Resources · AMA Guides by Jurisdiction
AMA Guides: The International Gold Standard
for Impairment Ratings
The AMA Guides to the Evaluation of Permanent Impairment is the most widely adopted impairment rating standard in the world — used across workers' compensation, personal injury, auto casualty, federal disability programs, and medicolegal proceedings in more than 15 countries. This reference tracks which edition each jurisdiction requires, verified against official statutes and updated regularly.
40+
US states & DC reference the Guides
15+
Countries using or referencing the Guides
4
Active editions in use worldwide
Apr 2026
Last verification date
Where in the World Are the AMA Guides Used for Impairment Ratings?
The AMA Guides to the Evaluation of Permanent Impairment are used across every legal and compensation context where permanent impairment must be quantified. This page covers the United States — all 50 states, the District of Columbia, US territories, and three federal compensation programs — followed by Canada, Australia, and other international jurisdictions. Not every jurisdiction uses the same edition, and some have developed their own derivative systems built on AMA Guides methodology. Data is verified against official statutes, agency publications, and peer-reviewed sources as of April 2026.
What's inside each entry
More than an edition number — every entry includes the law, the source, and the context.
Statute or regulatory authority
The specific code section, rule, or bulletin that mandates or permits AMA Guides use.
Live source link
A direct link to the official government source or verified publication.
How the Guides are actually used
Whether mandated, supplemental, or reference — plus physician certification requirements and jurisdiction-specific rules.
Corrections to common errors
Kansas, South Dakota, Massachusetts, Oregon — where we've found and verified corrections, we flag them explicitly.
Where the Guides are used
The AMA Guides appear across every compensation and liability context. Wherever they appear, trained physicians produce more defensible, accurate ratings.
Source & Confidence Key — applies to all entries on this page
Official government source verified
Third-party source — no official government URL confirmed
Unspecified — requires direct verification
Jump to your section
Need to perform impairment ratings?
AAEME certifies physicians in 5th and 6th Edition methodology nationwide.
CIRS™ and NIRSAT™ credentials are recognized in WC hearings, legal depositions, and disability determinations. The NIRSAT exam covers both Nevada requirements and national 5th Edition certification in a single exam.
United States
Which AMA Guides Does My State Use?
The answer varies significantly. Most states mandate the 5th or 6th Edition, but seven still require the 4th Edition, several use state-specific systems that replace the AMA Guides entirely, and a handful have no edition mandate. The District of Columbia is listed alphabetically among the states.
United States — States & DC
51 Jurisdictions↑ Source confidence indicators follow the key in the first section
Use ContextWorkers' compensation
Standard 4th Edition adoption. No legislative movement toward a newer edition identified.
Verified April 2026
Edition6th Edition — updated 2025 (Bulletin 26-01)
StatuteAS § 23.30.190; WC Bulletin 26-01
Sourcelabor.alaska.gov
Edition Trigger"Most recent edition" — adopts digital updates
🔴 Recently Updated Alaska adopted 2025 AMA Guides digital tables effective early 2026 via Bulletin 26-01.
Verified April 2026
Edition6th Edition — most recent edition mandated
StatuteARS § 23-1044; Rule R20-5-113(B)
Sourceazleg.gov
Edition TriggerMost recent edition specified in admin rule
Admin Rule R20-5-113(B) requires the most recent edition. Currently 6th Edition with 2025 digital updates.
Verified April 2026
Edition4th Edition — spinal ratings only
StatuteA.C.A. § 11-9-519; AWCC Rule 34
Sourceawcc.state.ar.us
ScopeSpine only; excludes pain and SLR/ROM sections
⚠️ Narrow Scope Rule 34 mandates the 4th Edition specifically for spinal anatomical impairment ratings, explicitly excluding sections on pain and range-of-motion tests.
Verified April 2026
Edition5th Edition — via PDRS (Permanent Disability Rating Schedule)
StatuteCal. Lab. Code § 4660; 8 Cal. Code Regs. § 9805
Sourcedir.ca.gov/dwc
Special RuleAlmaraz/Guzman: AMA Guides rating is rebuttable in complex cases
⚠️ Rebuttable Standard California integrates the 5th Edition into its own PDRS system (eff. 1/1/2005). The Almaraz/Guzman doctrine allows deviation from standard AMA ratings in complex cases. 5th Edition also widely used in auto PIP and PI litigation.
Verified April 2026
Edition3rd Edition, Revised (1990)
StatuteColo. Rev. Stat. § 8-42-101; § 8-42-107
Sourcecdle.colorado.gov/dwc
Physician CertificationLevel II Accreditation required by statute — Full or Limited
🟢 Certification Required Colorado requires Division of Workers' Compensation Level II Accreditation to perform impairment ratings — one of the most formal physician qualification systems in the country.
