The Right Credential
for Your Jurisdiction.
AAEME issues three certification credentials through three exams: 5th Edition CIRS™ for the most widely used AMA Guides edition, NIRSAT™ for Nevada-required certification under NV Rev. Stat. 616C.110, and 6th Edition CIRS for jurisdictions that have adopted the current edition. Pass the exam matched to your jurisdiction; earn your credential the same day.
What Credentials Do AAEME Exams Issue?
AAEME exams issue three credentials: 5th Edition CIRS for AMA Guides 5th Edition methodology, NIRSAT for Nevada-required certification under NV Rev. Stat. 616C.110, and 6th Edition CIRS for the AMA Guides 6th Edition. Each exam maps to its own credential, with one exception: passing the NIRSAT exam earns both NIRSAT and 5th Edition CIRS in a single sitting, since the NIRSAT exam covers the full 5th Edition content plus a Nevada legal section.
One credential per jurisdiction. Three exams to earn them.
Whether you need national certification for workers' compensation and liability cases under the 5th or 6th Edition, or you are required by Nevada statute to hold NIRSAT, each AAEME exam follows the same proven format: 4 hours, single sitting, open book, 75% to pass, and your credential is issued the same day you pass.
Which Exam Should I Take?
The right exam is the one matched to the jurisdiction and AMA Guides edition you actually use in practice. Most U.S. workers' compensation jurisdictions use the 5th Edition. Nevada physicians performing impairment ratings are required by statute to hold NIRSAT. A smaller number of jurisdictions have adopted the 6th Edition. The most common path is the 5th Edition CIRS.
5th Edition CIRS Exam
NIRSAT Exam
6th Edition CIRS Exam
What About the Nevada IR Stress Disorders Seminar and PNIR?
Two AAEME programs do not require a standalone certification exam: the Nevada IR Stress Disorders Seminar and the Psychological & Neurocognitive Impairment Rating program. Their assessments are bundled into the courses themselves. Complete the program, and the assessment is included. There is no $895 exam to register for separately.
Two programs that include their own assessment.
For these programs, the assessment is part of the course. You enroll once, complete the curriculum, and pass the embedded assessment to satisfy the requirement. No separate exam fee or registration.
- Nevada IR Stress Disorders Seminar. Required by Nevada statute for physicians who perform impairment ratings. Covers psychological and PTSD impairment evaluation methodology. The assessment is bundled with the course; no separate exam.
- Psychological & Neurocognitive Impairment Rating Program. Covers neuropsychological impairment assessment methodology. The assessment is bundled with the course; no separate exam.
Common Rules: 5th Edition, NIRSAT, and 6th Edition
All three AAEME certification exams share the same delivery format, scoring rules, materials policy, retake terms, and price. The only structural difference is question count. The 6th Edition exam has 45 questions instead of 100. CME/CEU credit is pending for all three exams at 4 hours each.
- Online, self-scheduled; sit when you are ready
- 4 hours total, completed in a single sitting (no save-and-resume)
- One question at a time; cannot return to previous after answering
- Open book with the AMA Guides edition matched to the exam, plus calculator and notes
- Honor system; activity is logged but no video proctoring
- 75% passing score required, calculated automatically
- Result displayed at the end of the exam
- Digital certificate issued the same day you pass
- Physical certificate available by mail for an additional fee
- e-Eval network listing is optional, not automatic
- 90-day window from purchase to sit the exam
- One free retake within 90 days if you do not pass
- Original exam fee non-refundable regardless of result
- Register when ready; the 90-day window is fixed
- 5th Edition CIRS: $895
- NIRSAT: $895; issues both NIRSAT and 5th Edition CIRS
- 6th Edition CIRS: $895
- No volume discounts; one exam, one fee
Exam Comparison at a Glance
A quick reference comparing the three AAEME certification exams. The differences are in question count, what's tested, and what credentials each issues. Format, duration, scoring, materials, retakes, and price are identical across all three.
