QME FINAL PAPER 2025/2026 QUESTIONS WITH ANSWERS GRADED A+

QME FINAL PAPER 2025/2026 QUESTIONS WITH ANSWERS
GRADED A+
✔✔Only admissible reports before a WCJ on the issue of permanent disability -
✔✔QME report
Evaluation(s) prepared by treating physician(s)

✔✔Apportionment - ✔✔Estimate of approximate percentage of permanent disability
caused by a work-related injury (& approximate percentage caused by other factors)

Only applies to permanent disability

✔✔Regions of the body - ✔✔(1) Hearing
(2) Vision
(3) Mental and behavioral disorders
(4) Spine
(5) Upper extremities, including shoulders
(6) Lower extremities, including hip joints
(7) Head
(8) Face
(9) CV system
(10) Respiratory system
(11) All other systems/regions

✔✔Criteria for presumptive 100% awards - ✔✔(1) Loss of both eyes or sight in both
eyes
(2) Loss of both hands or use of both hands
(3) Injury resulting in practically total paralysis
(4) Injury to the brain, resulting in incurable mental incapacitiy or insanity

✔✔Trigger for a comprehensive medical evaluation of permanent disability by an
AME/QME - ✔✔Injured worker or employer wishes to contest treating physician's
evaluation

✔✔Impairment (AMA Guides definition) - ✔✔Loss, loss of use, or derangement of any
body part, organ system or organ function

Change from a normal/pre-existing state implied in def'n

✔✔Disability (AMA Guides definition) - ✔✔Alteration of an individual's capacity to meet
personal, social, or occupational demands or statutory or regulatory requirements
because of an impairment

✔✔Combined Values Chart - ✔✔Used to combine multiple impairment ratings into a
summary value or WPI

, ✔✔Responsibility for assigning QME panels - ✔✔DWC Executive Medical Director

✔✔Time frame in which either party in represented cases may object to a medical
determination by the treating physician - ✔✔20 days, in writing

✔✔Time frame in which either party in unrepresented cases may object to a medication
determination by the treating physician - ✔✔30 days, in writing

✔✔Time limit for unrepresented injured worker to submit request for a QME panel after
receiving form from employer - ✔✔10 days

✔✔Time frame after which unrepresented worker has the right to obtain an evaluation
from any QME within a reasonable geographic area - ✔✔After 20 days, if request for
QME panel is not issued

✔✔Time frame in which an injured worker is required to select a physician from the
QME panel, make an appointment for the exam and inform the claims administrator of
the selection and appointment - ✔✔Within 10 days after the panel is issued

✔✔Rights of the claim administrator in selecting the QME and arranging the
appointment - ✔✔If injured worker does not inform the claims administrator of the
selection or date of appointment

✔✔Time frame in represented cases during which each party may strike one name from
the QME panel - ✔✔10 days after the assignment of the panel

✔✔Time frame in which selected QME must schedule an appointment to see the injured
worker - ✔✔Within 60 days of a request for an appointment (up to 90 days)

✔✔Time frame to submit the QME Appointment Notification Form - ✔✔Within 5
business days of making the appointment

✔✔Parties receiving service of the QME Appointment Notification Form - ✔✔Employee
(+ representative)
Employer/claims administrator (+ representative)

✔✔Trigger to send medical records and other information to the QME - ✔✔Receipt of
the QME Appointment Notification Form

✔✔Causes for issuance of a replacement panel - ✔✔(1) Failure to serve the QME
Appointment Notification Form;
(2) Disclosure of COI by an evaluator after an appointment has been made;