Verified April 2026
EditionNot Specified — 6th Edition used in practice
StatuteConn. Gen. Stat. Title 31, Ch. 568
Sourceportal.ct.gov/WCC
In Practice6th Edition used by practitioners as current standard
Connecticut statute does not specify an edition.
Verified April 2026
Use ContextWorkers' compensation
Delaware mandates the most recent edition — currently the 6th Edition.
Verified April 2026
Edition6th Edition — "most recent edition" language in statute
StatuteDC Code §§ 32-1505, 32-1508; § 1-623.07
Sourcecode.dccouncil.gov
Physician Certification§ 1-623.07 requires documented AMA Guides training for apportionment evaluations
🟢 Functional Certification Requirement § 1-623.07 requires physicians with "specific training and experience in the use of the AMA Guides" for apportionment — a functional certification requirement. DC workers on federal employment are covered under FECA, not DC WC law.
Verified April 2026
Edition6th Edition — mandated most recent edition
StatuteFla. Stat. § 440.13(2)(c); § 440.15(3)(d)
Sourcemyfloridacfo.com/wc
Non-WC UseAMA Guides WPI ratings used for serious injury threshold in PI cases
Florida mandates most recent edition. Training relevant beyond WC — WPI ratings used for the serious injury threshold in personal injury cases.
Verified April 2026
Edition5th Edition — Board Rule 61(a); mandated 2001
StatuteO.C.G.A. § 34-9-262; State Board WC Rule 61(a)
Sourcesbwc.georgia.gov
Use ContextWorkers' compensation
Georgia State Board Rule 61(a) mandates the 5th Edition. No legislative movement to the 6th Edition has been enacted.
Verified April 2026
EditionNot Specified — AMA Guides commonly used; no edition mandated
StatuteHRS Chapter 386
Sourcelabor.hawaii.gov/dcd
Use ContextWorkers' compensation
Hawaii does not mandate a specific edition. AMA Guides are used as medical evidence in WC proceedings.
Verified April 2026
Edition6th Edition — most current edition
StatuteIdaho Code § 72-425; IDAPA 17.02.11.001
Sourceiic.idaho.gov
Edition TriggerMost current edition — tracks 6th Edition digital updates
Idaho mandates the most current edition — currently the 6th Edition including digital updates.
Verified April 2026
EditionNot Specified — state schedule primary; AMA Guides for non-scheduled
Statute820 ILCS 305/8(e)
SourceIllinois WC Commission
Use ContextWorkers' compensation — schedule primary; AMA Guides for non-scheduled
Illinois uses a statutory schedule for scheduled injuries. AMA Guides commonly used for non-scheduled disabilities — no specific edition mandated.
Verified April 2026
Edition6th Edition — most recent edition; tracks digital updates per NCCI
StatuteInd. Code § 22-3-3-13
Sourcein.gov/workcomp
Edition TriggerMost recent edition — confirmed by NCCI to track digital updates
Indiana mandates most recent edition, currently 6th including digital updates confirmed by NCCI.
Verified April 2026
Edition5th Edition — Labor Commissioner retained after 2008 task force review
StatuteIowa Code § 85.34; Iowa Admin. Code 876
Sourcelegis.iowa.gov
History2008 eight-member task force reviewed 6th Edition and recommended against adoption
Iowa convened a task force in 2008, reviewed the 6th Edition, and deliberately retained the 5th Edition — one of the most deliberate 5th Edition decisions nationally.
Verified April 2026
Edition6th Edition — since 2015; upheld by KS Supreme Court 2021
StatuteK.S.A. § 44-510d; § 44-510e
Sourcedol.ks.gov
Legal HistoryJohnson v. U.S. Food Service (KS Supreme Court, 2021) upheld 6th Edition adoption
🔴 Commonly Mislisted Kansas is still listed as "4th Edition" in many references — incorrect. Kansas switched to 6th Edition in 2015. KS Supreme Court upheld it in 2021.
Verified April 2026
Change ProcessRequires new act of the legislature; explicitly defined "AMA Guides" as 5th Edition
Kentucky explicitly defined "AMA Guides" as the 5th Edition in statute via HB 38. Any change requires a new act of the legislature.
Verified April 2026
Edition6th Edition — most current edition; tracks digital updates
StatuteLa. Rev. Stat. Ann. § 23:1221(4)(q)
Sourcelegis.la.gov
Edition TriggerMost current edition — NCCI confirmed digital update tracking
Louisiana mandates most current edition. Automatically adopts updated digital 6th Edition tables as a "most current edition" state.
Verified April 2026
Use ContextWorkers' compensation
⚠️ Link Verification Needed Verify official WCB link at maine.gov/wcb before citing.
