QME EXAM NEWEST ACTUAL
COMPREHENSIVE QUESTIONS AND
SOLUTIONS 2026 STUDY GUIDE
Holds authority to appoint physicians as QME evaluators. Answer:
Administrative Director (AD) (LC 139.2)
⩥ Term of appointment as QME evaluator. Answer: 2 years (LC 139.2)
⩥ 3 requirements when seeking appointment as QME. 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.
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. 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. 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. 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*. Answer: Occurs as the result of a single incident or
exposure
⩥ *Cumulative injury*. Answer: Results from repetitive trauma (mental
or physical) over a period of time
⩥ 2 requirements for a condition to be considered an injury. Answer: (1)
Cause disability; or
(2) Result in a need for medical treatment
⩥ Occupational disease. Answer: Disease that in whole or part is caused
by work
⩥ 7 types of excluded injuries. 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;
COMPREHENSIVE QUESTIONS AND
SOLUTIONS 2026 STUDY GUIDE
Holds authority to appoint physicians as QME evaluators. Answer:
Administrative Director (AD) (LC 139.2)
⩥ Term of appointment as QME evaluator. Answer: 2 years (LC 139.2)
⩥ 3 requirements when seeking appointment as QME. 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.
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. 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. 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. 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*. Answer: Occurs as the result of a single incident or
exposure
⩥ *Cumulative injury*. Answer: Results from repetitive trauma (mental
or physical) over a period of time
⩥ 2 requirements for a condition to be considered an injury. Answer: (1)
Cause disability; or
(2) Result in a need for medical treatment
⩥ Occupational disease. Answer: Disease that in whole or part is caused
by work
⩥ 7 types of excluded injuries. 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;
