1
QME EXAM Actual Exam 2026/2027 Complete Questions
and Correct Detailed Answers | Verified Answers Already
Graded A+ Brand New Version Complete California
Qualified Medical Evaluator Exam Prep with QME Practice
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SECTION 1: CALIFORNIA WORKERS' COMPENSATION SYSTEM (Questions 1-20)
Q1: In the California workers' compensation system, what is the primary difference between a
Qualified Medical Evaluator (QME) and an Agreed Medical Evaluator (AME)?
A. QMEs are selected by the insurance carrier, while AMEs are selected by the applicant
B. QMEs are selected from a state-panel list when parties cannot agree, while AMEs are
mutually agreed upon by both parties. [CORRECT]
C. QMEs only evaluate psychiatric injuries, while AMEs evaluate physical injuries
D. QMEs cannot provide testimony, while AMEs can
Correct Answer: B Rationale: When parties cannot agree on a medical evaluator, they request a
QME panel from the DWC Medical Unit, and a QME is selected from that three-physician panel.
An AME is a physician mutually agreed upon by both parties (B). QMEs are not selected by
carriers (A). QMEs evaluate all injury types (C). Both QMEs and AMEs can provide testimony
(D).
Q2: Under California Labor Code Section 4600, which of the following best describes the
"primary treating physician" (PTP)?
A. A physician selected exclusively by the employer from a Medical Provider Network who has
no treatment authority
B. The physician primarily responsible for managing the injured worker's medical treatment and
who may make determinations on work capacity and permanent disability [CORRECT]
C. A physician appointed by the Workers' Compensation Appeals Board to oversee all medical
care
D. A specialist consulted only for impairment rating purposes
,2
Correct Answer: B Rationale: The PTP is the physician with primary responsibility for
managing the injured worker's medical treatment, making determinations regarding work
capacity, and may provide impairment ratings (B). The PTP has significant treatment authority
(A is incorrect). The WCAB does not appoint PTPs (C is incorrect). PTPs have broader roles
than just impairment rating (D is incorrect).
Q3: Which California Code of Regulations (CCR) Title 8 section governs the qualifications,
duties, and conduct of Qualified Medical Evaluators?
A. §9785 (Medical-Legal Expenses)
B. §10950-10969 (QME Regulations) [CORRECT]
C. §4600 (Medical Treatment)
D. §5703 (Reconsideration)
Correct Answer: B Rationale: CCR Title 8, Sections 10950-10969 specifically govern QME
qualifications, panel selection, evaluation procedures, report requirements, and disciplinary
standards (B). Section 9785 governs medical-legal fees (A). Labor Code §4600 governs medical
treatment generally (C). Section 5703 governs reconsideration procedures (D).
Q4: In the QME panel selection process, how many names appear on a standard QME panel
issued by the DWC Medical Unit?
A. One physician only
B. Two physicians
C. Three physicians [CORRECT]
D. Five physicians
Correct Answer: C Rationale: Standard QME panels issued by the DWC Medical Unit contain
three physician names from which the parties may agree on one, or each party may strike one
name, leaving the remaining physician as the evaluator (C). Single-physician panels are not
standard (A). Two or five physicians do not conform to standard panel requirements (B, D).
Q5: What is the time limit for a QME to issue a medical-legal report after examining an injured
worker, per CCR Title 8 §10961?
A. 10 days
,3
B. 15 days
C. 30 days [CORRECT]
D. 60 days
Correct Answer: C Rationale: CCR Title 8 §10961 requires QMEs to serve their medical-legal
reports within 30 days of the examination (C). The 10-day and 15-day timeframes (A, B) are too
short. While complex cases may require extensions, 60 days (D) exceeds the standard
requirement without proper justification and notification.
Q6: Which of the following constitutes an "ex parte communication" prohibited under California
workers' compensation law?
A. A telephone call between the QME and the applicant's attorney to schedule the examination
B. A written communication from the defense attorney to the QME providing medical records
with a cover letter arguing the legal significance of the case [CORRECT]
C. A conversation between the QME and the injured worker during the examination about the
worker's symptoms
D. Correspondence between the QME and the DWC Medical Unit regarding panel qualifications
Correct Answer: B Rationale: Ex parte communications are prohibited one-sided
communications regarding the substance of the case. Providing medical records with legal
arguments attempting to influence the QME's opinion constitutes prohibited ex parte
communication (B). Scheduling communications (A), clinical interviews with the patient (C),
and administrative correspondence with the DWC (D) are permitted.
Q7: Under Labor Code §4663, what is the standard for apportionment of permanent disability?