| Attribute | 5th Edition CIRS | NIRSAT | 6th Edition CIRS |
|---|---|---|---|
| Who it's for | National; jurisdictions using AMA Guides 5th Edition | Nevada physicians (required by statute) and out-of-state physicians handling Nevada cases | National; jurisdictions using AMA Guides 6th Edition |
| Question count | 100 | 100 (incl. Nevada legal section) | 45 |
| Duration | 4 hours, one sitting | 4 hours, one sitting | 4 hours, one sitting |
| Passing score | 75% | 75% | 75% |
| Open-book reference | AMA Guides 5th Edition | AMA Guides 5th Edition | AMA Guides 6th Edition |
| Credentials issued | 5th Edition CIRS | NIRSAT and 5th Edition CIRS | 6th Edition CIRS |
| Recommended prep | 5th Edition Advanced course; QRG Study Guide | 5th Edition Advanced; free Introduction to Nevada Workers' Comp Law course; QRG Study Guide | AMA Guides 6th Edition (course in development) |
| Retake policy | One free, within 90 days | One free, within 90 days | One free, within 90 days |
| CME/CEU | 4 hours (pending) | 4 hours (pending) | 4 hours (pending) |
| Price | $895 | $895 | $895 |
Frequently Asked Questions
Common questions about choosing between the three AAEME exams, what's bundled and what's separate, and how the credentials relate to each other.
Which exam should I take if I'm not sure?
Match the exam to the AMA Guides edition your jurisdiction has adopted. Most U.S. workers' compensation jurisdictions use the 5th Edition; sit the 5th Edition CIRS exam. If you perform impairment ratings on Nevada workers' compensation cases, you are required to hold NIRSAT under NV Rev. Stat. 616C.110; sit the NIRSAT exam. If your jurisdiction has adopted the 6th Edition, sit the 6th Edition CIRS exam. The AMA Guides by Jurisdiction reference lists which edition each state uses.
Do I need to take a course before sitting any of these exams?
No. None of the three exams require an AAEME course as a registration prerequisite. The exams are open to any physician confident in their applied knowledge of the relevant AMA Guides edition. Course preparation is recommended but optional.
If I pass NIRSAT, do I also get the 5th Edition CIRS?
Yes. Passing the NIRSAT exam issues both the NIRSAT credential and the 5th Edition CIRS credential at the same time. NIRSAT is essentially the 5th Edition CIRS exam with an additional Nevada legal section appended. One sitting earns both.
If I pass the 6th Edition CIRS, do I also get the 5th Edition CIRS?
No. The 5th and 6th Edition exams test different methodologies and issue separate credentials. Physicians who need both credentials must sit both exams. Only NIRSAT carries a dual-credential outcome.
Why doesn't the Nevada IR Stress Disorders Seminar have a separate exam?
The Nevada IR Stress Disorders Seminar and the Psychological & Neurocognitive Impairment Rating program both bundle the assessment into the course itself. You enroll, complete the curriculum, and pass the embedded assessment to satisfy the requirement. No separate $895 exam fee or registration. This is a structural choice: these programs cover specialty content where the assessment is most usefully tied directly to the learning module.
When will CME/CEU credit be confirmed for the exams?
CME/CEU accreditation is pending for all three exams at 4 hours each. Timing depends on the accrediting body's review cycle, not on AAEME alone. Once accreditation is confirmed, candidates who have already passed will receive their CME/CEU documentation retroactively. Subscribe to the AAEME newsletter for updates as soon as credit is confirmed.
Are the credentials issued by AAEME the same as ABIME or other certifications?
No. AAEME issues its own CIRS and NIRSAT credentials. These are distinct from credentials issued by other organizations such as ABIME. NIRSAT specifically is the credential written into Nevada law under NV Rev. Stat. 616C.110, and AAEME is the sole authorized provider. For other jurisdictions, the credential that matters is the one your state, employer, or counterparty recognizes; check your specific requirements before sitting any exam.
Can I register for more than one exam at once?
Yes. Each exam is purchased independently at $895, and each carries its own 90-day access window starting from the date of purchase. AAEME recommends sitting one exam, receiving your result, and only then registering for the next. The 90-day window is fixed and starts the day you pay, not the day you sit.
What is the refund policy?
All exam fees are non-refundable, regardless of result, change of mind, or failure to sit within the 90-day window. If you have questions before registering, please use our contact form.
Ready to Pick Your Exam?
Match the exam to your jurisdiction. Register when you are ready to sit. Earn your credential the same day you pass.