QME COMPETENCY EXAM MASTER BANK 200 QUESTIONS PLUS DETAILED RATIONALES CA WORKERS COMP AND AMA GUIDES 5TH ED 2024 to 2025 EDITION

QME COMPETENCY EXAM
MASTER BANK 200 QUESTIONS
PLUS DETAILED RATIONALES CA
WORKERS COMP AND AMA
GUIDES 5TH ED 2024 to 2025
EDITION



QME Competency Practice Exam
1. According to the California Code of Regulations, a QME must wait
how many days after the date of the face-to-face evaluation to serve
the medical-legal report?
a) 15 days
b) 30 days
c) 45 days
d) 60 days
Rationale: CCR § 38 requires the medical-legal report to be
served within 30 days of the evaluation unless an extension is
granted.
2. Under the AMA Guides 5th Edition, "Impairment" is best defined
as:
a) A loss, loss of use, or derangement of any body part,
organ system, or organ function.
b) A decrease in the ability to perform activities of daily living
(ADLs).
c) The impact of a medical condition on a patient’s ability to work.
d) The percentage of disability awarded by a judge.
Rationale: The AMA Guides specifically define impairment as an
anatomic or functional abnormality; disability and work
capacity are separate legal determinations.
3. Which of the following is considered a "Mandatory Component" of
a QME report according to Labor Code § 139.2?

, a) A list of all medications the patient has ever taken.
b) A declaration under penalty of perjury that the
evaluator has not violated Labor Code § 139.3 (Anti-
Referral).
c) A recommendation for a specific attorney for the applicant.
d) The social security number of the injured worker.
Rationale: Evaluators must certify that they have no prohibited
financial interests in the services they recommend.
4. When evaluating "Alcock’s Syndrome" or psychiatric injury, what
is the threshold for "predominant cause" for most cases?
a) 25%
b) 35%
c) Greater than 50%
d) 10%
Rationale: Labor Code § 3208.3 states that for a psychiatric
injury to be compensable, the employee must demonstrate that
events of employment were the predominant cause (more than
50%).
5. A QME is allowed to review "Sub Rosa" (surveillance) video
footage only if:
a) The applicant’s attorney gives written permission first.
b) The footage is provided to the QME by one of the
parties and is listed in the "documents reviewed" section.
c) The QME records the footage themselves.
d) Sub Rosa is never allowed to be reviewed by a QME.
Rationale: QMEs may review surveillance if provided by a party,
but they must disclose the review in the report.
6. What is the correct method for combining two different
impairment ratings (e.g., a spine rating and a knee rating) under
the AMA Guides?
a) Add the percentages together (10% + 10% = 20%).
b) Subtract the smaller from the larger.
c) Use the Combined Values Chart (CVC).
d) Only the highest rating is used; the other is discarded.
Rationale: The CVC prevents a total impairment from exceeding
100% by using a formula (A + B(1-A)).
7. "Apportionment" in a QME report must be based on:
a) Causation of the disability, not causation of the injury.

, b) Causation of the injury only.
c) The age of the patient.
d) The length of time the patient has worked for the employer.
Rationale: Under SB 899 (Labor Code § 4663), apportionment
must be based on the percentages of the permanent disability
caused by various factors.
8. An evaluator must provide an "Ex parte" communication
disclosure if:
a) They talk to their own medical assistant.
b) They communicate with one party (e.g., an attorney)
without the presence or knowledge of the other.
c) They talk to the injured worker during the exam.
d) They mail the report to the insurance carrier.
Rationale: Ex parte communication is strictly forbidden and can
lead to the disqualification of the QME and the report.
9. Which "Activities of Daily Living" (ADLs) are specifically
mentioned in the AMA Guides for assessing the impact of a
condition?
a) Driving a car and playing professional sports.
b) Self-care, communication, physical activity, sensory
function, and sleep.
c) Ability to earn a high salary.
d) Gardening and heavy lifting.
Rationale: The AMA Guides (p. 4) list specific ADLs that define the
baseline for functional loss.
10. If a QME requires a consultation with another specialist, they
must:
a) Schedule it immediately without telling anyone.
b) Notify the parties and obtain consent or an order from
a judge if there is an objection.
c) Refer the patient to their own business partner.
d) Perform the other specialty’s exam themselves even if not
qualified.
Rationale: CCR § 32 regulates how "consultative" reports are
obtained to ensure transparency.
11. The term "Maximum Medical Improvement" (MMI) is
synonymous with:
a) Permanent and Stationary (P&S).

, b) Temporary Total Disability (TTD).
c) Date of Injury (DOI).
d) Return to Work (RTW).
Rationale: MMI/P&S is the point at which the patient's condition
has plateaued and is not expected to improve significantly with
further treatment.
12.In the State of California, who is responsible for paying for a QME
evaluation?
a) The injured worker.
b) The employer or the insurance carrier.
c) The QME’s medical group.
d) The State of California General Fund.
Rationale: Medical-legal expenses are the liability of the
defendant (employer/carrier).
13.How many years must a QME maintain a copy of the medical-legal
report and all records reviewed?
a) 2 years.
b) 5 years.
c) 10 years.
d) Permanently.
Rationale: CCR § 39.5 requires records to be kept for at least five
years from the date of the evaluation.
14.Which Labor Code section governs "Substantial Medical
Evidence"?
a) § 123
b) § 4600
c) § 4628
d) § 5811
Rationale: § 4628 outlines the requirements for a report to be
admissible as evidence, including the disclosure of who performed
the work.
15. If an injured worker does not speak English, the QME is required
to:
a) Use the worker's child as a translator.
b) Use a bilingual medical assistant from the office.
c) Use a certified medical interpreter.
d) Cancel the exam.