QME Exam – Newest 2025/2026 Questions and Correct
Detailed Verified Answers | A+ Graded | Brand New
Version
Holds authorityto appointphysiciansas QME evaluatorsAdministrativeDirector(AD) (LC 139.2)
Term of appointmentas QME evaluator- ANSWER: 2 years(LC 139.2)
3 requirementswhenseekingappointmentas QME - ANSWER: (1) Pass theQME competency exam;
(2) Completea 12-hour coursein disabilityevalreportwriting;
(3) Devoteat least1/3rdof totalpracticetimeto providingdirectmedicaltreatment(or have served as a AME on 8+
occasions in past 12 mos prior to application)
of a QME w/oa hearing- ANSWER: (1) Licensing board
2 reasonsfor termination/suspension
suspends/revokes/terminates license to practice
(2) Failure to payrequired fee(upon appointment andyearlythereafter)
of QMEs aftera hearing- ANSWER: (1) Violation of material
6 reasonsfor discipline(suspension/termination)
statutory or administrative duty;
(2) Failure to followmedicalproceduresor qualifications;
(3) Failure to complywith thetimeframestandards;
(4) Failure to meetlicensing/certificationrequirements;
(5) Preparationof medical-legalevaluationsthatfail to meettheminimum standardsfor those reports as established
by the administrative director or the appeals board;
(6) Makingmaterialmisrepresentationsor falsestatementsin an applicationfor appointment or reappointment as a
qualified medical evaluator.
1
,3 typesof substantivemedicaldisputesresolvedby QMEs - ANSWER: (1) Compensability of the claim;
(2) Permanentdisability;
(3) "Catch-all" (temporarydisability,work restrictions,newand furtherdisabilitiesafter permanent disability
(detereoration of original injury), compensability
of new bodypart added to claim)
Definitionof *injury* in compensabilityclaims - ANSWER: (1) An injury or disease arising out of employment;
(2) A *derivative* injurycaused bytreatment of an injuryarising out ofemployment;
(3) Any reactionto or sideeffectfrom preventativehealthcaretheemployerprovidesto health care workers
*Specificinjury* - ANSWER: Occurs as the resultof a singleincidentor exposure
*Cumulativeinjury* - ANSWER: Resultsfrom repetitivetrauma(mentalor physical)over a period of time
2 requirementsfor a conditionto be consideredan injury - ANSWER: (1) Causedisability;or
(2) Resultin a needfor medicaltreatment
Occupationaldisease- ANSWER: Diseasethatin wholeor part is causedby work
7 typesof excludedinjuries - ANSWER: (1) Causedby employee'suseof alcoholor illegal controlled substances;
(2) Intentionallyself-inflictedinjuries;
(3) Suicide;
(4) Resultingfrom altercations,in whichtheinjuredemployeeis the*initial physicalaggressor*;
2
, (5) Resultingfrom theemployee'scommissionof a felony,for whichtheemployeehas been convicted (including
"wobbly felonies," which are crimes that may be prosecuted as misdemeanors or felonies)
(6) Resultingfrom off-dutyrecreationalactivities,in whichparticipationin theactivitiesdoes not constitute part of
the employee's work
-related duties and the activity is not an expressed or implicit condition of employment;
(7) Psychiatricinjuriesclaimedafternoticeof termination/layoffunlesscertainconditionsexist
4 basicconditionsto establisha workers'compensationclaim - ANSWER: (1) *Injury* (physiological or psychological
harm);
(2) Employmentrelationship;
(3) Injury causedby theemployment(This is alsoreferredto as arising out of employment[AOE].);
(4) Occurredin thecourseof theemployment(COE)
Aggravationof a pre-existing,non-industrialcondition- ANSWER: (1) Causesa temporary or permanent increase in
disability;
(2) Createsa newneedfor medicaltreatment;or
(3) Requiresa changein theexistingcourseof treatment
Symptomsthatdon'tconstitutea newinjury - ANSWER: *Flare-ups* or *recurrence*of a previous industrial injury
or illness; not been caused by the current employment
Dateof injury (DOI) -specificinjury - ANSWER: Dateon whichtheincidentor exposureoccurred
Date of injury(DOI) -cumulative injury- ANSWER: Date when the employee first suffered
disabilityfrom
the exposure,and eitherknew,or should haveknown,that the disability was caused by present or previous
