrial injuries or non-industrial causes
EXPERT RATIONALE: Apportionment refers to the process of determining what portion
of permanent disability is caused by the current industrial injury versus pre-existing
conditions or prior injuries. California Labor Code Section 4663 requires physicians to
address apportionment in their reports.
6. What is the maximum number of hours a QME may spend on a
comprehensive medical-legal evaluation before billing for additional time?
A. 2 hours
B. 3 hours
, C. 4 hours
D. 5 hours
E. 6 hours
CORRECT ANSWER: C. 4 hours
EXPERT RATIONALE: The DWC fee schedule allows QMEs to bill for up to 4 hours for a
comprehensive medical-legal evaluation (ML-200 code). Additional time beyond this
threshold requires documentation and separate billing codes.
7. Which edition of the AMA Guides is required for rating permanent disability
in California workers' compensation cases?
A. Third Edition
B. Fourth Edition
C. Fifth Edition
D. Sixth Edition
E. Any edition approved by the treating physician
CORRECT ANSWER: C. Fifth Edition
EXPERT RATIONALE: California Labor Code Section 4660 mandates the use of the AMA
Guides to the Evaluation of Permanent Impairment, Fifth Edition, for rating permanent
disability in workers' compensation cases.
8. What is the timeframe within which a QME must complete and serve a
comprehensive medical-legal report after the examination?
A. 15 days
B. 20 days
C. 30 days
D. 45 days
