HCC QME Exam
Section 1: Medical-Legal Process & Law
1. The QME’s primary role in the workers’ compensation system is to:
A. Represent the insurance company’s interest
B. Provide an impartial medical opinion
C. Represent the injured worker
D. Determine liability for benefits
Answer: B. Provide an impartial medical opinion
2. The governing body that regulates QMEs in California is:
A. California Medical Board
,B. Department of Industrial Relations, Division of Workers’ Compensation (DWC)
C. Department of Health Services
D. Department of Labor
Answer: B. DWC
3. Which California Code governs the QME process?
A. Business & Professions Code
B. Labor Code
C. Evidence Code
D. Penal Code
Answer: B. Labor Code
4. How long does a QME have to complete and serve a comprehensive medical-legal
report after an evaluation?
A. 5 calendar days
B. 10 business days
C. 30 calendar days
D. 45 calendar days
Answer: C. 30 calendar days
5. If a QME cannot complete a report within the required time frame, they must:
A. Notify the DWC Medical Unit and all parties
B. Complete the report anyway without notification
C. Call only the claims adjuster
D. Cancel the evaluation
Answer: A. Notify the DWC Medical Unit and all parties
6. A QME must keep all medical-legal records for:
A. 1 year
B. 3 years
C. 5 years
D. 10 years
, Answer: C. 5 years
7. A QME must disclose any conflict of interest:
A. Only if asked by the parties
B. At the start of the evaluation
C. After the report is issued
D. Never
Answer: B. At the start of the evaluation
8. Which of the following constitutes a conflict of interest for a QME?
A. Previous treatment of the injured worker
B. Having a financial interest in the employer
C. Prior consulting with the insurer
D. All of the above
Answer: D. All of the above
9. The QME exam is administered under which California Code of Regulations (CCR)?
A. Title 5
B. Title 8
C. Title 12
D. Title 16
Answer: B. Title 8
10. Failure to follow DWC QME regulations may result in:
A. License suspension
B. DWC disciplinary action or decertification
C. Civil fine
D. Nothing
Answer: B. DWC disciplinary action or decertification
Section 2: Disability & Apportionment
Section 1: Medical-Legal Process & Law
1. The QME’s primary role in the workers’ compensation system is to:
A. Represent the insurance company’s interest
B. Provide an impartial medical opinion
C. Represent the injured worker
D. Determine liability for benefits
Answer: B. Provide an impartial medical opinion
2. The governing body that regulates QMEs in California is:
A. California Medical Board
,B. Department of Industrial Relations, Division of Workers’ Compensation (DWC)
C. Department of Health Services
D. Department of Labor
Answer: B. DWC
3. Which California Code governs the QME process?
A. Business & Professions Code
B. Labor Code
C. Evidence Code
D. Penal Code
Answer: B. Labor Code
4. How long does a QME have to complete and serve a comprehensive medical-legal
report after an evaluation?
A. 5 calendar days
B. 10 business days
C. 30 calendar days
D. 45 calendar days
Answer: C. 30 calendar days
5. If a QME cannot complete a report within the required time frame, they must:
A. Notify the DWC Medical Unit and all parties
B. Complete the report anyway without notification
C. Call only the claims adjuster
D. Cancel the evaluation
Answer: A. Notify the DWC Medical Unit and all parties
6. A QME must keep all medical-legal records for:
A. 1 year
B. 3 years
C. 5 years
D. 10 years
, Answer: C. 5 years
7. A QME must disclose any conflict of interest:
A. Only if asked by the parties
B. At the start of the evaluation
C. After the report is issued
D. Never
Answer: B. At the start of the evaluation
8. Which of the following constitutes a conflict of interest for a QME?
A. Previous treatment of the injured worker
B. Having a financial interest in the employer
C. Prior consulting with the insurer
D. All of the above
Answer: D. All of the above
9. The QME exam is administered under which California Code of Regulations (CCR)?
A. Title 5
B. Title 8
C. Title 12
D. Title 16
Answer: B. Title 8
10. Failure to follow DWC QME regulations may result in:
A. License suspension
B. DWC disciplinary action or decertification
C. Civil fine
D. Nothing
Answer: B. DWC disciplinary action or decertification
Section 2: Disability & Apportionment