Verified April 2026
Use ContextWorkers' compensation
Maryland uses the 4th Edition under its Code of Maryland Regulations.
Verified April 2026
EditionNot Specified — 5th Edition used in practice by DIA impartial physicians
StatuteM.G.L. c. 152, § 36; DIA impartial physician system
Sourcemass.gov/DIA
Physician CertificationDIA impartial physician designation — functional certification requirement
🔴 Commonly Mislisted Massachusetts does not mandate a specific edition. The 5th Edition is used in practice. Commonly listed as "6th Edition" in other references — incorrect.
Verified April 2026
EditionNot Specified — AMA Guides used in practice; no edition mandated
StatuteMCL 418.301
Sourcemichigan.gov/leo/wc
Use ContextWorkers' compensation — primarily wage-loss based; AMA Guides as medical evidence
Michigan does not specify a particular guide or edition. AMA Guides commonly referenced by physicians but no statutory mandate exists.
Verified April 2026
EditionState Specific — own PPD schedule; AMA 2nd Edition referenced for some conditions
StatuteMinn. Stat. Ch. 176.101; Minn. Rules Part 5223
Sourcedli.mn.gov
Use ContextWorkers' compensation — own PPD schedule primary; current AMA editions have no statutory role
Minnesota uses its own comprehensive PPD schedule (Minn. Rules Part 5223). AMA 2nd Edition referenced for some conditions not in the schedule; current editions have no statutory role.
Verified April 2026
Edition Trigger"Most current edition" — will automatically adopt future updates
Mississippi mandates the most current edition, currently 6th with ongoing digital updates.
Verified April 2026
EditionNot Specified — AMA Guides accepted but no edition mandated
StatuteRSMo § 287.190
Sourcelabor.mo.gov/DWC
Use ContextWorkers' compensation
Missouri accepts AMA Guides ratings as medical evidence but does not mandate a specific edition.
Verified April 2026
Edition TriggerCurrent edition specified
Montana mandates the current edition of the AMA Guides — currently the 6th Edition.
Verified April 2026
EditionNot Specified — AMA Guides referenced but no edition mandated
StatuteNeb. Rev. Stat. § 48-121
Sourcenebraskalegislature.gov
Use ContextWorkers' compensation
Nebraska does not specify an edition. The Guides are used as medical evidence with no particular edition mandated.
Verified April 2026
Edition5th Edition — NAC 616C.002 (6th Edition never formally adopted despite statutory trigger)
StatuteNRS 616C.110; NAC 616C.002; NAC 616C.021
Sourceleg.state.nv.us
Physician CertificationRating Physician Designation required — NIRSAT exam mandated by statute under NAC 616C.021
DC RenewalDCs: exam once; AMA Guides course renewed every 2 years per NRS 616C.110
🟢 Certification Required Nevada requires Rating Physician Designation through the NIRSAT exam. Despite a statutory mandate to adopt the most recent edition within 18 months of publication, the 6th Edition was never formally adopted — NAC 616C.002 still specifies the 5th Edition. NIRSAT covers Nevada requirements and CIRS certification in one exam. Full Nevada requirements →
Verified April 2026
Edition5th Edition — legislature explicitly replaced "most recent" with "5th Edition" (2008)
StatuteRSA § 281-A:32
Sourcenh.gov/labor
History2008: Governor signed bill replacing "most recent edition" with explicit "5th Edition"
New Hampshire's legislature specifically amended the statute to name the 5th Edition in 2008, after reviewing the 6th Edition's impact on compensation levels.
Verified April 2026
EditionNot Specified — state schedule primary; AMA Guides for non-scheduled injuries
StatuteN.J. Stat. Ann. § 34:15-12
Sourcenj.gov/labor
Use ContextWorkers' compensation — schedule primary; AMA Guides for non-scheduled
New Jersey uses a statutory schedule. For non-scheduled disabilities, AMA Guides are used as evidence with no edition specified by statute.
Verified April 2026
Edition6th Edition — most recent edition mandated
StatuteNMSA § 52-1-24; § 52-1-26.4
Sourcenmlegis.gov
Notes§ 52-1-26.4: impairment level determined by weight of medical evidence
New Mexico mandates the most recent edition to determine whether impairment exists.
Verified April 2026
EditionState Specific — WCB Disability Guidelines (WC); AMA 4th Edition for motor vehicle/PI
StatuteNY Work. Comp. Law § 15; NY WCB Medical Guidelines
Sourcewcb.ny.gov
Non-WC UseAMA 4th Edition used for CTP/motor vehicle personal injury claims
NY WC system uses its own WCB Guidelines — not AMA Guides. However, AMA 4th Edition is used for motor vehicle CTP and PI claims, making training relevant for NY physicians in the PI space.
