QME EXAM NEWEST ACTUAL EXAM 2026
COMPLETE 350 QUESTIONS AND CORRECT
DETAILED VERIFIED ANSWERS ALREADY
GRADED TEST PAPER COMPLETE
QUESTIONS AND SOLUTIONS
⩥ permanent and stationary. Answer: When a condition reaches a state
of maximal medical improvement.
⩥ Escobedo case. Answer: -Set standard of reasonable medical
probability (standard a physician is expected to follow, that based on
superior evidence, something is probably/more likely than not)
-These words turn the report into substantial evidence
⩥ Rolda issues/Limits on compensability of psych issues. Answer: 1.
Did psych injury involve "actual events of employment"? (IW has
burden of proof)
2. Is there >50% industrial causation (IW burden)
3. Was there personnel action and was it lawful, non-discriminatory, and
in good faith? (Defense burden)
4. Were personnel actions the substantial (>35-40%) cause of the psych
injury. (defense burden)
,⩥ Granado case. Answer: -Set standard that medical tx (MT) is not
apportionable
⩥ Benson case. Answer: -Clarified parsing out impairment to different
injury dates
-If they can't be parceled out, you can say they are "inextricably
intertwined."
⩥ Guzman case/Almaraz-Guzman standard. Answer: -Alternative rating
of disability (when case is complex/extraordinary and AMA good
doesn't accurately reflect the persons impairment)
-WPI rating can be made if it's accurate and based on AMA guides
(fairness is not allowed anymore)
⩥ Blackledge v BofA. Answer: WCAB defined roles for:
-physician
-DEU rater
-parties
-Work comp judge
⩥ Blackledge case: physician requirements. Answer: 1. Compare
medical findings
2. List WPI for each med condition
3. Select impairment in the range based on impact on ADLs
,4. ADL analogies
-Role of evaluator is to assess WPI % by a report that sets forth facts and
reasoning to support conclusions and are in line with AMA & case law
⩥ Alternative rating under Almaraz/Guzman. Answer: 1. Begin w strict
rating found in the chapter address the injured body part
2. Explain what specific facts require an alternative rating
3. Provide analysis as to why alternative rating is more accurate
4. Set forth how Dr arrived at alt rating
5. State position with reasonable medical probability
⩥ Original intent of WC. Answer: -Provide minimum level of benefits
promptly
-To prevent IW from becoming a burden on others and help IW return to
work thru rehab
-Help dependents if IW dies
-MT for job related injuries/illness
-TD benefits for lost wages
-PD benefits for finished ability to compete in open labor market
⩥ Boyton act. Answer: -1913: required most employers to have WC
coverage
-Later expanded to include provision that when rating disability, persons
diminished ability to compete in open job market should be considered
, ⩥ Historic compromise. Answer: -Trade-off of rights and benefits
-Employee gives up right to sue for lots of $ and gets protection from
legal system against discrimination
-Employer provides benefits regardless of fault in exchange for
protection from lawsuits
-3 components
1. No fault
2. Exclusive remedy
3. Assured and fixed benefits
⩥ No Fault & exceptions. Answer: -Employer pays benefits no matter
who caused injury, as long as it occurred during employment
*Exceptions
-self inflicted injury
-injury from serious/willful misconduct by employee: benefits reduced
by half unless employee died or has PD of 70% or more
-injury from failure of employer to comply with health and safety reg
-employee was under 16yo
⩥ Exclusive Remedy. Answer: Workers' compensation benefits are the
only benefits injured workers may receive to compensate for a work-
related injury. (Even if employer negligent)
-unless employer uninsured
COMPLETE 350 QUESTIONS AND CORRECT
DETAILED VERIFIED ANSWERS ALREADY
GRADED TEST PAPER COMPLETE
QUESTIONS AND SOLUTIONS
⩥ permanent and stationary. Answer: When a condition reaches a state
of maximal medical improvement.
⩥ Escobedo case. Answer: -Set standard of reasonable medical
probability (standard a physician is expected to follow, that based on
superior evidence, something is probably/more likely than not)
-These words turn the report into substantial evidence
⩥ Rolda issues/Limits on compensability of psych issues. Answer: 1.
Did psych injury involve "actual events of employment"? (IW has
burden of proof)
2. Is there >50% industrial causation (IW burden)
3. Was there personnel action and was it lawful, non-discriminatory, and
in good faith? (Defense burden)
4. Were personnel actions the substantial (>35-40%) cause of the psych
injury. (defense burden)
,⩥ Granado case. Answer: -Set standard that medical tx (MT) is not
apportionable
⩥ Benson case. Answer: -Clarified parsing out impairment to different
injury dates
-If they can't be parceled out, you can say they are "inextricably
intertwined."
⩥ Guzman case/Almaraz-Guzman standard. Answer: -Alternative rating
of disability (when case is complex/extraordinary and AMA good
doesn't accurately reflect the persons impairment)
-WPI rating can be made if it's accurate and based on AMA guides
(fairness is not allowed anymore)
⩥ Blackledge v BofA. Answer: WCAB defined roles for:
-physician
-DEU rater
-parties
-Work comp judge
⩥ Blackledge case: physician requirements. Answer: 1. Compare
medical findings
2. List WPI for each med condition
3. Select impairment in the range based on impact on ADLs
,4. ADL analogies
-Role of evaluator is to assess WPI % by a report that sets forth facts and
reasoning to support conclusions and are in line with AMA & case law
⩥ Alternative rating under Almaraz/Guzman. Answer: 1. Begin w strict
rating found in the chapter address the injured body part
2. Explain what specific facts require an alternative rating
3. Provide analysis as to why alternative rating is more accurate
4. Set forth how Dr arrived at alt rating
5. State position with reasonable medical probability
⩥ Original intent of WC. Answer: -Provide minimum level of benefits
promptly
-To prevent IW from becoming a burden on others and help IW return to
work thru rehab
-Help dependents if IW dies
-MT for job related injuries/illness
-TD benefits for lost wages
-PD benefits for finished ability to compete in open labor market
⩥ Boyton act. Answer: -1913: required most employers to have WC
coverage
-Later expanded to include provision that when rating disability, persons
diminished ability to compete in open job market should be considered
, ⩥ Historic compromise. Answer: -Trade-off of rights and benefits
-Employee gives up right to sue for lots of $ and gets protection from
legal system against discrimination
-Employer provides benefits regardless of fault in exchange for
protection from lawsuits
-3 components
1. No fault
2. Exclusive remedy
3. Assured and fixed benefits
⩥ No Fault & exceptions. Answer: -Employer pays benefits no matter
who caused injury, as long as it occurred during employment
*Exceptions
-self inflicted injury
-injury from serious/willful misconduct by employee: benefits reduced
by half unless employee died or has PD of 70% or more
-injury from failure of employer to comply with health and safety reg
-employee was under 16yo
⩥ Exclusive Remedy. Answer: Workers' compensation benefits are the
only benefits injured workers may receive to compensate for a work-
related injury. (Even if employer negligent)
-unless employer uninsured