A. Apportionment is prohibited in all California workers' compensation cases
B. Apportionment must be based on causation, with the employer liable only for the percentage
of permanent disability directly caused by the industrial injury [CORRECT]
C. Apportionment is determined solely by the date of injury, with older injuries receiving higher
apportionment
D. Apportionment is calculated based on the employer's ability to pay
Correct Answer: B Rationale: Labor Code §4663 requires apportionment based on causation,
with the employer responsible only for the percentage of permanent disability directly caused by
, 4
the industrial injury (B). Apportionment is not prohibited (A). Date of injury (C) and employer
ability to pay (D) are not valid apportionment standards.
Q8: What does "AOE/COE" stand for in California workers' compensation terminology?
A. Administrative Order of Evidence / Certificate of Eligibility
B. Arising Out of Employment / Course of Employment [CORRECT]
C. Assessment of Earnings / Calculation of Expenses
D. Authorized Occupational Expert / Certified Orthopedic Examiner
Correct Answer: B Rationale: AOE/COE stands for "Arising Out of Employment / Course of
Employment," which establishes whether an injury occurred during work activities and is
therefore compensable (B). The other options (A, C, D) are not recognized workers'
compensation terminology.
Q9: Which of the following is TRUE regarding a QME's role in determining work restrictions?
A. QMEs may not make any recommendations regarding work restrictions
B. QMEs may recommend work restrictions based on the industrial injury but should not
consider non-industrial conditions
C. QMEs may recommend work restrictions considering the total disability from all causes, but
should identify which restrictions are due to the industrial injury [CORRECT]
D. Only the employer may determine work restrictions
Correct Answer: C Rationale: QMEs may recommend work restrictions based on the total
disability picture but must identify which restrictions are attributable to the industrial injury
versus other causes (C). QMEs do make work restriction recommendations (A is incorrect). Non-
industrial conditions affecting work capacity must be considered (B is incorrect). Employers
implement but do not unilaterally determine restrictions (D is incorrect).
Q10: Under CCR Title 8 §10961, what must a QME include in the medical-legal report when
there is a finding of permanent disability?
A. Only the final impairment rating percentage
B. An impairment rating calculated according to the AMA Guides, apportionment analysis, and
work restrictions [CORRECT]
QME EXAM Actual Exam 2026/2027 Complete Questions
and Correct Detailed Answers | Verified Answers Already
Graded A+ Brand New Version Complete California
Qualified Medical Evaluator Exam Prep with QME Practice
Test Pass Guaranteed - A+ Graded
SECTION 1: CALIFORNIA WORKERS' COMPENSATION SYSTEM (Questions 1-20)
Q1: In the California workers' compensation system, what is the primary difference between a
Qualified Medical Evaluator (QME) and an Agreed Medical Evaluator (AME)?
A. QMEs are selected by the insurance carrier, while AMEs are selected by the applicant
B. QMEs are selected from a state-panel list when parties cannot agree, while AMEs are
mutually agreed upon by both parties. [CORRECT]
C. QMEs only evaluate psychiatric injuries, while AMEs evaluate physical injuries
D. QMEs cannot provide testimony, while AMEs can
Correct Answer: B Rationale: When parties cannot agree on a medical evaluator, they request a
QME panel from the DWC Medical Unit, and a QME is selected from that three-physician panel.
An AME is a physician mutually agreed upon by both parties (B). QMEs are not selected by
carriers (A). QMEs evaluate all injury types (C). Both QMEs and AMEs can provide testimony
(D).
Q2: Under California Labor Code Section 4600, which of the following best describes the
"primary treating physician" (PTP)?
A. A physician selected exclusively by the employer from a Medical Provider Network who has
no treatment authority
B. The physician primarily responsible for managing the injured worker's medical treatment and
who may make determinations on work capacity and permanent disability [CORRECT]
C. A physician appointed by the Workers' Compensation Appeals Board to oversee all medical
care
D. A specialist consulted only for impairment rating purposes
,2
Correct Answer: B Rationale: The PTP is the physician with primary responsibility for
managing the injured worker's medical treatment, making determinations regarding work
capacity, and may provide impairment ratings (B). The PTP has significant treatment authority
(A is incorrect). The WCAB does not appoint PTPs (C is incorrect). PTPs have broader roles
than just impairment rating (D is incorrect).
Q3: Which California Code of Regulations (CCR) Title 8 section governs the qualifications,
duties, and conduct of Qualified Medical Evaluators?
