California QME Qualified Medical Evaluator Competency Examination
Question Bank (Latest 2026/2027 Edition) – 100% Correct Questions,
Answers & Detailed Rationales
Total Questions: 50
Time Allowed: 90 Minutes
Passing Score: 70%
Instructions: Select the BEST answer for each question based on California Workers'
Compensation laws, regulations, AMA Guides (5th Edition), and QME procedures.
SECTION 1: CLINICAL ASSESSMENT / EVALUATION AND MEDICAL
TREATMENT
Questions 1–13
Question 1
A QME is evaluating a 42-year-old construction worker who sustained a low back injury.
During the clinical examination, which of the following is the MOST appropriate
approach to obtaining an accurate history of the work-related injury?
A. Rely solely on the medical records provided by the employer's insurance carrier
B. Interview the injured worker directly, review all available medical records, and
document the mechanism of injury and job duties
,C. Accept the applicant attorney's summary of the injury as the definitive history
D. Interview the employer's representative to obtain the history without speaking to the
injured worker
Correct Answer: B
Rationale: The QME must obtain a comprehensive history by directly interviewing the
injured worker and reviewing all available medical records. This includes documenting
the mechanism of injury, specific job duties, and any prior or subsequent injuries.
Relying solely on records from one party or accepting an attorney's summary
compromises impartiality and thoroughness. The QME is an independent evaluator who
must gather information from multiple sources.
Question 2
A 35-year-old warehouse worker presents for QME evaluation six months after a
shoulder injury. The treating physician has not yet declared MMI. The QME's
examination reveals full range of motion and no objective findings. What is the MOST
appropriate action?
A. Declare the worker at MMI and rate impairment immediately
B. Defer MMI determination to the treating physician and document current findings
C. Refuse to examine the worker until the treating physician declares MMI
D. Recommend immediate surgery to resolve any remaining symptoms
Correct Answer: B
,Rationale: The QME should not usurp the treating physician's role in declaring MMI
unless specifically asked to address that issue. The QME should document current
findings and may indicate that based on the examination, the worker appears to have
reached a plateau, but the formal MMI determination typically remains with the treating
physician unless the parties have agreed to have the QME make that determination. The
QME's role is to evaluate, not to direct treatment.
Question 3
During a QME evaluation of a psychiatric injury claim, the evaluating physician
determines that additional records are needed to assess causation. Which records are
MOST relevant to obtain?
A. Only the workers' compensation billing records
B. Prior psychiatric treatment records, substance abuse history, and occupational stress
documentation
C. Only the current employer's personnel file
D. The injured worker's elementary school report cards
Correct Answer: B
Rationale: For psychiatric injury causation, the QME must review prior psychiatric
treatment records to identify pre-existing conditions, substance abuse history which
may be a contributing factor, and documentation of occupational stressors. Psychiatric
injury causation requires analysis of industrial vs. non-industrial factors under Labor
Code §3208.3. Elementary school records are generally irrelevant, and billing records or
personnel files alone are insufficient.
, Question 4
A QME is examining a worker with a claimed cumulative trauma injury to the wrists.
Which element is MOST critical to document in the occupational history?
A. The worker's hobbies and recreational activities only
B. The specific job duties, frequency of repetitive motions, force requirements, and
duration of exposure
C. The worker's salary and benefits information
D. The names of coworkers who can verify the injury
Correct Answer: B
Rationale: For cumulative trauma claims, the QME must document the specific
occupational exposures including repetitive motions, force requirements, posture,
vibration, and duration of exposure. This information is essential to determine whether
the injury arose out of and occurred in the course of employment (AOE/COE). Salary
and coworker names are not relevant to the medical-legal causation analysis.
Question 5
A QME orthopedic surgeon is evaluating a knee injury. The examination reveals a
15-degree flexion contracture. According to the AMA Guides 5th Edition, how should
this finding be documented for impairment rating purposes?
