About AAEME

The Standard for AMA Impairment
Rating Education in the United States.

Since 1996, AAEME has been developing and delivering the clinical and educational standards that define impairment rating practice in the United States. Formally established in 2003, we were the first organization to offer accredited impairment rating programs to physicians nationwide. We did not enter an existing field. We built one.

10,000+
Healthcare providers educated through AAEME programs
4,000+
Physicians holding the CIRS credential
47+
States where AMA Guides standards AAEME helped shape are in effect
Sole
State-authorized NIRSAT certification provider in Nevada

What Is AAEME and What Do We Do?

The American Academy of Expert Medical Evaluators (AAEME) provides clinician-led AMA impairment rating education and certification for licensed healthcare professionals nationwide. Formally established in 2003, building on clinical and educational work that began in 1996, AAEME develops and administers the CIRS™ and NIRSAT™ credentials, the most rigorous and widely recognized impairment rating certifications in the country.

Impairment ratings determine the degree of permanent functional loss a patient has sustained from an injury or illness. They carry significant legal and financial weight, forming the basis of workers' compensation settlements, disability determinations, and personal injury evaluations. An impairment rating that does not hold up in a legal proceeding is worse than no rating at all.

AAEME was founded on a straightforward premise: most physicians performing impairment ratings had not been trained to do so with the rigor that legal proceedings require. The AMA Guides to the Evaluation of Permanent Impairment are technically demanding, jurisdiction-specific, and regularly updated. A physician who does not know how to apply them correctly, or who cannot defend their methodology under cross-examination, produces reports that get challenged, overturned, or disregarded.

We built the curriculum, the credentials, and the testing infrastructure to change that. Our courses teach physicians to produce impairment ratings that are accurate, defensible, and compliant with the legal standards of their jurisdiction. Our certification examinations verify that they have achieved that standard.

An independent review of impairment rating reports performed for the University of California determined that eight out of ten reports contained errors. AAEME's certification programs exist precisely to address this gap between clinical practice and the documentation standards required by workers' compensation law.

What We Offer
  • Online courses covering AMA Guides 5th Edition methodology, Nevada-specific NIRSAT requirements, and psychological and neurological impairment evaluation
  • Certification examinations for NIRSAT, AMA Guides 5th Edition, and AMA Guides 6th Edition
  • CIRS and NIRSAT credentials recognized in workers' compensation proceedings, depositions, and legal settings nationwide
  • Free training resources covering introductory impairment rating methodology and body region measurement guides
  • The e-Eval referral network connecting certified physicians with referring parties
  • WholePerson® Impairment Rating Software through WPIRS, Inc., supporting certified physicians in producing defensible impairment rating reports

The CIRS™ and NIRSAT™ Credentials

AAEME issues two credentials that are recognized across the United States in workers' compensation proceedings, legal depositions, and disability determinations. Both were developed with clinical rigor and are administered through secure, proctored online examinations. Neither credential is honorary. Both require completion of accredited coursework and a passing examination score.

National Credential
CIRS: Certified Impairment Rating Specialist
The CIRS credential certifies physicians and healthcare providers in AMA Guides impairment rating methodology across the 4th, 5th, and 6th editions. It was developed in cooperation with Tufts School of Medicine, Boston, Massachusetts, and provides Continuing Medical Education (CME) and Continuing Education Unit (CEU) credits fully accredited for MDs, DOs, and DCs. Over 4,000 physicians and healthcare providers hold the CIRS designation. It is recognized in workers' compensation proceedings, motor vehicle cases, personal injury matters, and disability determinations nationwide.
Nevada State-Mandated Credential
NIRSAT: Nevada Impairment Rating Skills Assessment Test
The NIRSAT credential is required by Nevada statute under NV Rev. Stat. 616C.110 for any physician performing workers' compensation impairment ratings in Nevada. AAEME created the NIRSAT program in 2006 and has been the sole state-designated certification provider since the law's enactment. NIRSAT is the only privately developed impairment rating certification program incorporated into a state's governing statutes in the United States. Passing the NIRSAT exam satisfies both the Nevada state requirement and the national AMA Guides 5th Edition CIRS requirement simultaneously.

How AAEME Was Built

AAEME did not emerge from an academic institution or a professional association. It was built from direct clinical experience, from the recognition that physicians performing impairment ratings lacked the training to do so with the rigor that legal proceedings require, and from decades of work building the infrastructure to address that gap.