Verified April 2026
EditionState Specific — NC Workers' Compensation Rating Guide
StatuteNC Gen. Stat. § 97-31; NC Industrial Commission Medical Guidelines
Sourceic.nc.gov
Use ContextWorkers' compensation — own state-specific Rating Guide; AMA Guides have no mandatory WC role
North Carolina uses its own state-specific Rating Guide. AMA Guides have no mandatory WC role.
Verified April 2026
Edition6th Edition — modified for ND law; admin rules updated January 1, 2024
StatuteN.D. Cent. Code § 65-05-12.2; NDAC 92-01-02
Sourcendlegis.gov
Physician CertificationWSI must maintain a list of qualified providers; ratings by approved providers carry presumptive weight
🟢 Certification Required Statute explicitly requires WSI to maintain a list of providers trained in the 6th Edition. Independent reviewer ratings carry presumptive weight — rebuttable only by clear and convincing evidence.
Verified April 2026
Edition5th Edition — required by Ohio Industrial Commission Medical Examination Manual
StatuteORC § 4123.57; Ohio Admin. Code § 4123-3
Sourceic.ohio.gov
Physician CertificationDisability Evaluator Panel (DEP) — physicians must be DEP-approved; 5th Edition training required
🟢 Certification Required Ohio has a formal Disability Evaluator Panel (DEP). Physicians must be DEP-approved to perform impairment evaluations. AAEME's 5th Edition course meets DEP training requirements.
Verified April 2026
Edition6th Edition — current edition at time of injury
Statute85A Okla. Stat. § 45(c)
Sourceowcc.state.ok.us
Edition Trigger"Current edition in effect at the time of injury"
Oklahoma statute specifies the current edition in effect at the time of injury — currently the 6th Edition.
Verified April 2026
EditionState Specific — Oregon WCD Disability Standards (OAR 436-035); AMA Guides have no statutory role
StatuteORS § 656.214; ORS § 656.726; OAR Chapter 436, Division 35
Sourcewcd.oregon.gov
Use ContextWorkers' compensation — own OAR 436-035 system only
🔴 Commonly Mislisted Oregon is frequently listed as "3rd Edition Revised" — historically inaccurate. Oregon's OAR 436-035 is a fully independent rating system. Oregon does not use or reference any edition of the AMA Guides.
Verified April 2026
Edition6th Edition, 2nd printing (April 2009) — explicitly named in 34 Pa. Code § 123.105
Statute77 P.S. § 511.3 (Act 111 of 2018); 34 Pa. Code § 123.105 (amended Jan. 25, 2025)
Sourcepacodeandbulletin.gov
Disability ThresholdImpairment ≥ 35% WBI = total disability (Act 111)
Physician CertificationIRE physicians must be ABMS board-certified (licensed in PA)
🔴 Complex Legal History PA Supreme Court's 2017 Protz v. WCAB struck down "most recent edition" language as unconstitutional. Act 111 of 2018 explicitly names the "Sixth Edition (second printing April 2009)." Regulation last amended January 25, 2025.
Verified April 2026
Edition6th Edition — effective January 1, 2011 for injuries on/after that date
StatuteRI Gen. Laws §§ 28-29-2(3)(ii) and 28-33-18(c)(i)
Sourcerilegislature.gov
Date Rule6th Edition required for injuries on or after January 1, 2011
Rhode Island requires the 6th Edition for loss-of-use determinations for injuries on or after January 1, 2011.
Verified April 2026
EditionNot Specified — state schedule primary; AMA Guides permitted for unscheduled injuries
StatuteSC Code Ann. §§ 42-9-10, 42-9-20; SC Code Regs. § 67-1101
Sourcewcc.sc.gov
Use ContextWorkers' compensation — schedule primary; AMA Guides or other accepted medical authority for unscheduled injuries
SC Code Regs. § 67-1101 permits use of AMA Guides or "other accepted medical authority" for unscheduled disabilities, with no edition specified.
Verified April 2026
Date RuleInjuries before July 1, 2013 may use 4th Edition
🔴 Commonly Mislisted as 4th Edition South Dakota switched to 6th Edition effective July 1, 2013. Many references still list it as 4th — over 12 years out of date. SDCL § 62-1-1.2 explicitly reads "sixth edition."
Verified April 2026
Edition6th Edition — locked in statute "until General Assembly designates a new edition"
StatuteT.C.A. § 50-6-102(2)
Sourcejustia.com/Tennessee
Edition TriggerRequires General Assembly action to change; tracks 6th Edition digital updates per NCCI
Tennessee's statute defines "AMA guides" as the 6th Edition until the General Assembly designates otherwise — structurally different from "most recent edition" states.
