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QME Exam| Comprehensive Q&A For
Certification Success 2026
Acceleration - correct-answer - Disease process is accelerated by virtue of work
exposure. The date of the onset of the disease is much sooner than it would have
been in the absence of the exposure.
Precipitation - correct-answer - Work exposure *precipitates* the manifestation
of the illness. For example, an underlying tendency or asymptomatic problem was
present, but the work exposure causes it to clinically manifest.
Aggravation - correct-answer - A medical condition may be present already, but
work exposure makes it worse
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Principle of "taking employees as you find them" - correct-answer - The employer
cannot avoid liability for an occupational injury by claiming that the injury would
not have happened if the worker had been in a different physical
or emotional condition before the accident.
Criteria for compensation of psychiatric injuries - correct-answer - (1) Diagnosed
mental disorder;
(2) Causes disability or need for medical treatment; and
(3) Employee can demonstrate that events of employment were *predominant
cause* of the injury
Limits for claims of psychiatric injury - correct-answer - (1) *Actual events of
employment* were the *predominant cause* (> 50%) among all combined causes
of the psychiatric injury (except if the injury is a derivative of an underlying
physical injury)
(2) If the injury resulted from a violent act or from direct exposure to a significant
violent act, the actual events of employment must have been a *substantial
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cause* of the injury (contributed >= 35% of the causation from all sources
combined)
(3) Employee was employed by employer >= 6 months (not continuously), unless
the injury was caused by a sudden and extraordinary employment condition
(4) Injury was not substantially (>=35%) caused by "lawful, nondiscriminatory,
good faith personnel actions" (e.g., being passed over for promotion or being
transferred to another department)
(5) Claim can not be filed after notification of termination or layoff
Perception is not disability - correct-answer - Disability is not based on how much
stress *should* have been felt by employee, but rather how much stress *is* felt
by an individual worker reacting uniquely to the work environment
Stress must have proximately caused the injury
Proximate cause - correct-answer - Causal connection between injury and
employment
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*Employment need not be sole cause of injury, just a contributing cause
Criteria for compensability of psychiatric claims after notice of termination/layoff
- correct-answer - (1) Injury was the result of sudden and extraordinary events of
employment
(2) Employer had notice of the injury before the notice of termination or layoff.
(3) Medical records existing before the notice of termination/layoff contain
evidence of treatment of the psychiatric injury
(4) Contractual, administrative, regulatory, or judicial trier of fact has found that
there was sexual or racial harassment.
(5) There is evidence that the DOI is subsequent to the date of notice of
termination, but before the effective date of the termination. (Allows post-
termination claims for cumulative
injuries or occupational illnesses that do not manifest themselves until after the
employee has left the job)
QME Exam| Comprehensive Q&A For
Certification Success 2026
Acceleration - correct-answer - Disease process is accelerated by virtue of work
exposure. The date of the onset of the disease is much sooner than it would have
been in the absence of the exposure.
Precipitation - correct-answer - Work exposure *precipitates* the manifestation
of the illness. For example, an underlying tendency or asymptomatic problem was
present, but the work exposure causes it to clinically manifest.
Aggravation - correct-answer - A medical condition may be present already, but
work exposure makes it worse
,2|Page
Principle of "taking employees as you find them" - correct-answer - The employer
cannot avoid liability for an occupational injury by claiming that the injury would
not have happened if the worker had been in a different physical
or emotional condition before the accident.
Criteria for compensation of psychiatric injuries - correct-answer - (1) Diagnosed
mental disorder;
(2) Causes disability or need for medical treatment; and
(3) Employee can demonstrate that events of employment were *predominant
cause* of the injury
Limits for claims of psychiatric injury - correct-answer - (1) *Actual events of
employment* were the *predominant cause* (> 50%) among all combined causes
of the psychiatric injury (except if the injury is a derivative of an underlying
physical injury)
(2) If the injury resulted from a violent act or from direct exposure to a significant
violent act, the actual events of employment must have been a *substantial
,3|Page
cause* of the injury (contributed >= 35% of the causation from all sources
combined)
(3) Employee was employed by employer >= 6 months (not continuously), unless
the injury was caused by a sudden and extraordinary employment condition
(4) Injury was not substantially (>=35%) caused by "lawful, nondiscriminatory,
good faith personnel actions" (e.g., being passed over for promotion or being
transferred to another department)
(5) Claim can not be filed after notification of termination or layoff
Perception is not disability - correct-answer - Disability is not based on how much
stress *should* have been felt by employee, but rather how much stress *is* felt
by an individual worker reacting uniquely to the work environment
Stress must have proximately caused the injury
Proximate cause - correct-answer - Causal connection between injury and
employment
, 4|Page
*Employment need not be sole cause of injury, just a contributing cause
Criteria for compensability of psychiatric claims after notice of termination/layoff
- correct-answer - (1) Injury was the result of sudden and extraordinary events of
employment
(2) Employer had notice of the injury before the notice of termination or layoff.
(3) Medical records existing before the notice of termination/layoff contain
evidence of treatment of the psychiatric injury
(4) Contractual, administrative, regulatory, or judicial trier of fact has found that
there was sexual or racial harassment.
(5) There is evidence that the DOI is subsequent to the date of notice of
termination, but before the effective date of the termination. (Allows post-
termination claims for cumulative
injuries or occupational illnesses that do not manifest themselves until after the
employee has left the job)
