California QME Exam Guide: Format, Content and Study Plan

The DWC Medical Unit sets the exam and approves applicants. CPS HR Consulting manages registration and sends eligible candidates a registration notice, and Pearson VUE delivers the test at its centers. Questions about eligibility or your application go to the DWC Medical Unit at 510-286-3700 or QMETest@dir.ca.gov.

The 200 questions are divided into four content areas:

Basic Laws, Regulations and Report Writing Elements: 80 questions (40%): The largest section. Labor Code and DWC regulations that govern QMEs, medical-legal procedures, timelines, and the required elements of a ratable QME report.

Disability, QIW, Vouchers and P&S Status: 50 questions (25%): Permanent and temporary disability, qualified injured worker status, supplemental job displacement vouchers, and when a worker is permanent and stationary (maximum medical improvement).

Clinical Assessment, Evaluation and Medical Treatment: 40 questions (20%): History, examination and impairment rating under the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, plus treatment and future medical care.

Causation and Apportionment: 30 questions (15%): Industrial causation, and how to apportion permanent disability between industrial and non-industrial factors with substantial medical evidence.

• Book your seat as soon as the registration notice arrives. Seats in popular locations fill early.

• Bring government-issued photo ID. The name must match your registration exactly.

• Arrive early for check-in. Pearson VUE test centers follow strict security procedures.

• Pace yourself: 200 questions in 3 hours is about 54 seconds per question. Mark hard questions and come back.

DWC notifies candidates of their results after the exam window closes. If you pass, you apply for appointment as a QME. Before appointment, medical doctors, osteopaths, psychologists, acupuncturists, dentists, optometrists and podiatrists complete a 16-hour disability evaluation report writing course and 2 hours of anti-bias training; chiropractors meet this through their 25-hour Workers' Compensation Evaluation certificate.

If you do not pass, you can apply again for a later exam. The $125 fee is nonrefundable and does not carry over, so you pay it again with the new application.

• Weeks 1 and 2: Take a diagnostic test to find your weakest areas. Start the Labor Code and DWC regulations for QMEs.

• Weeks 3 and 4: Report writing elements, timelines and medical-legal procedures. Practice questions every day.

• Weeks 5 and 6: Disability, P&S status, causation and apportionment. AMA Guides 5th Edition review.

• Week 7: First full-length timed simulation. Review every missed question.

• Week 8: Second full simulation, then light review of weak areas. Rest the day before.

QME Review follows this structure: a pre-test, subject blocks based on the DIR test plan, a simulator with over 2,000 questions in 13 study units, and two full-length timed simulations.

200 multiple-choice questions, with 3 hours to finish.

California workers' compensation uses the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, so that is the edition to study.

The exam tests regulations and medical-legal knowledge more than general clinical skill, so exam-specific preparation matters.

Yes. You apply again for a later exam window and pay the $125 fee again, since it does not carry over.

On computer at a Pearson VUE test center. Your registration notice lists the available locations.