QME EXAM NEWEST ACTUAL EXAM COMPLETE 350 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION 2026!!!
Question 1
Which entity or individual holds the statutory authority to appoint physicians to the role of
Qualified Medical Evaluator (QME)?
A) The Governor of California
B) The Appeals Board (WCAB)
C) The Administrative Director (AD)
D) The Medical Board of California
E) The Lead Primary Treating Physician
Correct Answer: C) The Administrative Director (AD)
Rationale: Per Labor Code 139.2, the Administrative Director is the specific official charged
with the authority to appoint physicians as QMEs. This role involves overseeing the
application process and ensuring evaluators meet the necessary regulatory standards for
competency and conduct.
Question 2
What is the standard term of appointment for a physician serving as a Qualified Medical
Evaluator?
A) 1 year
B) 2 years
C) 4 years
D) 5 years
E) Indefinite, pending good standing
Correct Answer: B) 2 years
Rationale: Under Labor Code 139.2, a QME's term of appointment is strictly limited to 2
years. At the end of this period, the physician must apply for reappointment and
demonstrate that they continue to meet all statutory and administrative requirements.
Question 3
To qualify for appointment as a QME, a physician must demonstrate that they devote what
minimum portion of their total practice time to providing direct medical treatment?
A) At least 10%
B) At least 25%
C) At least 33.3% (1/3rd)
D) At least 50%
E) At least 75%
Correct Answer: C) At least 1/3rd of total practice time
Rationale: Administrative regulations require QME applicants to spend at least one-third of
their total practice time in direct medical treatment. An exception exists for those who have
served as an Agreed Medical Evaluator (AME) on eight or more occasions in the 12 months
prior to their application.
, 2
Question 4
Which of the following is a valid reason for the Administrative Director to terminate or suspend
a QME's appointment without a hearing?
A) Failure to follow a specific medical procedure
B) Making a material misrepresentation on an application
C) Failure to pay the required annual fee
D) Submission of an inadequate medical-legal report
E) Disrespectful conduct toward an injured worker
Correct Answer: C) Failure to pay the required annual fee
Rationale: Summary suspension or termination (without a hearing) is permitted in two
specific instances: if the physician’s licensing board revokes or terminates their license to
practice, or if the physician fails to pay the required appointment or yearly fees.
Question 5
Following a hearing, a QME may be disciplined or terminated for which of the following
reasons?
A) Failure to meet licensing/certification requirements
B) Failure to comply with timeframe standards for reports
C) Preparation of reports that fail to meet minimum standards
D) Making material misrepresentations in a reappointment application
E) All of the above
Correct Answer: E) All of the above
Rationale: Administrative guidelines provide six primary reasons for discipline after a
hearing: violation of statutory duties, failure to follow procedures, failure to meet timelines,
loss of licensing, poor report quality, and misrepresentations on applications.
Question 6
QMEs are primarily used to resolve substantive medical disputes. Which of the following is
considered a "catch-all" dispute resolved by a QME?
A) Determination of the date of injury (DOI)
B) Issues regarding temporary disability and work restrictions
C) The initial employment relationship
D) The selection of a vocational rehab counselor
E) The calculation of the worker's average weekly wage
Correct Answer: B) Issues regarding temporary disability and work restrictions
Rationale: QMEs resolve three main types of disputes: 1) Compensability, 2) Permanent
Disability, and 3) "Catch-all" issues. The catch-all category includes temporary disability,
work restrictions, new/further disability claims, and the compensability of new body parts
added to a claim.
, 3
Question 7
In the context of workers' compensation, how is a "Cumulative Injury" defined?
A) An injury resulting from a single traumatic incident
B) A reaction to a side effect from preventative health care
C) Repetitive mental or physical trauma over a period of time
D) An injury caused by an initial physical aggressor
E) A disease caused entirely by non-industrial exposures
Correct Answer: C) Results from repetitive trauma (mental or physical) over a period of
time
Rationale: Unlike a "specific injury" which is a one-time event, a cumulative injury occurs
due to the repetitive nature of job tasks (such as carpal tunnel from typing or back strain
from lifting) that manifest over a duration of employment.
Question 8
Which of the following conditions is required for a medical state to be legally considered an
"injury" in a compensability claim?
A) It must cause a financial loss to the employer
B) it must result in a need for medical treatment or cause disability
C) It must be a diagnosed genetic disorder
D) It must have occurred at the employee's residence
E) It must require at least 3 months of hospitalization
Correct Answer: B) Result in a need for medical treatment OR cause disability
Rationale: For a condition to be compensable under the workers' compensation system, it
must meet at least one of two criteria: it must cause disability (inability to work) or
necessitate medical treatment.
Question 9
Under Labor Code exclusions, which injury is generally not compensable?
