QME EXAM ACTUAL EXAM QUESTIONS
WITH CORRECT ANSWERS 2025/2026
GRADED A
Rights of the claim administrator in selecting the QME and arranging the
appointment - CORRECT ANSWER>>If injured worker does not inform the claims
administrator of the selection or date of appointment
Time frame in represented cases during which each party may strike one name
from the QME panel - CORRECT ANSWER>>10 days after the assignment of the
panel
Time frame in which selected QME must schedule an appointment to see the
injured worker - CORRECT ANSWER>>Within 60 days of a request for an
appointment (up to 90 days)
Time frame to submit the QME Appointment Notification Form -
CORRECT ANSWER>>Within 5 business days of making the appointment
Parties receiving service of the QME Appointment Notification Form -
CORRECT ANSWER>>Employee (+ representative)
,Employer/claims administrator (+ representative)
Trigger to send medical records and other information to the QME -
CORRECT ANSWER>>Receipt of the QME Appointment Notification Form
Causes for issuance of a replacement panel - CORRECT ANSWER>>(1)
Failure to serve the QME Appointment Notification Form;
(2) Disclosure of COI by an evaluator after an appointment has been made;
(3) Necessity for subsequent examination by a QME in a different specialty
(due to limitations in scope of practice or clinical competency)
(4) QME doesn't practice in the requested specialty
(5) QME cannot schedule an appointment within 60 days of the initial request of
the appointment
(6) Injured worker changes address since initial request for a panel but before
initial appointment
(7) Two or more members of a QME panel are from the same group practice
(8) QME is unavailabile
(9) QME who previously reported on the case is unavailable
(10) QME is currently, or has been, the treating physician of the worker for the
injury currently under dispute
, (11) Claims administrator/employer agrees that a new panel be issued based
upon the geographic area of the worker's employment
(12) Untimely filing of report by QME
(13) QME doesn't cancel an appointment in a timely manner
(14) QME panel was issued more than 24 months prior to the request for the
replacement panel and none of the QMEs have examined the worker (15)
Qualifed and competent QME refuses to provide an evaluation or written
statement explaining why he/she is not qualified or competent to address
one or more issues in dispute in the case (16) Administrative Director orders
an additional QME evaluation
Responsibility for arranging for and paying an interpreter for the QME exam
- CORRECT ANSWER>>Employer
Information which may be provided to the QME by any party - CORRECT
ANSWER>>(1) All records prepared/maintained by treating physician(s) (2) Other
medical records, relevant to the determination of the medical issue in dispute
(3) Letter outlining medical determination of the primary treating physician or
the compensability issue requested to address in the evaluation (4) If concerning
a dispute over a UR decision, a copy of the treating physician's report and the
claim administrator's decision to approve, delay, deny or modify the disputed
treatment
WITH CORRECT ANSWERS 2025/2026
GRADED A
Rights of the claim administrator in selecting the QME and arranging the
appointment - CORRECT ANSWER>>If injured worker does not inform the claims
administrator of the selection or date of appointment
Time frame in represented cases during which each party may strike one name
from the QME panel - CORRECT ANSWER>>10 days after the assignment of the
panel
Time frame in which selected QME must schedule an appointment to see the
injured worker - CORRECT ANSWER>>Within 60 days of a request for an
appointment (up to 90 days)
Time frame to submit the QME Appointment Notification Form -
CORRECT ANSWER>>Within 5 business days of making the appointment
Parties receiving service of the QME Appointment Notification Form -
CORRECT ANSWER>>Employee (+ representative)
,Employer/claims administrator (+ representative)
Trigger to send medical records and other information to the QME -
CORRECT ANSWER>>Receipt of the QME Appointment Notification Form
Causes for issuance of a replacement panel - CORRECT ANSWER>>(1)
Failure to serve the QME Appointment Notification Form;
(2) Disclosure of COI by an evaluator after an appointment has been made;
(3) Necessity for subsequent examination by a QME in a different specialty
(due to limitations in scope of practice or clinical competency)
(4) QME doesn't practice in the requested specialty
(5) QME cannot schedule an appointment within 60 days of the initial request of
the appointment
(6) Injured worker changes address since initial request for a panel but before
initial appointment
(7) Two or more members of a QME panel are from the same group practice
(8) QME is unavailabile
(9) QME who previously reported on the case is unavailable
(10) QME is currently, or has been, the treating physician of the worker for the
injury currently under dispute
, (11) Claims administrator/employer agrees that a new panel be issued based
upon the geographic area of the worker's employment
(12) Untimely filing of report by QME
(13) QME doesn't cancel an appointment in a timely manner
(14) QME panel was issued more than 24 months prior to the request for the
replacement panel and none of the QMEs have examined the worker (15)
Qualifed and competent QME refuses to provide an evaluation or written
statement explaining why he/she is not qualified or competent to address
one or more issues in dispute in the case (16) Administrative Director orders
an additional QME evaluation
Responsibility for arranging for and paying an interpreter for the QME exam
- CORRECT ANSWER>>Employer
Information which may be provided to the QME by any party - CORRECT
ANSWER>>(1) All records prepared/maintained by treating physician(s) (2) Other
medical records, relevant to the determination of the medical issue in dispute
(3) Letter outlining medical determination of the primary treating physician or
the compensability issue requested to address in the evaluation (4) If concerning
a dispute over a UR decision, a copy of the treating physician's report and the
claim administrator's decision to approve, delay, deny or modify the disputed
treatment