Verified April 2026
Edition4th Edition — adopted by admin rule 2001; no update since
StatuteTex. Lab. Code Ann. § 408.124; 28 Tex. Admin. Code § 130.1(c)(2)(B)(i)
Sourcetdi.texas.gov/wc
Use ContextWorkers' compensation — one of the largest 4th Edition states by workforce
Texas adopted the 4th Edition in 2001. No formal change enacted. AAEME developed the first state impairment rating education curriculum nationally for Texas physicians in 1996.
Verified April 2026
EditionState Specific — three-tier: (1) statutory schedule, (2) Utah 2006 Impairment Guides, (3) AMA 5th supplemental
StatuteUtah Code Ann. § 34A-2-412; Utah Admin. Code R612-300-9
Sourcelaborcommission.utah.gov
AMA Guides Role5th Edition used only when condition not addressed by statutory schedule or Utah 2006 Guides
Utah developed its own 2006 Impairment Guides — cited as a model for reducing WC litigation. AMA 5th Edition used only as a last resort when neither the statutory schedule nor the state guides address the condition.
Verified April 2026
Edition5th Edition — explicitly named in statute; change requires Commissioner rulemaking
Statute21 V.S.A. § 648(b)
Sourcelegislature.vermont.gov
Psych CoverageWC Rules § 11.1500 explicitly covers psychological system impairment
Vermont statute text explicitly reads "the whole person determinations as set out in the Fifth Edition." WC Rules § 11.1500 specifically covers psychological impairments — one of the more explicit state-level frameworks for psychological IR.
Verified April 2026
EditionNot Specified — AMA Guides commonly used and accepted by courts; no edition mandated
StatuteVa. Code Ann. § 65.2-503
Sourcevwc.state.va.us
Non-WC UseAMA Guides widely used in VA personal injury and disability proceedings
Virginia does not mandate a specific guide or edition. AMA Guides accepted in both WC and personal injury contexts.
Verified April 2026
EditionMixed — State WAC categories primary; AMA 5th for extremities, vision, and hearing loss
StatuteRCW § 51.32.080; WAC 296-20-220; WAC 296-23-381
Sourcelni.wa.gov
Physician CertificationFormal IME Provider credentialing — L&I can suspend or terminate IME provider number
🟢 IME Provider Credentialing Washington has a formal IME Provider credentialing system. AMA Guides 5th Edition referenced in WAC 296-23-381 for extremity injuries, hearing loss, and vision loss.
Verified April 2026
Edition4th Edition — confirmed by WV Supreme Court of Appeals decisions through 2024
StatuteWV Code of State Rules, Series 85-20; WV Title § 85-20-3
Sourcewvinsurance.gov
Psych FrameworkDedicated Series 85-22 — separate psychiatric permanent impairment rules
🟣 Psychiatric IR Framework West Virginia has a dedicated admin rule Series 85-22 governing psychiatric IR separately. WV Supreme Court confirmed 4th Edition methodology in multiple 2024 decisions including Logan-Mingo Area Mental Health, Inc. v. Lester (June 2024).
Verified April 2026
EditionState Specific — Wisconsin PPD Schedules; AMA Guides not used
StatuteWis. Admin. Code §§ DWD 80.32, 80.33; Wis. Stat. Ch. 102
Sourcedwd.wisconsin.gov/wc
Use ContextWorkers' compensation — own schedules only; AMA Guides not used
Wisconsin uses its own PPD schedules and has stated it is "not anticipating use of Guides." One of the most independent WC systems in the country.
Verified April 2026
Edition6th Edition — most recent edition mandated; tracks digital updates
StatuteWY Stat. § 27-14-405(g)
Sourcedws.wyo.gov
Edition TriggerMost recent edition — NCCI confirmed digital update tracking
Wyoming mandates most recent edition — confirmed by NCCI to adopt 6th Edition digital updates.
Verified April 2026
United States
US Territories
Pending VerificationAMA Guides use in US territories is not well documented in publicly available sources. Several territories operate government-administered insurance funds without published impairment rating methodology. Based on multiple third-party sources, all territories that conduct formal impairment ratings are believed to use the 6th Edition — but this has not been confirmed from official sources for any territory.
↑ Source confidence indicators follow the key in the first section
EditionUnspecified — likely 6th Edition per third-party sources; not confirmed officially
StatuteAct No. 45 of 1935
For Verificationcfse.pr.gov
System TypeState monopoly — CFSE (Corporación del Fondo del Seguro del Estado)
Puerto Rico operates a mandatory government monopoly WC system. AMA Guides use by CFSE is unconfirmed. CFSE may use a proprietary benefit schedule.