A) An injury caused by the employee's use of illegal controlled substances
B) An injury arising from treatment of a work-related condition
C) A derivative injury caused by an employer-provided vaccine
D) An injury caused by an employer's negligence
E) An injury occurring during a mandatory staff meeting
Correct Answer: A) An injury caused by the employee's use of illegal controlled substances
Rationale: Certain injuries are excluded from the system, including those caused by
intoxication (alcohol or illegal drugs), intentionally self-inflicted injuries, suicides, and
injuries where the employee was the initial physical aggressor in an altercation.
Question 10
If an employee is injured during an off-duty recreational activity, such as a company softball
game, under what condition is the injury compensable?
, 4
A) If the employee was the team captain
B) If the employee’s participation was an expressed or implied condition of employment
C) If the employer paid for the uniforms
D) If the game was held at a city park
E) These injuries are never compensable under any circumstances
Correct Answer: B) If the activity is an expressed or implicit condition of employment
Rationale: Generally, off-duty recreational activities are excluded. However, if the employer
requires participation or if the employee reasonably believes participation is expected for
their job (implied condition), the injury may be compensable.
Question 11
What are the four basic conditions required to establish a valid workers' compensation claim?
A) Injury, Age, Salary, and Fault
B) Injury, Employment Relationship, AOE (Arising out of Employment), and COE (Course of
Employment)
C) Specific Injury, Cumulative Injury, Occupational Disease, and Derivative Injury
D) Medical probability, Preponderance, Liability, and Negligence
E) Treatment, Hospitalization, Medication, and Recovery
Correct Answer: B) Injury, Employment Relationship, AOE, and COE
Rationale: To establish a claim, there must be: 1) Harm (Physiological or Psychological), 2)
A legal employment relationship, 3) Causation (AOE), and 4) Proper context/timing (COE).
Question 12
An "Aggravation" of a pre-existing, non-industrial condition occurs when work exposure results
in:
A) The worker feeling temporary subjective pain without clinical change
B) A new need for medical treatment or a change in the existing course of treatment
C) A "flare-up" that subsides within 24 hours
D) The discovery of a genetic predisposition
E) No change in disability status
Correct Answer: B) Creates a new need for medical treatment or a change in the existing
course of treatment
Rationale: An aggravation is distinguished from a mere "recurrence" or "flare-up." It must
cause a temporary or permanent increase in disability or necessitate a medical intervention
that was not previously required.
Question 13
How is the "Date of Injury" (DOI) determined for a cumulative injury?
A) The first day the employee started the job
B) The date of the very last exposure
C) The date the employee first suffered disability and knew (or should have known) it was work-
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION 2026!!!
Question 1
Which entity or individual holds the statutory authority to appoint physicians to the role of
Qualified Medical Evaluator (QME)?
A) The Governor of California
B) The Appeals Board (WCAB)
C) The Administrative Director (AD)
D) The Medical Board of California
E) The Lead Primary Treating Physician
Correct Answer: C) The Administrative Director (AD)
Rationale: Per Labor Code 139.2, the Administrative Director is the specific official charged
with the authority to appoint physicians as QMEs. This role involves overseeing the
application process and ensuring evaluators meet the necessary regulatory standards for
competency and conduct.
Question 2
What is the standard term of appointment for a physician serving as a Qualified Medical
Evaluator?
A) 1 year
B) 2 years
C) 4 years
D) 5 years
E) Indefinite, pending good standing
Correct Answer: B) 2 years
Rationale: Under Labor Code 139.2, a QME's term of appointment is strictly limited to 2
years. At the end of this period, the physician must apply for reappointment and
demonstrate that they continue to meet all statutory and administrative requirements.
Question 3
To qualify for appointment as a QME, a physician must demonstrate that they devote what
minimum portion of their total practice time to providing direct medical treatment?
A) At least 10%
B) At least 25%
C) At least 33.3% (1/3rd)
D) At least 50%
E) At least 75%
Correct Answer: C) At least 1/3rd of total practice time
Rationale: Administrative regulations require QME applicants to spend at least one-third of
their total practice time in direct medical treatment. An exception exists for those who have
served as an Agreed Medical Evaluator (AME) on eight or more occasions in the 12 months
prior to their application.
, 2
Question 4
Which of the following is a valid reason for the Administrative Director to terminate or suspend
a QME's appointment without a hearing?
A) Failure to follow a specific medical procedure
B) Making a material misrepresentation on an application
C) Failure to pay the required annual fee
D) Submission of an inadequate medical-legal report
E) Disrespectful conduct toward an injured worker
Correct Answer: C) Failure to pay the required annual fee
Rationale: Summary suspension or termination (without a hearing) is permitted in two
specific instances: if the physician’s licensing board revokes or terminates their license to
practice, or if the physician fails to pay the required appointment or yearly fees.
Question 5
Following a hearing, a QME may be disciplined or terminated for which of the following
reasons?
