QME CERTIFICATION EXAM STUDY GUIDE
NEWEST 2026 | CALIFORNIA QUALIFIED
MEDICAL EVALUATOR TEST BANK | WORKERS
COMP, AMA GUIDES , REPORTS WRITING | 300+
Q&A | A+ BUNDLE 2026
Question: Who holds the authority to appoint physicians as Qualified Medical
Evaluators (QMEs)?
A) Workers' Compensation Appeals Board (WCAB)
B) Administrative Director (AD)
C) Division of Workers' Compensation (DWC)
D) California Medical Board
Correct Answer: B Administrative Director (AD)
Expert Rationale: The Administrative Director (AD) has the statutory authority to appoint
QMEs under Labor Code §139.2. Understanding this is essential because the AD oversees
the QME system and ensures qualified physicians are available to resolve medical
disputes. The AD's authority includes appointment, reappointment, and disciplinary
actions.
Question: What is the term of appointment for a QME evaluator?
A) 1 year
B) 2 years
C) 3 years
D) 5 years
Correct Answer: B 2 years
Expert Rationale: QME appointments are for a 2-year term under Labor Code §139.2.
Understanding this is essential because QMEs must reapply and meet reappointment
requirements every 2 years. Reappointment requires continued compliance with all
eligibility criteria.
,Question: Which of the following is a requirement for seeking appointment as a QME?
A) Pass the QME competency exam
B) Complete a 12-hour course in disability evaluation report writing
C) Devote at least 1/3 of total practice time to providing direct medical treatment
D) All of the above
Correct Answer: D All of the above
Expert Rationale: All three requirements are mandatory for QME appointment: passing the
competency exam, completing the 12-hour report writing course, and devoting at least 1/3
of practice time to direct treatment or serving as an AME on 8+ occasions in the past 12
months. Understanding these requirements is essential because QMEs must maintain
clinical competency and meet specific practice standards.
Question: Which of the following is a reason for termination/suspension of a QME
without a hearing?
A) Violation of material statutory duty
B) Licensing board revokes license to practice
C) Failure to follow medical procedures
D) Preparation of inadequate medical-legal evaluations
Correct Answer: B Licensing board revokes license to practice
Expert Rationale: A licensing board action that suspends, revokes, or terminates a license
to practice is grounds for immediate suspension/termination without a hearing.
Understanding this is essential because QMEs must maintain an active, unrestricted
license. Failure to pay required fees is also grounds for termination without a hearing.
Question: Which of the following is a reason for discipline of a QME after a hearing?
A) Violation of material statutory or administrative duty
B) Failure to pay required fee
C) Licensing board revocation
D) Both A and B
Correct Answer: A Violation of material statutory or administrative duty
Expert Rationale: Violation of statutory or administrative duties requires a hearing before
discipline. Understanding this is essential because due process requires a hearing for
,substantive violations of professional duties. The six reasons include failure to follow
medical procedures, comply with timeframes, meet licensing requirements, and prepare
adequate reports.
Question: Which of the following is NOT a type of substantive medical dispute
resolved by QMEs?
A) Compensability of the claim
B) Permanent disability
C) Temporary disability
D) Criminal liability of the employer
Correct Answer: D Criminal liability of the employer
Expert Rationale: QMEs resolve medical disputes such as compensability, permanent
disability, and "catch-all" issues including temporary disability and work restrictions.
Understanding this is essential because QMEs do not address criminal liability—that falls
under criminal law, not workers' compensation.
Question: What is the definition of injury in compensability claims?
A) An injury or disease arising out of employment
B) Any injury occurring while at work
C) Any injury during work hours
D) An injury caused by employer negligence
Correct Answer: A An injury or disease arising out of employment
Expert Rationale: Compensability requires that the injury or disease arises out of
employment, including derivative injuries from treatment and reactions to employer-
provided preventive care. Understanding this is essential because the definition
establishes the scope of workers' compensation coverage.
Question: What is a specific injury?
A) Results from repetitive trauma over time
B) Occurs as the result of a single incident or exposure
C) An occupational disease
D) A psychiatric injury
, Correct Answer: B Occurs as the result of a single incident or exposure
Expert Rationale: A specific injury results from a single, identifiable incident or exposure.
Understanding this is essential because it distinguishes specific injuries from cumulative
injuries, which develop over time. The date of injury for specific injuries is the date of the
incident.
Question: What is a cumulative injury?
A) Occurs as a result of a single incident
B) Results from repetitive trauma over a period of time
C) An occupational disease
D) A specific injury
Correct Answer: B Results from repetitive trauma over a period of time
Expert Rationale: Cumulative injuries result from repetitive trauma (physical or mental)
that develops over time. Understanding this is essential because the date of injury for
cumulative injuries is when the employee first suffered disability and knew or should have
known it was work-related.
Question: Which of the following is NOT a type of excluded injury?
A) Caused by employee's use of alcohol or illegal controlled substances
B) Intentionally self-inflicted injuries
C) Injuries from recreational activities
D) Injuries caused by employer negligence
Correct Answer: D Injuries caused by employer negligence
Expert Rationale: Employer negligence is not an excluded injury category. Understanding
this is essential because workers' compensation is a no-fault system that covers injuries
regardless of negligence. Excluded injuries include those caused by alcohol/drugs, self-
inflicted injuries, suicide, altercations where the employee is the aggressor, felony
commission, off-duty recreational activities, and certain psychiatric injuries after
termination.
Question: What are the four basic conditions to establish a workers' compensation
claim?