Verified April 2026
EditionUnspecified — likely 6th Edition per third-party sources; not confirmed officially
Statute22 GCA Ch. 9 — LHWCA-modeled statute
For Verificationdol.guam.gov
System TypeLHWCA-modeled; Guam WC Commission
Guam's WC law is modeled on the LHWCA. Significant military and federal workforce is covered under FECA/LHWCA — those workers follow federal 5th or 6th Edition standards.
Verified April 2026
EditionUnspecified — likely 6th Edition per third-party sources; not confirmed officially
Statute24 V.I.C. §§ 250–292
For Verificationvidol.gov
System TypeGovernment Insurance Fund (GIF)
Act 8859 (December 2024) enacted significant WC changes — edition of AMA Guides, if any, requires verification at vidol.gov before relying on this entry.
Verified April 2026
EditionUnspecified — insufficient public documentation to confirm
StatuteTitle 32, American Samoa Code
System TypeLocally administered WC system
American Samoa has a locally administered WC system with very limited public documentation available.
Verified April 2026
EditionUnspecified — likely 6th for LHWCA-covered workers; territorial system unconfirmed
Statute4 CMC § 9101 et seq.; LHWCA also applies to many workers
System TypeOwn territorial WC law; LHWCA applies to many workers — particularly construction and maritime
Federal workers covered under LHWCA/FECA follow federal 5th or 6th Edition standards. AMA Guides use in the territorial system itself is unconfirmed.
Verified April 2026
United States
Federal Programs
OWCP / DOLThree federal compensation programs independently require impairment rating under the AMA Guides, covering federal civilian employees, maritime and overseas workers, and energy workers at nuclear facilities. These programs apply regardless of which state the claimant resides in. A significant 2024 policy change under FECA altered which edition applies to federal civilian claims.
↑ Source confidence indicators follow the key in the first section
Edition5th OR 6th Edition — claimant election permitted since 2024 policy change
Statute5 U.S.C. § 8107; 20 C.F.R. § 10.404
Sourcedol.gov/owcp/FECA
CoversAll federal civilian employees including postal workers
Schedule AwardsExtremities, hearing, vision, and specified organs — spine is not scheduled
🔴 Major 2024 Policy Change After 15+ years requiring the 6th Edition only (since FECA Bulletin 09-03, 2009), OWCP issued a 2024 transmittal permitting use of either the 5th or 6th Edition. The new Form CA-9 allows claimants to elect their edition. Driven by concerns that the 6th Edition systematically produced lower ratings.
Verified April 2026
CoversMaritime workers; extends to DBA (overseas contractors), OCSLA (offshore oil/gas)
ScopeScheduled injuries only — upper extremity (except shoulder), lower extremity, hearing, vision
Extends via Defense Base Act to federal contractors overseas — relevant for physicians serving military contractors globally. 6th Edition applies.
Verified April 2026
Edition6th Edition — consistent with OWCP standards
Statute42 U.S.C. § 7384 et seq.
Sourcedol.gov/owcp/energy
CoversCurrent and former DOE employees and contractors at nuclear weapons facilities
Benefit TypePart E: toxic substance illness claims — lump-sum and medical benefits for radiation/chemical exposure
Part E benefit uses AMA Guides consistent with OWCP standards. 6th Edition applies.
Verified April 2026
Performing ratings under FECA, LHWCA, or state WC?
AAEME's 5th and 6th Edition courses are accepted for training in multiple jurisdictions.
The NIRSAT exam covers both Nevada and national certification. Rating software available for both editions through WPIRS.
Canada
Which AMA Guides Does My Province Use?
Canadian workers' compensation is provincially administered — there is no national system. Most provinces use or formally reference the AMA Guides, though adoption varies significantly: some mandate it as the primary tool, others as a supplement, and a few have built entirely independent systems.
Provinces
7 Provinces↑ Source confidence indicators follow the key in the first section
Edition6th Edition — tracks every digital update, including 2025 tables effective April 1, 2026
AuthorityWCB Policy 04-04, Addendum B
Sourcewcb.ab.ca
Use TypeMandated — primary PCI (Permanent Clinical Impairment) rating tool
🟢 Most Current Adopter Globally WCB-Alberta's Addendum B explicitly tracks every AMA Guides digital update with formal effective dates — one of the most progressive AMA Guides adopters in the world.
Verified April 2026
Edition6th Edition — most recent edition required
AuthorityWorkSafeNB Policy 21-250 (updated June 2025)
Sourceworksafenb.ca
Use TypeMandated — most recent edition required
WorkSafeNB explicitly mandates the "most recent edition." Policy 21-250 updated June 6, 2025 — one of the most recently verified policies in our research.