A. §9785 (Medical-Legal Expenses)
B. §10950-10969 (QME Regulations) [CORRECT]
C. §4600 (Medical Treatment)
D. §5703 (Reconsideration)
Correct Answer: B Rationale: CCR Title 8, Sections 10950-10969 specifically govern QME
qualifications, panel selection, evaluation procedures, report requirements, and disciplinary
standards (B). Section 9785 governs medical-legal fees (A). Labor Code §4600 governs medical
treatment generally (C). Section 5703 governs reconsideration procedures (D).
Q4: In the QME panel selection process, how many names appear on a standard QME panel
issued by the DWC Medical Unit?
A. One physician only
B. Two physicians
C. Three physicians [CORRECT]
D. Five physicians
Correct Answer: C Rationale: Standard QME panels issued by the DWC Medical Unit contain
three physician names from which the parties may agree on one, or each party may strike one
name, leaving the remaining physician as the evaluator (C). Single-physician panels are not
standard (A). Two or five physicians do not conform to standard panel requirements (B, D).
Q5: What is the time limit for a QME to issue a medical-legal report after examining an injured
worker, per CCR Title 8 §10961?
A. 10 days
,3
B. 15 days
C. 30 days [CORRECT]
D. 60 days
Correct Answer: C Rationale: CCR Title 8 §10961 requires QMEs to serve their medical-legal
reports within 30 days of the examination (C). The 10-day and 15-day timeframes (A, B) are too
short. While complex cases may require extensions, 60 days (D) exceeds the standard
requirement without proper justification and notification.
Q6: Which of the following constitutes an "ex parte communication" prohibited under California
workers' compensation law?
A. A telephone call between the QME and the applicant's attorney to schedule the examination
B. A written communication from the defense attorney to the QME providing medical records
with a cover letter arguing the legal significance of the case [CORRECT]
C. A conversation between the QME and the injured worker during the examination about the
worker's symptoms
D. Correspondence between the QME and the DWC Medical Unit regarding panel qualifications
Correct Answer: B Rationale: Ex parte communications are prohibited one-sided
communications regarding the substance of the case. Providing medical records with legal
arguments attempting to influence the QME's opinion constitutes prohibited ex parte
communication (B). Scheduling communications (A), clinical interviews with the patient (C),
and administrative correspondence with the DWC (D) are permitted.
Q7: Under Labor Code §4663, what is the standard for apportionment of permanent disability?
A. Apportionment is prohibited in all California workers' compensation cases
B. Apportionment must be based on causation, with the employer liable only for the percentage
of permanent disability directly caused by the industrial injury [CORRECT]
C. Apportionment is determined solely by the date of injury, with older injuries receiving higher
apportionment
D. Apportionment is calculated based on the employer's ability to pay
Correct Answer: B Rationale: Labor Code §4663 requires apportionment based on causation,
with the employer responsible only for the percentage of permanent disability directly caused by
, 4
the industrial injury (B). Apportionment is not prohibited (A). Date of injury (C) and employer
ability to pay (D) are not valid apportionment standards.
Q8: What does "AOE/COE" stand for in California workers' compensation terminology?
A. Administrative Order of Evidence / Certificate of Eligibility
B. Arising Out of Employment / Course of Employment [CORRECT]
C. Assessment of Earnings / Calculation of Expenses
D. Authorized Occupational Expert / Certified Orthopedic Examiner
Correct Answer: B Rationale: AOE/COE stands for "Arising Out of Employment / Course of
Employment," which establishes whether an injury occurred during work activities and is
therefore compensable (B). The other options (A, C, D) are not recognized workers'
compensation terminology.
Q9: Which of the following is TRUE regarding a QME's role in determining work restrictions?
A. QMEs may not make any recommendations regarding work restrictions
B. QMEs may recommend work restrictions based on the industrial injury but should not
consider non-industrial conditions
C. QMEs may recommend work restrictions considering the total disability from all causes, but
should identify which restrictions are due to the industrial injury [CORRECT]
D. Only the employer may determine work restrictions
Correct Answer: C Rationale: QMEs may recommend work restrictions based on the total
disability picture but must identify which restrictions are attributable to the industrial injury
versus other causes (C). QMEs do make work restriction recommendations (A is incorrect). Non-
industrial conditions affecting work capacity must be considered (B is incorrect). Employers
implement but do not unilaterally determine restrictions (D is incorrect).
Q10: Under CCR Title 8 §10961, what must a QME include in the medical-legal report when
there is a finding of permanent disability?
A. Only the final impairment rating percentage
B. An impairment rating calculated according to the AMA Guides, apportionment analysis, and
work restrictions [CORRECT]