NEWEST 2026 | CALIFORNIA QUALIFIED
MEDICAL EVALUATOR TEST BANK | WORKERS
COMP, AMA GUIDES , REPORTS WRITING | 300+
Q&A | A+ BUNDLE 2026
Question: Who holds the authority to appoint physicians as Qualified Medical
Evaluators (QMEs)?
A) Workers' Compensation Appeals Board (WCAB)
B) Administrative Director (AD)
C) Division of Workers' Compensation (DWC)
D) California Medical Board
Correct Answer: B Administrative Director (AD)
Expert Rationale: The Administrative Director (AD) has the statutory authority to appoint
QMEs under Labor Code §139.2. Understanding this is essential because the AD oversees
the QME system and ensures qualified physicians are available to resolve medical
disputes. The AD's authority includes appointment, reappointment, and disciplinary
actions.
Question: What is the term of appointment for a QME evaluator?
A) 1 year
B) 2 years
C) 3 years
D) 5 years
Correct Answer: B 2 years
Expert Rationale: QME appointments are for a 2-year term under Labor Code §139.2.
Understanding this is essential because QMEs must reapply and meet reappointment
requirements every 2 years. Reappointment requires continued compliance with all
eligibility criteria.
,Question: Which of the following is a requirement for seeking appointment as a QME?
A) Pass the QME competency exam
B) Complete a 12-hour course in disability evaluation report writing
C) Devote at least 1/3 of total practice time to providing direct medical treatment
D) All of the above
Correct Answer: D All of the above
Expert Rationale: All three requirements are mandatory for QME appointment: passing the
competency exam, completing the 12-hour report writing course, and devoting at least 1/3
of practice time to direct treatment or serving as an AME on 8+ occasions in the past 12
months. Understanding these requirements is essential because QMEs must maintain
clinical competency and meet specific practice standards.
Question: Which of the following is a reason for termination/suspension of a QME
without a hearing?
A) Violation of material statutory duty
B) Licensing board revokes license to practice
C) Failure to follow medical procedures
D) Preparation of inadequate medical-legal evaluations
Correct Answer: B Licensing board revokes license to practice
Expert Rationale: A licensing board action that suspends, revokes, or terminates a license
to practice is grounds for immediate suspension/termination without a hearing.
Understanding this is essential because QMEs must maintain an active, unrestricted
license. Failure to pay required fees is also grounds for termination without a hearing.
Question: Which of the following is a reason for discipline of a QME after a hearing?
A) Violation of material statutory or administrative duty
B) Failure to pay required fee
C) Licensing board revocation
D) Both A and B
Correct Answer: A Violation of material statutory or administrative duty
Expert Rationale: Violation of statutory or administrative duties requires a hearing before
discipline. Understanding this is essential because due process requires a hearing for
,substantive violations of professional duties. The six reasons include failure to follow
medical procedures, comply with timeframes, meet licensing requirements, and prepare
adequate reports.
Question: Which of the following is NOT a type of substantive medical dispute
resolved by QMEs?
A) Compensability of the claim
B) Permanent disability
C) Temporary disability
D) Criminal liability of the employer
Correct Answer: D Criminal liability of the employer
Expert Rationale: QMEs resolve medical disputes such as compensability, permanent
disability, and "catch-all" issues including temporary disability and work restrictions.
Understanding this is essential because QMEs do not address criminal liability—that falls
under criminal law, not workers' compensation.
Question: What is the definition of injury in compensability claims?
A) An injury or disease arising out of employment
B) Any injury occurring while at work
C) Any injury during work hours
D) An injury caused by employer negligence
Correct Answer: A An injury or disease arising out of employment
Expert Rationale: Compensability requires that the injury or disease arises out of
employment, including derivative injuries from treatment and reactions to employer-
provided preventive care. Understanding this is essential because the definition
establishes the scope of workers' compensation coverage.
Question: What is a specific injury?
A) Results from repetitive trauma over time
B) Occurs as the result of a single incident or exposure
C) An occupational disease
D) A psychiatric injury
, Correct Answer: B Occurs as the result of a single incident or exposure
Expert Rationale: A specific injury results from a single, identifiable incident or exposure.
Understanding this is essential because it distinguishes specific injuries from cumulative
injuries, which develop over time. The date of injury for specific injuries is the date of the
incident.
Question: What is a cumulative injury?
A) Occurs as a result of a single incident
B) Results from repetitive trauma over a period of time
C) An occupational disease
D) A specific injury
Correct Answer: B Results from repetitive trauma over a period of time
Expert Rationale: Cumulative injuries result from repetitive trauma (physical or mental)
that develops over time. Understanding this is essential because the date of injury for
cumulative injuries is when the employee first suffered disability and knew or should have
known it was work-related.
Question: Which of the following is NOT a type of excluded injury?
A) Caused by employee's use of alcohol or illegal controlled substances
B) Intentionally self-inflicted injuries
C) Injuries from recreational activities
D) Injuries caused by employer negligence
Correct Answer: D Injuries caused by employer negligence
Expert Rationale: Employer negligence is not an excluded injury category. Understanding
this is essential because workers' compensation is a no-fault system that covers injuries
regardless of negligence. Excluded injuries include those caused by alcohol/drugs, self-
inflicted injuries, suicide, altercations where the employee is the aggressor, felony
commission, off-duty recreational activities, and certain psychiatric injuries after
termination.
Question: What are the four basic conditions to establish a workers' compensation
claim?
