QME EXAM NEWEST ACTUAL EXAM COMPLETE AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION 2026!!!
Holds authority to appoint physicians as QME evaluators - CORRECT ANSWER-Administrative
Director (AD) (LC 139.2)
Term of appointment as QME evaluator - CORRECT ANSWER-2 years (LC 139.2)
3 requirements when seeking appointment as QME - CORRECT ANSWER-(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 - CORRECT ANSWER-(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 - CORRECT
ANSWER-(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 - CORRECT ANSWER-(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 - CORRECT ANSWER-(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* - CORRECT ANSWER-Occurs as the result of a single incident or exposure
*Cumulative injury* - CORRECT ANSWER-Results from repetitive trauma (mental or physical)
over a period of time
2 requirements for a condition to be considered an injury - CORRECT ANSWER-(1) Cause
disability; or
(2) Result in a need for medical treatment
Occupational disease - CORRECT ANSWER-Disease that in whole or part is caused by work
7 types of excluded injuries - CORRECT ANSWER-(1) Caused by employee's use of alcohol or
illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
(4) Resulting from altercations, in which the injured employee is the *initial physical
aggressor*;
(5) Resulting from the employee's commission of a felony, for which the employee has been
convicted (including "wobbly felonies," which are crimes that may be prosecuted as
misdemeanors or felonies)
, (6) Resulting from off-duty recreational activities, in which participation in the activities does
not constitute part of the employee's work-related duties and the activity is not an
expressed or implicit condition of employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless certain conditions
exist
4 basic conditions to establish a workers' compensation claim - CORRECT ANSWER-(1)
*Injury* (physiological or psychological harm);
(2) Employment relationship;
(3) Injury caused by the employment (This is also referred to as arising out of employment
[AOE].);
(4) Occurred in the course of the employment (COE)
Aggravation of a pre-existing, non-industrial condition - CORRECT ANSWER-(1) Causes a
temporary or permanent increase in disability;
(2) Creates a new need for medical treatment; or
(3) Requires a change in the existing course of treatment
Symptoms that don't constitute a new injury - CORRECT ANSWER-*Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the current
employment
Date of injury (DOI)-specific injury - CORRECT ANSWER-Date on which the incident or
exposure occurred
Date of injury (DOI)-cumulative injury - CORRECT ANSWER-Date when the employee first
suffered disability from the exposure, and either knew, or should have known, that the
disability was caused by present or previous employment
Items determined by the DOI - CORRECT ANSWER-(1) Statute of limitations for particular
procedures within the workers' compensation system;
(2) Regulations that will apply to the worker's injury;
(3) Compensation rate for the worker's injury;
DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION 2026!!!
Holds authority to appoint physicians as QME evaluators - CORRECT ANSWER-Administrative
Director (AD) (LC 139.2)
Term of appointment as QME evaluator - CORRECT ANSWER-2 years (LC 139.2)
3 requirements when seeking appointment as QME - CORRECT ANSWER-(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 - CORRECT ANSWER-(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 - CORRECT
ANSWER-(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 - CORRECT ANSWER-(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 - CORRECT ANSWER-(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* - CORRECT ANSWER-Occurs as the result of a single incident or exposure
*Cumulative injury* - CORRECT ANSWER-Results from repetitive trauma (mental or physical)
over a period of time
2 requirements for a condition to be considered an injury - CORRECT ANSWER-(1) Cause
disability; or
(2) Result in a need for medical treatment
Occupational disease - CORRECT ANSWER-Disease that in whole or part is caused by work
7 types of excluded injuries - CORRECT ANSWER-(1) Caused by employee's use of alcohol or
illegal controlled substances;
(2) Intentionally self-inflicted injuries;
(3) Suicide;
(4) Resulting from altercations, in which the injured employee is the *initial physical
aggressor*;
(5) Resulting from the employee's commission of a felony, for which the employee has been
convicted (including "wobbly felonies," which are crimes that may be prosecuted as
misdemeanors or felonies)
, (6) Resulting from off-duty recreational activities, in which participation in the activities does
not constitute part of the employee's work-related duties and the activity is not an
expressed or implicit condition of employment;
(7) Psychiatric injuries claimed after notice of termination/layoff unless certain conditions
exist
4 basic conditions to establish a workers' compensation claim - CORRECT ANSWER-(1)
*Injury* (physiological or psychological harm);
(2) Employment relationship;
(3) Injury caused by the employment (This is also referred to as arising out of employment
[AOE].);
(4) Occurred in the course of the employment (COE)
Aggravation of a pre-existing, non-industrial condition - CORRECT ANSWER-(1) Causes a
temporary or permanent increase in disability;
(2) Creates a new need for medical treatment; or
(3) Requires a change in the existing course of treatment
Symptoms that don't constitute a new injury - CORRECT ANSWER-*Flare-ups* or
*recurrence* of a previous industrial injury or illness; not been caused by the current
employment
Date of injury (DOI)-specific injury - CORRECT ANSWER-Date on which the incident or
exposure occurred
Date of injury (DOI)-cumulative injury - CORRECT ANSWER-Date when the employee first
suffered disability from the exposure, and either knew, or should have known, that the
disability was caused by present or previous employment
Items determined by the DOI - CORRECT ANSWER-(1) Statute of limitations for particular
procedures within the workers' compensation system;
(2) Regulations that will apply to the worker's injury;
(3) Compensation rate for the worker's injury;