Verified April 2026
Edition6th Edition — AMA Guides Combined Values Chart specifically referenced
AuthorityWCB Saskatchewan POL 33/2024
Sourcewcbsask.com
Use TypeMandated — AMA Guides CVC used for combining multiple PFI ratings
Saskatchewan WCB uses the AMA Guides Combined Values Chart for combining multiple Permanent Functional Impairment ratings. Policy updated October 2024.
Verified April 2026
Edition6th Edition (4th and 6th printings cited) — supplemental to Manitoba's own Schedule A
AuthorityWCB Manitoba Policy 44.90.10
Sourcewcb.mb.ca
Use TypeSupplemental — own Schedule A primary; AMA 6th used for conditions not covered
Manitoba uses its own PPI rating schedule as primary. AMA Guides 6th used when the schedule doesn't cover a condition. Chapter 20 (mental health) in the Manitoba schedule is explicitly based on AMA 6th Edition.
Verified April 2026
EditionNot Used — own Loss of Function/Earning Capacity system
AuthorityWorkSafeBC; Workers Compensation Act (BC)
Sourceworksafebc.com
Use TypeOwn system — AMA Guides not part of the official assessment framework
BC uses its own Permanent Disability Evaluation Schedule based on loss of function and earning capacity. AMA Guides are not part of the official assessment framework.
Verified April 2026
EditionNot Used for WC — own Non-Economic Loss (NEL) rating system
AuthorityWSIB Ontario; Workplace Safety and Insurance Act 1997
Sourcewsib.ca
ExceptionOntario's SABS (auto insurance) references AMA Guides for some determinations
Ontario WSIB uses its own NEL assessment system. AMA Guides not used for WC since the 1990s reforms. Ontario's auto insurance SABS does reference AMA Guides — relevant for physicians in the auto insurance space.
Verified April 2026
EditionNot Used — civil law system; own Barème des dommages corporels
AuthorityCNESST; LSST
Sourcecnesst.gouv.qc.ca
Use TypeQuebec's civil law tradition uses its own Schedule of Physical Damages for all bodily injury compensation
Quebec operates under civil law and uses its own Barème des dommages corporels for all bodily injury compensation including WC. AMA Guides have no role.
Verified April 2026
Australia
Which AMA Guides Does Australia Use?
Australia has a nationally coordinated template guideline based on AMA Guides 5th Edition (AMA5), adopted by most states and territories. Australian Guidelines take precedence over AMA5 wherever they differ. Assessors must be specifically trained and accredited in each state — making Australia one of the most developed physician certification ecosystems globally.
Australian Guidelines take precedence over AMA5 wherever they differ. Each state and territory requires formal accreditation of assessors. Psychiatric impairment chapters have been replaced in all state guidelines with Australian-specific frameworks — the most developed alternative psychiatric IR framework found internationally.
AU States & Territories
5 Entries↑ Source confidence indicators follow the key in the first section
Edition BaseAMA5 — via SIRA NSW Guidelines (4th Ed., March 2021)
AuthoritySIRA NSW Guidelines for the Evaluation of Permanent Impairment, 4th Ed.
Sourcesira.nsw.gov.au
ModificationsCh. 14 (Psych) replaced with Australian chapter; Ch. 18 (Pain) excluded; Vision uses AMA4
Assessor CertificationFormal accreditation required for all assessors
SIRA NSW Guidelines based on AMA5 with significant modifications. Physicians cannot perform impairment assessments without completing formal accreditation.
Verified April 2026
Edition BaseAMA5 — WorkSafe Qld Guidelines for Evaluation of Permanent Impairment
AuthorityWorkSafe Queensland Guidelines
Sourceworksafe.qld.gov.au
ModificationsCh. 14 (Psych) replaced; Ch. 18 (Pain) excluded; specialists must be trained and registered
Queensland WorkSafe Guidelines based on AMA5 with the same core modifications as NSW. Physicians must be trained and registered to perform assessments.
Verified April 2026
Edition BaseAMA5 — WorkCover WA Guidelines (1st Ed., July 2024)
AuthorityWorkCover WA Guidelines for the Evaluation of Permanent Impairment
Sourceworkcover.wa.gov.au
ModificationsUpdated July 1, 2024; Vision uses AMA4; APIA (Approved Permanent Impairment Assessor) designation required
WorkCover WA Guidelines updated July 2024. Physicians must hold APIA status to perform assessments.
Verified April 2026
Edition BaseAMA5 — state-specific versions of Safe Work Australia national template
AuthoritySafe Work Australia national template; individual state regulators
ModificationsSame core modifications as NSW/QLD — psychiatric chapter replaced, pain excluded
Assessor CertificationFormal accreditation required in each jurisdiction
These jurisdictions use state-specific versions of the Safe Work Australia national template. Grouped here because their approach is substantively identical to NSW/QLD.
