QME EXAM –COMPLETE STUDY GUIDE | PRACTICE
QUESTIONS AND ANSWERS-RATIONALES | EXAM
PREP | DOWNLOAD INSTANT PDF | GUARANTEED
PASS || LATEST EXAM 2026-2027
1. When a Qualified Medical Evaluator (QME) is evaluating an injured worker in
California, what is the primary purpose of determining permanent and stationary (P&S)
status?
A. To determine the exact date the employee will return to their pre-injury wage level
B. To establish whether the employee's medical condition has reached a plateau where it is
unlikely to change substantially with or without medical treatment
C. To calculate the final vocational rehabilitation voucher amount without needing further
apportionment
D. To legally terminate the employer's obligation to provide any future medical care related to
the industrial injury
A permanent and stationary status or maximum medical improvement means the employee's
condition has reached a medical plateau where it is unlikely to change substantially, with or
without medical treatment, which is necessary before permanent disability can be rated.
2. Which of the following best describes the QME's legal responsibility regarding medical-
legal report timeliness in California workers' compensation?
A. Reports must be served within 30 days of the evaluation unless an extension is granted
for specific statutory reasons
B. Reports can be submitted within 90 days if the worker is still receiving temporary disability
benefits
C. Reports have no strict statutory deadline as long as both parties sign a waiver prior to the
examination
D. Reports must be completed and filed with the Workers' Compensation Appeals Board
(WCAB) within 10 business days regardless of diagnostic test results
California Code of Regulations require QME reports to be served within 30 calendar days of
the date of the examination, with specific procedural exceptions and extensions available for
delayed test results.
,3. In the context of QME evaluations, what is apportionment primarily designed to
accomplish?
A. To assign financial liability directly to the injured worker for failing to disclose pre-existing
health conditions
B. To separate the approximate percentage of permanent disability caused by the
industrial injury from non-industrial factors and prior injuries
C. To distribute the cost of the medical-legal evaluation equally between the applicant's attorney
and defense counsel
D. To determine how much of the temporary disability indemnity should be refunded to the state
employment development department
Apportionment requires the QME to make an explicit legal and medical determination
regarding what percentage of the permanent disability is directly caused by the industrial
injury versus prior injuries or non-industrial conditions.
4. An injured worker presents with a complex spinal injury, and the QME needs to
determine the appropriate impairment rating. Which AMA Guides edition is mandated for
use in California for injuries occurring on or after January 1, 2005?
A. Fifth Edition of the AMA Guides to the Evaluation of Permanent Impairment
B. Fourth Edition of the AMA Guides with specific California modifications
C. Sixth Edition of the AMA Guides to the Evaluation of Permanent Impairment
D. California Specific Disability Evaluation Schedule without reference to any AMA Guides
California law mandates the use of the American Medical Association (AMA) Guides to the
Evaluation of Permanent Impairment, 5th Edition, for evaluating permanent disability for
injuries occurring on or after January 1, 2005.
5. Which of the following is considered an ex parte communication violation for a QME?
A. Discussing the medical findings with the designated claims administrator during a formal
deposition where both parties are represented
B. Reviewing medical records provided jointly by both the applicant's attorney and defense
counsel through the proper document exchange process
C. Speaking privately about the merits of the case with only one party's attorney or
representative without the other party's participation or consent
, D. Requesting authorization for specialized diagnostic testing from the utilization review
organization after notifying both legal representatives
Ex parte communication rules strictly prohibit a QME from engaging in unauthorized private
discussions or correspondence regarding the evaluation with only one side of the litigation
without the opposing party being included.
6. When a QME identifies a need for diagnostic testing that was not initially authorized,
what is the correct procedural step?
A. Order the tests immediately and bill the primary treating physician for the cost of the facility
fees
B. Request authorization through the appropriate administrative or utilization review
channels or consult with the parties regarding panel guidelines
C. Cancel the evaluation entirely and refer the injured worker back to the state disability office
D. Perform the tests during the physical exam using office equipment and include the charges in
the baseline medical-legal fee schedule
QMEs must follow established medical-legal and administrative procedures for securing
authorization or adhering to panel guidelines when additional specialized testing is clinically
necessary.
7. Under California workers' compensation law, what is the definition of a "industrial
injury"?
A. Any injury that occurs on the employer's premises regardless of whether the employee was
performing work duties
B. Any injury or illness arising out of and in the course of employment (AOE/COE)
C. Only acute physical trauma sustained during heavy lifting or machinery operation
D. Any medical condition diagnosed within 48 hours of clocking out from a scheduled shift
An industrial injury is legally defined as any injury or occupational disease arising out of and
in the course of employment, commonly referred to as AOE/COE.
8. If a QME panel is issued by the Medical Bureau, within how many days must the injured
worker or the employer select a QME and schedule an appointment?