employment
3
Detailed Verified Answers | A+ Graded | Brand New
Version
Holds authorityto appointphysiciansas QME evaluatorsAdministrativeDirector(AD) (LC 139.2)
Term of appointmentas QME evaluator- ANSWER: 2 years(LC 139.2)
3 requirementswhenseekingappointmentas QME - ANSWER: (1) Pass theQME competency exam;
(2) Completea 12-hour coursein disabilityevalreportwriting;
(3) Devoteat least1/3rdof totalpracticetimeto providingdirectmedicaltreatment(or have served as a AME on 8+
occasions in past 12 mos prior to application)
of a QME w/oa hearing- ANSWER: (1) Licensing board
2 reasonsfor termination/suspension
suspends/revokes/terminates license to practice
(2) Failure to payrequired fee(upon appointment andyearlythereafter)
of QMEs aftera hearing- ANSWER: (1) Violation of material
6 reasonsfor discipline(suspension/termination)
statutory or administrative duty;
(2) Failure to followmedicalproceduresor qualifications;
(3) Failure to complywith thetimeframestandards;
(4) Failure to meetlicensing/certificationrequirements;
(5) Preparationof medical-legalevaluationsthatfail to meettheminimum standardsfor those reports as established
by the administrative director or the appeals board;
(6) Makingmaterialmisrepresentationsor falsestatementsin an applicationfor appointment or reappointment as a
qualified medical evaluator.
1
,3 typesof substantivemedicaldisputesresolvedby QMEs - ANSWER: (1) Compensability of the claim;
(2) Permanentdisability;
(3) "Catch-all" (temporarydisability,work restrictions,newand furtherdisabilitiesafter permanent disability
(detereoration of original injury), compensability
of new bodypart added to claim)
Definitionof *injury* in compensabilityclaims - ANSWER: (1) An injury or disease arising out of employment;
(2) A *derivative* injurycaused bytreatment of an injuryarising out ofemployment;
(3) Any reactionto or sideeffectfrom preventativehealthcaretheemployerprovidesto health care workers
*Specificinjury* - ANSWER: Occurs as the resultof a singleincidentor exposure
*Cumulativeinjury* - ANSWER: Resultsfrom repetitivetrauma(mentalor physical)over a period of time
2 requirementsfor a conditionto be consideredan injury - ANSWER: (1) Causedisability;or
(2) Resultin a needfor medicaltreatment
Occupationaldisease- ANSWER: Diseasethatin wholeor part is causedby work
7 typesof excludedinjuries - ANSWER: (1) Causedby employee'suseof alcoholor illegal controlled substances;
(2) Intentionallyself-inflictedinjuries;
(3) Suicide;
(4) Resultingfrom altercations,in whichtheinjuredemployeeis the*initial physicalaggressor*;
2
, (5) Resultingfrom theemployee'scommissionof a felony,for whichtheemployeehas been convicted (including
"wobbly felonies," which are crimes that may be prosecuted as misdemeanors or felonies)
(6) Resultingfrom off-dutyrecreationalactivities,in whichparticipationin theactivitiesdoes not constitute part of
the employee's work
-related duties and the activity is not an expressed or implicit condition of employment;
(7) Psychiatricinjuriesclaimedafternoticeof termination/layoffunlesscertainconditionsexist
4 basicconditionsto establisha workers'compensationclaim - ANSWER: (1) *Injury* (physiological or psychological
harm);
(2) Employmentrelationship;
(3) Injury causedby theemployment(This is alsoreferredto as arising out of employment[AOE].);
(4) Occurredin thecourseof theemployment(COE)
Aggravationof a pre-existing,non-industrialcondition- ANSWER: (1) Causesa temporary or permanent increase in
disability;
(2) Createsa newneedfor medicaltreatment;or
(3) Requiresa changein theexistingcourseof treatment
Symptomsthatdon'tconstitutea newinjury - ANSWER: *Flare-ups* or *recurrence*of a previous industrial injury
or illness; not been caused by the current employment
Dateof injury (DOI) -specificinjury - ANSWER: Dateon whichtheincidentor exposureoccurred
Date of injury(DOI) -cumulative injury- ANSWER: Date when the employee first suffered
disabilityfrom
the exposure,and eitherknew,or should haveknown,that the disability was caused by present or previous
employment
3