Verified April 2026
Edition BaseAMA5-Derived — own Guide to the Assessment of the Degree of Permanent Impairment, Edition 2.1
AuthoritySafety, Rehabilitation and Compensation Act 1988
Sourcecomcare.gov.au
Use TypeFederal government employees and licensed self-insured corporations
Comcare uses its own Guide Edition 2.1, derived from AMA5 but a standalone regulatory document — not the state-level guidelines above.
Verified April 2026
Other International Jurisdictions
Where Else in the World Are the AMA Guides Used?
Beyond North America and Australia, the AMA Guides are used or referenced across Asia, Europe, the Middle East, the Pacific, and through international organizations. The level of adoption ranges from statutory WC mandates to foundational influence on national rating methodologies. Where no official government source link has been confirmed, the Source row is omitted from the entry.
↑ Source confidence indicators follow the key in the first section
New Zealand & Pacific
Edition4th Edition — ACC User Handbook; proposed switch to 6th Edition pending regulatory amendment
Use TypeMandated — national no-fault system (ACC); covers all injury types, not just work injuries
Sourceacc.co.nz
Assessor CertificationACC-approved training required; post-course test required
PsychiatricChapter 14 assessments require a psychiatrist
⚠️ Proposed Edition Change New Zealand's ACC uses AMA Guides 4th Edition with the ACC User Handbook. A proposed switch to the 6th Edition is pending regulatory amendment — verify current status at acc.co.nz before relying on this entry.
Verified April 2026
Africa & Asia
Edition6th Edition (PI litigation); varies by WC scheme
Use TypePI litigation ("serious injury" threshold); WC reference
ContextPrimarily medicolegal and PI context rather than statutory WC mandate
AMA Guides 6th Edition used to determine the "serious injury" threshold in PI and motor vehicle claims. Other editions used in WC schemes under COIDA. Source: peer-reviewed AMA Guides Newsletter (2011, 2020).
Verified April 2026
EditionNot Specified
Use TypeAll personal injury and WC damages — medicolegal reference
ContextUsed as reference standard by physicians for medicolegal reports across all compensation contexts
AMA Guides used to evaluate all types of damages for PI and WC claims. Source: peer-reviewed AMA Guides Newsletter (2020).
Verified April 2026
EditionNot Specified
Use TypeOfficial use in adjudication proceedings
ContextOfficial adjudication role confirmed — stronger level of adoption than reference use
Malaysia uses AMA Guides officially in adjudication. Specific statutory basis not identified in available sources. Source: peer-reviewed AMA Guides Newsletter (2011).
Verified April 2026
EditionMethodology influence — own national systems built on AMA Guides principles
Use TypeFoundational influence on national impairment rating systems
ContextGrouped because available data does not distinguish between these jurisdictions at country level
These countries have impairment rating systems built on or significantly influenced by AMA Guides philosophy. Physicians working in these systems benefit from AMA Guides training to understand the methodological foundation. Source: peer-reviewed AMA Guides Newsletter (2011).
Verified April 2026
Europe, Middle East & International Organizations
EditionReference use — no uniform edition across European jurisdictions
Use TypeWC and social welfare reference; medicolegal; cross-border evaluations
ContextEU member states each administer their own WC systems; AMA Guides used as common framework for cross-border work
"Certain European countries" use AMA Guides as a reference in WC and social welfare determinations. Physicians performing cross-border medicolegal evaluations or working with international employers frequently use the AMA Guides as a common framework. Source: peer-reviewed AMA Guides Newsletter (2020).
Verified April 2026
EditionReference use — no uniform edition across GCC and broader Middle East jurisdictions
Use TypeMedicolegal; WC reference; personal injury
ContextGCC countries maintain own statutory compensation schedules; AMA Guides used for complex or disputed claims and by physicians serving the international expatriate workforce
The large international expatriate workforce in Gulf states creates demand for AMA Guides-trained physicians — particularly for complex, disputed, or cross-border claims. Source: peer-reviewed AMA Guides Newsletter (2020).
Verified April 2026
Edition6th Edition — referenced in UN General Assembly Resolution 61/276 (2008)
Use TypePeacekeeping disability & death compensation
ContextPeacekeepers come from dozens of countries; any physician evaluating UN-affiliated personnel may need AMA Guides training regardless of home jurisdiction
The AMA Guides 6th Edition is referenced in UN General Assembly Resolution 61/276 (2008), para. 7, for compensating death and disability of UN peacekeeping personnel. Source: peer-reviewed AMA Guides Newsletter (2020).
Verified April 2026
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