A. Within 10 calendar days of the panel issuance date
QUESTIONS AND ANSWERS-RATIONALES | EXAM
PREP | DOWNLOAD INSTANT PDF | GUARANTEED
PASS || LATEST EXAM 2026-2027
1. When a Qualified Medical Evaluator (QME) is evaluating an injured worker in
California, what is the primary purpose of determining permanent and stationary (P&S)
status?
A. To determine the exact date the employee will return to their pre-injury wage level
B. To establish whether the employee's medical condition has reached a plateau where it is
unlikely to change substantially with or without medical treatment
C. To calculate the final vocational rehabilitation voucher amount without needing further
apportionment
D. To legally terminate the employer's obligation to provide any future medical care related to
the industrial injury
A permanent and stationary status or maximum medical improvement means the employee's
condition has reached a medical plateau where it is unlikely to change substantially, with or
without medical treatment, which is necessary before permanent disability can be rated.
2. Which of the following best describes the QME's legal responsibility regarding medical-
legal report timeliness in California workers' compensation?
A. Reports must be served within 30 days of the evaluation unless an extension is granted
for specific statutory reasons
B. Reports can be submitted within 90 days if the worker is still receiving temporary disability
benefits
C. Reports have no strict statutory deadline as long as both parties sign a waiver prior to the
examination
D. Reports must be completed and filed with the Workers' Compensation Appeals Board
(WCAB) within 10 business days regardless of diagnostic test results
California Code of Regulations require QME reports to be served within 30 calendar days of
the date of the examination, with specific procedural exceptions and extensions available for
delayed test results.
,3. In the context of QME evaluations, what is apportionment primarily designed to
accomplish?
A. To assign financial liability directly to the injured worker for failing to disclose pre-existing
health conditions
B. To separate the approximate percentage of permanent disability caused by the
industrial injury from non-industrial factors and prior injuries
C. To distribute the cost of the medical-legal evaluation equally between the applicant's attorney
and defense counsel
D. To determine how much of the temporary disability indemnity should be refunded to the state
employment development department
Apportionment requires the QME to make an explicit legal and medical determination
regarding what percentage of the permanent disability is directly caused by the industrial
injury versus prior injuries or non-industrial conditions.
4. An injured worker presents with a complex spinal injury, and the QME needs to
determine the appropriate impairment rating. Which AMA Guides edition is mandated for
use in California for injuries occurring on or after January 1, 2005?
A. Fifth Edition of the AMA Guides to the Evaluation of Permanent Impairment
B. Fourth Edition of the AMA Guides with specific California modifications
C. Sixth Edition of the AMA Guides to the Evaluation of Permanent Impairment
D. California Specific Disability Evaluation Schedule without reference to any AMA Guides
California law mandates the use of the American Medical Association (AMA) Guides to the
Evaluation of Permanent Impairment, 5th Edition, for evaluating permanent disability for
injuries occurring on or after January 1, 2005.
5. Which of the following is considered an ex parte communication violation for a QME?
A. Discussing the medical findings with the designated claims administrator during a formal
deposition where both parties are represented
B. Reviewing medical records provided jointly by both the applicant's attorney and defense
counsel through the proper document exchange process
C. Speaking privately about the merits of the case with only one party's attorney or
representative without the other party's participation or consent
, D. Requesting authorization for specialized diagnostic testing from the utilization review
organization after notifying both legal representatives
Ex parte communication rules strictly prohibit a QME from engaging in unauthorized private
discussions or correspondence regarding the evaluation with only one side of the litigation
without the opposing party being included.
6. When a QME identifies a need for diagnostic testing that was not initially authorized,
what is the correct procedural step?
A. Order the tests immediately and bill the primary treating physician for the cost of the facility
fees
B. Request authorization through the appropriate administrative or utilization review
channels or consult with the parties regarding panel guidelines
C. Cancel the evaluation entirely and refer the injured worker back to the state disability office
D. Perform the tests during the physical exam using office equipment and include the charges in
the baseline medical-legal fee schedule
QMEs must follow established medical-legal and administrative procedures for securing
authorization or adhering to panel guidelines when additional specialized testing is clinically
necessary.
7. Under California workers' compensation law, what is the definition of a "industrial
injury"?
A. Any injury that occurs on the employer's premises regardless of whether the employee was
performing work duties
B. Any injury or illness arising out of and in the course of employment (AOE/COE)
C. Only acute physical trauma sustained during heavy lifting or machinery operation
D. Any medical condition diagnosed within 48 hours of clocking out from a scheduled shift
An industrial injury is legally defined as any injury or occupational disease arising out of and
in the course of employment, commonly referred to as AOE/COE.
8. If a QME panel is issued by the Medical Bureau, within how many days must the injured
worker or the employer select a QME and schedule an appointment?
A. Within 10 calendar days of the panel issuance date