A. Ignore the flexion contracture and rate only based on range of motion
B. Document the flexion contracture and apply the appropriate impairment value from
the Lower Extremity Chapter
Question Bank (Latest 2026/2027 Edition) – 100% Correct Questions,
Answers & Detailed Rationales
Total Questions: 50
Time Allowed: 90 Minutes
Passing Score: 70%
Instructions: Select the BEST answer for each question based on California Workers'
Compensation laws, regulations, AMA Guides (5th Edition), and QME procedures.
SECTION 1: CLINICAL ASSESSMENT / EVALUATION AND MEDICAL
TREATMENT
Questions 1–13
Question 1
A QME is evaluating a 42-year-old construction worker who sustained a low back injury.
During the clinical examination, which of the following is the MOST appropriate
approach to obtaining an accurate history of the work-related injury?
A. Rely solely on the medical records provided by the employer's insurance carrier
B. Interview the injured worker directly, review all available medical records, and
document the mechanism of injury and job duties
,C. Accept the applicant attorney's summary of the injury as the definitive history
D. Interview the employer's representative to obtain the history without speaking to the
injured worker
Correct Answer: B
Rationale: The QME must obtain a comprehensive history by directly interviewing the
injured worker and reviewing all available medical records. This includes documenting
the mechanism of injury, specific job duties, and any prior or subsequent injuries.
Relying solely on records from one party or accepting an attorney's summary
compromises impartiality and thoroughness. The QME is an independent evaluator who
must gather information from multiple sources.
Question 2
A 35-year-old warehouse worker presents for QME evaluation six months after a
shoulder injury. The treating physician has not yet declared MMI. The QME's
examination reveals full range of motion and no objective findings. What is the MOST
appropriate action?
A. Declare the worker at MMI and rate impairment immediately
B. Defer MMI determination to the treating physician and document current findings
C. Refuse to examine the worker until the treating physician declares MMI
D. Recommend immediate surgery to resolve any remaining symptoms
Correct Answer: B
,Rationale: The QME should not usurp the treating physician's role in declaring MMI
unless specifically asked to address that issue. The QME should document current
findings and may indicate that based on the examination, the worker appears to have
reached a plateau, but the formal MMI determination typically remains with the treating
physician unless the parties have agreed to have the QME make that determination. The
QME's role is to evaluate, not to direct treatment.
Question 3
During a QME evaluation of a psychiatric injury claim, the evaluating physician
determines that additional records are needed to assess causation. Which records are
MOST relevant to obtain?
A. Only the workers' compensation billing records
B. Prior psychiatric treatment records, substance abuse history, and occupational stress
documentation
C. Only the current employer's personnel file
D. The injured worker's elementary school report cards
Correct Answer: B
Rationale: For psychiatric injury causation, the QME must review prior psychiatric
treatment records to identify pre-existing conditions, substance abuse history which
may be a contributing factor, and documentation of occupational stressors. Psychiatric
injury causation requires analysis of industrial vs. non-industrial factors under Labor
Code §3208.3. Elementary school records are generally irrelevant, and billing records or
personnel files alone are insufficient.
, Question 4
A QME is examining a worker with a claimed cumulative trauma injury to the wrists.
Which element is MOST critical to document in the occupational history?
A. The worker's hobbies and recreational activities only
B. The specific job duties, frequency of repetitive motions, force requirements, and
duration of exposure
C. The worker's salary and benefits information
D. The names of coworkers who can verify the injury
Correct Answer: B
Rationale: For cumulative trauma claims, the QME must document the specific
occupational exposures including repetitive motions, force requirements, posture,
vibration, and duration of exposure. This information is essential to determine whether
the injury arose out of and occurred in the course of employment (AOE/COE). Salary
and coworker names are not relevant to the medical-legal causation analysis.
Question 5
A QME orthopedic surgeon is evaluating a knee injury. The examination reveals a
15-degree flexion contracture. According to the AMA Guides 5th Edition, how should
this finding be documented for impairment rating purposes?
A. Ignore the flexion contracture and rate only based on range of motion
B. Document the flexion contracture and apply the appropriate impairment value from
the Lower Extremity Chapter
