QME FINAL EXAM PAPER 2026 FULL
QUESTIONS WITH CORRECT ANSWERS
◉ 4 basic conditions to establish a workers' compensation claim.
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. 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. 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. Answer: Date on which the
incident or exposure occurred
,◉ Date of injury (DOI)-cumulative injury. 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. 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;
(4) Employers who are liable for the claim.
◉ Reasonable medical probability. Answer: Standard by which QME
uses combination of existing medical and scientific knowledge and
the occupational and medical history of the individual worker to
conclude whether the work exposure contributed to the injury
◉ Evidentiary standard of causation/contribution in compensability
disputes. Answer: Preponderance of the evidence (51%; more likely
than not)
◉ 3 factors to establish in making a causation determination.
Answer: (1) Presence of pathological conditions and disability
(2) Relevant work exposures
(3) Non-industrial exposures (other causes of disease)
, ◉ 5 major types of causation. Answer: (1) Direct
(2) Contributing
(3) Acceleration
(4) Precipitation
(5) Aggravation
◉ Direct causation. Answer: Work exposures are directly
responsible for the health outcomes
◉ Contributing causation. Answer: Several factors led to the disease;
work exposure is one of these factors
◉ Acceleration. 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. 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. Answer: A medical condition may be present already,
but work exposure makes it worse
QUESTIONS WITH CORRECT ANSWERS
◉ 4 basic conditions to establish a workers' compensation claim.
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. 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. 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. Answer: Date on which the
incident or exposure occurred
,◉ Date of injury (DOI)-cumulative injury. 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. 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;
(4) Employers who are liable for the claim.
◉ Reasonable medical probability. Answer: Standard by which QME
uses combination of existing medical and scientific knowledge and
the occupational and medical history of the individual worker to
conclude whether the work exposure contributed to the injury
◉ Evidentiary standard of causation/contribution in compensability
disputes. Answer: Preponderance of the evidence (51%; more likely
than not)
◉ 3 factors to establish in making a causation determination.
Answer: (1) Presence of pathological conditions and disability
(2) Relevant work exposures
(3) Non-industrial exposures (other causes of disease)
, ◉ 5 major types of causation. Answer: (1) Direct
(2) Contributing
(3) Acceleration
(4) Precipitation
(5) Aggravation
◉ Direct causation. Answer: Work exposures are directly
responsible for the health outcomes
◉ Contributing causation. Answer: Several factors led to the disease;
work exposure is one of these factors
◉ Acceleration. 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. 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. Answer: A medical condition may be present already,
but work exposure makes it worse
