QME EXAM QUESTIONS AND ANSWERS
(QUALIFIED MEDICAL EVALUATOR) LATEST
2025-2026
Holds authority to appoint physicians as QME evaluators
Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator
2 years (LC 139.2)
3 requirements when seeking appointment as QME
(1) Pass the QME competency exam;
(2) Complete a 12-hour course in disability eval report writing;
(3) Devote at least 1/3rd of total practice time to providing direct medical treatment
(or have served as a AME on 8+ occasions in past 12 mos prior to application)
2 reasons for termination/suspension of a QME w/o a hearing
(1) Licensing board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
,6 reasons for discipline (suspension/termination) of QMEs after a hearing
(1) Violation of material statutory or administrative duty;
(2) Failure to follow medical procedures or qualifications;
(3) Failure to comply with the timeframe standards;
(4) Failure to meet licensing/certification requirements;
(5) Preparation of medical-legal evaluations that fail to meet the minimum
standards for those reports as established by the administrative director or the
appeals board;
(6) Making material misrepresentations or false statements in an application for
appointment or reappointment as a qualified medical evaluator.
3 types of substantive medical disputes resolved by QMEs
(1) Compensability of the claim;
(2) Permanent disability;
(3) "Catch-all" (temporary disability, work restrictions, new and further disabilities
after permanent disability (detereoration of original injury), compensability of new
body part added to claim)
Definition of injury in compensability claims
(1) An injury or disease arising out of employment;
, (2) A derivative injury caused by treatment of an injury arising out of employment;
(3) Any reaction to or side effect from preventative health care the employer
provides to health care workers
Specific injury
Occurs as the result of a single incident or exposure
Cumulative injury
Results from repetitive trauma (mental or physical) over a period of time
2 requirements for a condition to be considered an injury
(1) Cause disability; or
(2) Result in a need for medical treatment
Occupational disease
Disease that in whole or part is caused by work
7 types of excluded injuries
(QUALIFIED MEDICAL EVALUATOR) LATEST
2025-2026
Holds authority to appoint physicians as QME evaluators
Administrative Director (AD) (LC 139.2)
Term of appointment as QME evaluator
2 years (LC 139.2)
3 requirements when seeking appointment as QME
(1) Pass the QME competency exam;
(2) Complete a 12-hour course in disability eval report writing;
(3) Devote at least 1/3rd of total practice time to providing direct medical treatment
(or have served as a AME on 8+ occasions in past 12 mos prior to application)
2 reasons for termination/suspension of a QME w/o a hearing
(1) Licensing board suspends/revokes/terminates license to practice
(2) Failure to pay required fee (upon appointment and yearly thereafter)
,6 reasons for discipline (suspension/termination) of QMEs after a hearing
(1) Violation of material statutory or administrative duty;
(2) Failure to follow medical procedures or qualifications;
(3) Failure to comply with the timeframe standards;
(4) Failure to meet licensing/certification requirements;
(5) Preparation of medical-legal evaluations that fail to meet the minimum
standards for those reports as established by the administrative director or the
appeals board;
(6) Making material misrepresentations or false statements in an application for
appointment or reappointment as a qualified medical evaluator.
3 types of substantive medical disputes resolved by QMEs
(1) Compensability of the claim;
(2) Permanent disability;
(3) "Catch-all" (temporary disability, work restrictions, new and further disabilities
after permanent disability (detereoration of original injury), compensability of new
body part added to claim)
Definition of injury in compensability claims
(1) An injury or disease arising out of employment;
, (2) A derivative injury caused by treatment of an injury arising out of employment;
(3) Any reaction to or side effect from preventative health care the employer
provides to health care workers
Specific injury
Occurs as the result of a single incident or exposure
Cumulative injury
Results from repetitive trauma (mental or physical) over a period of time
2 requirements for a condition to be considered an injury
(1) Cause disability; or
(2) Result in a need for medical treatment
Occupational disease
Disease that in whole or part is caused by work
7 types of excluded injuries
