Impairment Rating Foundations
Six free courses covering the foundational principles every physician needs before performing a rated evaluation, from the Combined Values Chart and MMI through spinal rating methodology and the full upper extremity evaluation sequence. No enrollment fee. No exam required. Available with a free AAEME account.
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These courses are free. A free AAEME account is required to access course content. Account creation takes less than two minutes. Create your free account →
Six Courses. Zero Enrollment Fee.
The Impairment Rating Foundations series covers the clinical and methodological fundamentals of AMA Guides impairment rating, the concepts and procedures every physician needs before performing rated evaluations, and the technical depth that makes advanced coursework easier to absorb.
- The three combining methods in the AMA Guides and when to use each
- MMI: what triggers it and what to do at that point
- Unlisted conditions: analogous rating and clinical judgment
- DRE is the default; when ROM is appropriate instead
- All five DRE categories: clinical basis and percentage ranges
- Multi-region injuries: DRE still applies in most cases
- The sacral hip flexion angle: required, and consistently missing from reports
- The Straight Leg Raise rule for lumbar validity, not the orthopedic test
- Raw data documentation: why worksheets must be included in the report
- Peripheral nerve grading: identifying the nerve, sensory and motor deficit grades
- No-double-counting rule: when nerve and ROM impairment cannot both be rated
- Strength evaluation: last resort only, with strict timing and eligibility rules
- The digit-hand-UE-WPI conversion chain with multipliers
- ACOEM guidelines: when you can deviate and how to document it
- Active vs. passive motion and the bilateral comparison standard
- NV Rev. Stat. 616C.110 and the NIRSAT certification requirement
- Renewal obligations for MDs/DOs vs. DCs under Nevada law
- Recommended preparation before the NIRSAT exam
How Do I Access These Courses?
- 01 Create a free AAEME accountAccount creation collects your professional credentials for certification tracking. It takes less than two minutes and gives you immediate access to the full Impairment Rating Foundations series.
- 02 Access any course in the seriesAll six courses are available immediately after account creation. Each is self-paced. Start, pause, and return on your schedule. There is no required order, though Introduction to Impairment Ratings is the recommended starting point for physicians new to the AMA Guides.
- 03 Continue to certification when readyThe Foundations series does not lead to certification on its own. When you are ready to pursue the CIRS™ or NIRSAT™ credential, your AAEME account carries forward. No new registration is needed to enroll in the 5th Edition Advanced course or schedule an exam.
Take the Next Step Toward CIRS or NIRSAT
Questions About the Foundations Series
Are all six courses really free?
Yes. All six courses are free. A free AAEME account is required to access them. CME/CEU credit is not offered on Foundations courses; if you need formal continuing education credit, see our certification courses.
Do I need to take the courses in order?
No required order. Physicians already familiar with foundational impairment rating methodology can go directly to the course most relevant to their practice. For physicians new to the AMA Guides, Introduction to Impairment Ratings is the recommended starting point. The two Spine courses work best in sequence: DRE & ROM Overview before ROM Method in Depth.
Does completing these courses satisfy any certification requirement?
No. The Impairment Rating Foundations series is foundational education, not a certification program. CIRS certification requires completing the 5th Edition Advanced course and passing the CIRS exam. NIRSAT requires the same, plus satisfies Nevada's statutory requirement under NV Rev. Stat. 616C.110. See the courses page and exams page for full certification options.
Which edition of the AMA Guides do these courses cover?
Most Foundations courses are based on AMA Guides 5th Edition methodology, which remains the most widely used edition in U.S. workers' compensation jurisdictions. The foundational principles covered (the Combined Values Chart, MMI, DRE method, ROM measurement) apply broadly across editions. Edition is noted on each individual course page where it differs.
Will more courses be added to the series?
Yes. Additional body region courses and clinical methodology modules are in development. Create a free AAEME account to be notified when new courses are added to the Impairment Rating Foundations series.
Start Learning at No Cost
Create a free AAEME account to access all six Impairment Rating Foundations courses immediately.