QME ACTUAL EXAM 2025/2026 QUESTIONS WITH
ANSWERS GRADED A+
✔✔firefighters, forestry officers, peace officers, and correctional employees. conditions
that mani-fest or develop during the period of active service and following termination of
service for up to five years - ✔✔specific conditions (e.g. hernias, pneumonia,
tuberculosis, heart disease, and can-cer) as work related when they affect which certain
employees?
✔✔it is a diagnosed mental disorder that causes disability or need for medical treat-
ment, and the employee can demonstrate that the events of employment were the
"predominant cause" of the injury. - ✔✔A psychiatric injury is compensable if
✔✔psychiatric injuries and claims filed after notice of termination or layoff/termination
are not compensable unless the actual events of employment were the predom-inant
cause and any of the following conditions are met:
• The injury was the result of sudden and extraordinary events of employment.
• The employer had notice of the injury before the notice of termination or layoff.
• Medical records existing before the notice of termination or layoff contain evidence of
treatment of the psychiatric injury.
• A contractual, administrative, regulatory, or judicial trier of fact (judge, referee, or other
individual who hears and makes decisions on a case) has found that there was sexual
or racial harassment.
• There is evidence that the DOI is subsequent to the date of notice of termination, but
before the effective date of the termination. This provision allows post-termination
claims for cu-mulative injuries or occupatio - ✔✔What Happens If a psychiatric Claim Is
Filed after Notice of Termination or Layoff?
✔✔To receive compensation, an employee who sustains a work-related specific injury,
occupational illness, or cumulative trauma must inform the employer about the injury or
illness within 30 days of the date of injury. - ✔✔how long does an employee have to
report a work leaked injury?
✔✔how long does an employer have after notified of a disability - ✔✔The employer
must furnish the employee with an Employee's Claim for Work-ers' Compensation
Benefits (DWC 1) claim form within one working day of learning of the injury.
✔✔• Provide a safe and healthful workplace for their employees
• Carry insurance to meet their obligations under workers' compensation law or to
provide the DIR with proof of self-insurance
• Provide information about workers' compensation to their employees, including infor-
mation on where and how to file a claim and on how to predesignate a personal
physician
• Maintain records of occupational injuries and diseases
, • Report immediately to the Division of Occupational Safety and Health (DOSH), better
known as Cal/OSHA, any death or serious injury.
• Provide the claim form (DWC 1) within one working day of the employer's knowledge
of the injury
• Complete an Employer's Report of Occupational Injury or Illness ("Employer's First
Report" Form 5020), within five days of being notified by the employee of an
occupational injury or illness. - ✔✔Employers are obligated to:
✔✔A serious injury is defined as an injury that results in more than 24 hours of
hospitalization for something other than observation, loss of a body part, or any serious
degree of disfigurement. - ✔✔serious injury definition
✔✔• Discriminating against workers for their health and safety activities or for filing a
workers' compensation claim
• Terminating an injured worker during the period of temporary disability, unless the em-
ployer can prove that the termination was due to a "business necessity"
• an employer cannot refuse to reinstate an injured worker, unless the worker can no
longer perform the essential functions of the job or based on a medical opinion that pro-
vides reasonable fear of re-injury. - ✔✔Employers are prohibited from:
✔✔Insurance Carriers and Claims Administrators role - ✔✔providing a communication
conduit be-tween the parties
✔✔Employers have an obligation to authorize medical treat-ment up to $10,000 within
one working day after the claim is filed. - ✔✔how much medical treatment can be auth
in one day after claim filed?
✔✔• Temporary disability is not paid to injured workers for the first three days of missed
work unless they are hospitalized or miss more than 14 days of work. - ✔✔temp dis. is
not paid for how many days of missed work?
✔✔• Payments must begin within 14 days of the employer's knowledge of the claim and
disabil-ity, unless the employer contests the claim. The employer has 90 days from the
notification of the injury to contest the claim. - ✔✔how many days till payments begin
after employer knows of the claim?
✔✔The payments are equal to two-thirds of the employee's average weekly earnings at
the time of the injury, up to a ceiling determined by the legislature. - ✔✔how much are
temp disability payments?