1980s
Pioneering the Independent Medical Evaluation industry
Health Management Systems (HMS) established one of the first physician networks dedicated to independent medical evaluations in the United States, organizing more than 500 physicians across 43 specialties throughout New England. Clients included Aetna, Liberty Mutual, the Commonwealth of Massachusetts, Raytheon, the City of Boston, and the U.S. Army. Educational seminars for physicians and corporations on occupational health and workers' compensation methodology followed.
1991
Launched the first AMA Guides impairment rating software
Through WholePerson Technologies, the WholePerson Premiere software was launched. It was the first software designed specifically to operationalize the AMA Guides to the Evaluation of Permanent Impairment. The software guides physicians through the correct diagnostic tests for accepted diagnoses and performs the complex impairment calculations with full AMA Guides references. It has been continuously updated through the 3rd, 3rd Revised, 4th, 5th, and 6th editions of the AMA Guides and is used nationwide in workers' compensation and motor vehicle cases. It is now operated under WPIRS, Inc.
1996
First state impairment rating education curriculum: Texas
The clinical and educational work that would become AAEME began in Texas in 1996 with the development of the first state impairment rating education curriculum in the country. Built around the WholePerson Premiere software methodology and grounded in the AMA Guides 3rd Edition Revised and 4th Edition, the program was accredited for CME and CEU credit through Tufts School of Medicine and other accrediting bodies. It set the template for everything that followed.
2003
AAEME founded: the first accredited impairment rating education organization in the United States
Drawing on seven years of physician education experience and an established curriculum, the American Academy of Expert Medical Evaluators was formally established in 2003 to deliver rigorous, accredited impairment rating education and certification at a national scale. AAEME was the first organization to offer accredited programs to physicians nationwide on how to perform and document impairment ratings under the AMA Guides.
2003
CIRS designation developed and launched
The Certified Impairment Rating Specialist (CIRS) designation for the AMA Guides 5th Edition was developed in cooperation with Tufts School of Medicine, Boston, Massachusetts, and launched as AAEME's flagship national credential. Learn more about CIRS 5th Edition →
2003
TIRSAT developed for Texas
The Texas Impairment Rating Specialist Accreditation Test (TIRSAT) was developed as a Texas-specific companion to the 1996 curriculum and was subsequently administered to more than 3,200 physicians throughout the state. The DDE evaluation program that resulted remains in effect in Texas today.
2006
Nevada NIRSAT program established: embedded in state law
AAEME created the Nevada Impairment Rating Skills Assessment Test (NIRSAT) for the State of Nevada, the first impairment rating certification program to be incorporated into a state's workers' compensation statutes. Under NV Rev. Stat. 616C.110, all physicians seeking to perform impairment ratings in Nevada are required by law to complete AAEME's program and pass the NIRSAT examination. More than 200 physicians have been certified through NIRSAT in Nevada.
2016
CIRS 6th Edition launched
Following the publication of the AMA Guides 6th Edition, AAEME developed and launched the CIRS 6th Edition certification track to support physicians in jurisdictions that adopted the new edition.
2023
Nevada IR Stress Disorders Seminar launched
A Nevada-required program covering stress, PTSD, and traumatic brain injury impairment evaluation, developed to meet the state's specific statutory requirements for Nevada-licensed physicians performing workers' compensation impairment ratings.
2023
Psychological & Neurocognitive Impairment Rating launched nationally
A parallel national program for physicians outside Nevada, covering stress, PTSD, and traumatic brain injury impairment evaluation under the AMA Guides without the Nevada-specific statutory framing.
Today
The national standard for impairment rating certification
AAEME continues to operate as the only organization offering the full spectrum of accredited impairment rating education, from introductory free resources through NIRSAT and CIRS credentialing, to physicians and healthcare providers nationwide. Courses are delivered entirely online and self-paced, designed for clinicians in active practice who cannot attend fixed-schedule training programs.

The Faculty Behind AAEME

AAEME's instructors are physicians and educators with decades of clinical and medicolegal experience in impairment rating evaluation. Each program is taught by faculty who have built and defended impairment rating reports in active workers' compensation, motor vehicle, and disability proceedings. They are not classroom theorists.

Meet the Faculty

Shaping Impairment Rating Standards Across the United States

AAEME has testified before state legislatures and national policy bodies on impairment rating standards and workers' compensation cost containment. That testimony has directly influenced the adoption of AMA Guides standards across 47 states and multiple federal jurisdictions.

California
AMA Guides 5th Edition adopted as the California workers' compensation standard
AAEME's testimony before the California state legislature contributed to the adoption of the AMA Guides 5th Edition as the mandated standard for impairment ratings. Kaiser Permanente subsequently engaged AAEME to certify more than 300 occupational physicians statewide. The University of California engaged the AAEME educational team for more than 100 physicians in their Occupational Medical Clinics.
Nevada
NIRSAT embedded in Nevada statute: the only program of its kind in the country
AAEME created Nevada's impairment rating certification requirement from the ground up. The NIRSAT program is embedded in NV Rev. Stat. 616C.110, making Nevada the only state in the country to have incorporated a privately developed impairment rating certification program into its governing statutes. AAEME has been the sole designated provider since the law's enactment.
Texas
First state-required impairment rating education program in the country
In 1996, the first state impairment rating education curriculum in the country was developed for Texas physicians, accredited through Tufts School of Medicine and other bodies. The TIRSAT™ examination was subsequently administered to more than 3,200 Texas physicians. The DDE evaluation program that resulted remains in effect in Texas today.

The e-Eval Physician Referral Network

The e-Eval network is a searchable directory of CIRS and NIRSAT certified physicians available to referring parties (attorneys, insurers, employers, and claims administrators) who need qualified impairment rating evaluators. Certification through AAEME is the entry requirement for network membership.

For Certified Physicians
Join the e-Eval Network
CIRS and NIRSAT certified physicians are eligible to join the e-Eval referral network upon certification. Network membership connects certified providers with attorneys, insurers, and employers seeking qualified impairment rating evaluators in their jurisdiction. Membership is open to all AAEME-certified physicians nationwide.
Learn About e-Eval

Ready to Get Certified?

Join more than 4,000 physicians who have earned their CIRS or NIRSAT credential through AAEME, the organization that built this field.

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