A) Failure to meet licensing/certification requirements
B) Failure to comply with timeframe standards for reports
C) Preparation of reports that fail to meet minimum standards
D) Making material misrepresentations in a reappointment application
E) All of the above
Correct Answer: E) All of the above
Rationale: Administrative guidelines provide six primary reasons for discipline after a
hearing: violation of statutory duties, failure to follow procedures, failure to meet timelines,
loss of licensing, poor report quality, and misrepresentations on applications.
Question 6
QMEs are primarily used to resolve substantive medical disputes. Which of the following is
considered a "catch-all" dispute resolved by a QME?
A) Determination of the date of injury (DOI)
B) Issues regarding temporary disability and work restrictions
C) The initial employment relationship
D) The selection of a vocational rehab counselor
E) The calculation of the worker's average weekly wage
Correct Answer: B) Issues regarding temporary disability and work restrictions
Rationale: QMEs resolve three main types of disputes: 1) Compensability, 2) Permanent
Disability, and 3) "Catch-all" issues. The catch-all category includes temporary disability,
work restrictions, new/further disability claims, and the compensability of new body parts
added to a claim.
, 3
Question 7
In the context of workers' compensation, how is a "Cumulative Injury" defined?
A) An injury resulting from a single traumatic incident
B) A reaction to a side effect from preventative health care
C) Repetitive mental or physical trauma over a period of time
D) An injury caused by an initial physical aggressor
E) A disease caused entirely by non-industrial exposures
Correct Answer: C) Results from repetitive trauma (mental or physical) over a period of
time
Rationale: Unlike a "specific injury" which is a one-time event, a cumulative injury occurs
due to the repetitive nature of job tasks (such as carpal tunnel from typing or back strain
from lifting) that manifest over a duration of employment.
Question 8
Which of the following conditions is required for a medical state to be legally considered an
"injury" in a compensability claim?
A) It must cause a financial loss to the employer
B) it must result in a need for medical treatment or cause disability
C) It must be a diagnosed genetic disorder
D) It must have occurred at the employee's residence
E) It must require at least 3 months of hospitalization
Correct Answer: B) Result in a need for medical treatment OR cause disability
Rationale: For a condition to be compensable under the workers' compensation system, it
must meet at least one of two criteria: it must cause disability (inability to work) or
necessitate medical treatment.
Question 9
Under Labor Code exclusions, which injury is generally not compensable?
A) An injury caused by the employee's use of illegal controlled substances
B) An injury arising from treatment of a work-related condition
C) A derivative injury caused by an employer-provided vaccine
D) An injury caused by an employer's negligence
E) An injury occurring during a mandatory staff meeting
Correct Answer: A) An injury caused by the employee's use of illegal controlled substances
Rationale: Certain injuries are excluded from the system, including those caused by
intoxication (alcohol or illegal drugs), intentionally self-inflicted injuries, suicides, and
injuries where the employee was the initial physical aggressor in an altercation.
Question 10
If an employee is injured during an off-duty recreational activity, such as a company softball
game, under what condition is the injury compensable?
, 4
A) If the employee was the team captain
B) If the employee’s participation was an expressed or implied condition of employment
C) If the employer paid for the uniforms
D) If the game was held at a city park
E) These injuries are never compensable under any circumstances
Correct Answer: B) If the activity is an expressed or implicit condition of employment
Rationale: Generally, off-duty recreational activities are excluded. However, if the employer
requires participation or if the employee reasonably believes participation is expected for
their job (implied condition), the injury may be compensable.
Question 11
What are the four basic conditions required to establish a valid workers' compensation claim?
A) Injury, Age, Salary, and Fault
B) Injury, Employment Relationship, AOE (Arising out of Employment), and COE (Course of
Employment)
C) Specific Injury, Cumulative Injury, Occupational Disease, and Derivative Injury
D) Medical probability, Preponderance, Liability, and Negligence
E) Treatment, Hospitalization, Medication, and Recovery
Correct Answer: B) Injury, Employment Relationship, AOE, and COE
Rationale: To establish a claim, there must be: 1) Harm (Physiological or Psychological), 2)
A legal employment relationship, 3) Causation (AOE), and 4) Proper context/timing (COE).
Question 12
An "Aggravation" of a pre-existing, non-industrial condition occurs when work exposure results
in:
A) The worker feeling temporary subjective pain without clinical change
B) A new need for medical treatment or a change in the existing course of treatment
C) A "flare-up" that subsides within 24 hours
D) The discovery of a genetic predisposition
E) No change in disability status
Correct Answer: B) Creates a new need for medical treatment or a change in the existing
course of treatment
Rationale: An aggravation is distinguished from a mere "recurrence" or "flare-up." It must
cause a temporary or permanent increase in disability or necessitate a medical intervention
that was not previously required.
Question 13
How is the "Date of Injury" (DOI) determined for a cumulative injury?
A) The first day the employee started the job
B) The date of the very last exposure
C) The date the employee first suffered disability and knew (or should have known) it was work-