✔✔TD for an injury may last up to 104 weeks within five years from the DOI for dates of
injury from January 1, 2008, to the pre-sent; for dates of injury from April 19, 2004, to
December 31, 2007, 104 weeks commencing from the first date TD is actually paid;
before April 19, 2004, 240 weeks or more. The TD limit is extended to 240 weeks within
ANSWERS GRADED A+
✔✔firefighters, forestry officers, peace officers, and correctional employees. conditions
that mani-fest or develop during the period of active service and following termination of
service for up to five years - ✔✔specific conditions (e.g. hernias, pneumonia,
tuberculosis, heart disease, and can-cer) as work related when they affect which certain
employees?
✔✔it is a diagnosed mental disorder that causes disability or need for medical treat-
ment, and the employee can demonstrate that the events of employment were the
"predominant cause" of the injury. - ✔✔A psychiatric injury is compensable if
✔✔psychiatric injuries and claims filed after notice of termination or layoff/termination
are not compensable unless the actual events of employment were the predom-inant
cause and any of the following conditions are met:
• The injury was the result of sudden and extraordinary events of employment.
• The employer had notice of the injury before the notice of termination or layoff.
• Medical records existing before the notice of termination or layoff contain evidence of
treatment of the psychiatric injury.
• A contractual, administrative, regulatory, or judicial trier of fact (judge, referee, or other
individual who hears and makes decisions on a case) has found that there was sexual
or racial harassment.
• There is evidence that the DOI is subsequent to the date of notice of termination, but
before the effective date of the termination. This provision allows post-termination
claims for cu-mulative injuries or occupatio - ✔✔What Happens If a psychiatric Claim Is
Filed after Notice of Termination or Layoff?
✔✔To receive compensation, an employee who sustains a work-related specific injury,
occupational illness, or cumulative trauma must inform the employer about the injury or
illness within 30 days of the date of injury. - ✔✔how long does an employee have to
report a work leaked injury?
✔✔how long does an employer have after notified of a disability - ✔✔The employer
must furnish the employee with an Employee's Claim for Work-ers' Compensation
Benefits (DWC 1) claim form within one working day of learning of the injury.
✔✔• Provide a safe and healthful workplace for their employees
• Carry insurance to meet their obligations under workers' compensation law or to
provide the DIR with proof of self-insurance
• Provide information about workers' compensation to their employees, including infor-
mation on where and how to file a claim and on how to predesignate a personal
physician
• Maintain records of occupational injuries and diseases
, • Report immediately to the Division of Occupational Safety and Health (DOSH), better
known as Cal/OSHA, any death or serious injury.
• Provide the claim form (DWC 1) within one working day of the employer's knowledge
of the injury
• Complete an Employer's Report of Occupational Injury or Illness ("Employer's First
Report" Form 5020), within five days of being notified by the employee of an
occupational injury or illness. - ✔✔Employers are obligated to:
✔✔A serious injury is defined as an injury that results in more than 24 hours of
hospitalization for something other than observation, loss of a body part, or any serious
degree of disfigurement. - ✔✔serious injury definition
✔✔• Discriminating against workers for their health and safety activities or for filing a
workers' compensation claim
• Terminating an injured worker during the period of temporary disability, unless the em-
ployer can prove that the termination was due to a "business necessity"
• an employer cannot refuse to reinstate an injured worker, unless the worker can no
longer perform the essential functions of the job or based on a medical opinion that pro-
vides reasonable fear of re-injury. - ✔✔Employers are prohibited from:
✔✔Insurance Carriers and Claims Administrators role - ✔✔providing a communication
conduit be-tween the parties
✔✔Employers have an obligation to authorize medical treat-ment up to $10,000 within
one working day after the claim is filed. - ✔✔how much medical treatment can be auth
in one day after claim filed?
✔✔• Temporary disability is not paid to injured workers for the first three days of missed
work unless they are hospitalized or miss more than 14 days of work. - ✔✔temp dis. is
not paid for how many days of missed work?
✔✔• Payments must begin within 14 days of the employer's knowledge of the claim and
disabil-ity, unless the employer contests the claim. The employer has 90 days from the
notification of the injury to contest the claim. - ✔✔how many days till payments begin
after employer knows of the claim?
✔✔The payments are equal to two-thirds of the employee's average weekly earnings at
the time of the injury, up to a ceiling determined by the legislature. - ✔✔how much are
temp disability payments?
✔✔TD for an injury may last up to 104 weeks within five years from the DOI for dates of
injury from January 1, 2008, to the pre-sent; for dates of injury from April 19, 2004, to
December 31, 2007, 104 weeks commencing from the first date TD is actually paid;
before April 19, 2004, 240 weeks or more. The TD limit is extended to 240 weeks within
