5th Edition CIRS™
Certification Exam.
The CIRS™ exam is the national AMA Guides 5th Edition credential for physicians producing impairment ratings in workers' compensation, motor vehicle, and other liability cases. It is open to any physician; completion of an AAEME course is recommended preparation, but not a prerequisite for registration.
Who Is the 5th Edition CIRS Exam For?
The 5th Edition CIRS exam is for physicians who produce permanent impairment ratings under the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition. This is still the edition adopted by most U.S. workers' compensation jurisdictions and many motor vehicle insurance frameworks. Passing the exam earns the CIRS credential, the national AMA Guides 5th Edition certification issued by AAEME.
How Is the CIRS Exam Structured?
The CIRS exam is delivered online and self-scheduled. It contains 100 questions in mixed formats (multiple choice, calculation, and case-based) drawn from the methodology and clinical scenarios covered by the AMA Guides 5th Edition. Candidates have 4 hours to complete the exam in a single sitting and must achieve 75% to pass.
- 100 questions in mixed formats: multiple choice, case-based scenarios, and impairment calculations
- 4 hours total time, one sitting; the timer runs continuously
- One question at a time; you cannot return to a previous question after answering
- 75% passing score required; result is calculated and displayed at the end of the exam
- Online, self-scheduled; sit when you are ready, from your own location
- 90-day window from purchase to sit the exam
- The AMA Guides 5th Edition; the exam is open book, physical or digital copy permitted
- A calculator; physical, on-screen, or web-based
- Personal notes from your course preparation
- Any reference materials you find helpful; there is no restricted-resource list
- What is tracked: IP address, exam start and end times, time spent, session activity, and answer pattern. Video proctoring is not used at this time
- What is not allowed: assistance from another person. The exam tests your competency, not collective
What Does the CIRS Exam Cover?
The CIRS exam tests applied knowledge of AMA Guides 5th Edition impairment rating methodology across all major specialties and body systems. Questions are drawn from the same content covered in AAEME's 5th Edition Advanced course: the Combined Values Chart, whole person impairment, body-region-specific evaluation techniques, and the documentation standards required for defensible reporting.
The exam emphasizes applied methodology (case scenarios, calculations, and judgment under the Guides) over rote memorization. Candidates should be comfortable navigating the AMA Guides 5th Edition while answering.
How Should I Prepare for the CIRS Exam?
No course is required to register for the CIRS exam. It is open to any physician confident in their AMA Guides 5th Edition methodology. That said, AAEME strongly recommends structured preparation. Most candidates take the 5th Edition Advanced course, the QRG Study Guide, or both before sitting the exam.
Bringing the AMA Guides 5th Edition to the exam is allowed and expected. Candidates without ready access to the Guides should plan to obtain a copy before sitting.
What Happens After I Take the Exam?
Your score is calculated automatically and displayed at the end of the exam. If you achieve 75% or higher, your CIRS certificate is issued the same day. If you do not pass, you are eligible for one free retake within 90 days. Exam fees are non-refundable in either case.
- Digital certificate emailed to you immediately upon passing
- Physical certificate available by mail for an additional fee
- e-Eval network access: optional listing in AAEME's certified physician referral network. You choose whether to be listed; it is not automatic
- Recognized credential for use in workers' compensation hearings, depositions, motor vehicle cases, and other liability proceedings
- No renewal required for the CIRS credential itself
- One retake at no additional cost, scheduled within 90 days of your first attempt
- Same exam structure: 100 questions, 4 hours, one sitting, 75% to pass
- Use the time to prepare: the QRG Study Guide and 5th Edition Advanced course are recommended before retaking
- Original exam fee is non-refundable regardless of result, including in the event of a failed retake
How Do I Register and Sit the Exam?
Registration is straightforward: purchase the exam, schedule your sitting within the 90-day access window, complete the exam in one continuous 4-hour session, and receive your result. There is no application form, no committee review, and no waiting list. You should purchase the exam when you are ready to take it.
Frequently Asked Questions
Common questions about the 5th Edition CIRS certification exam, including format, materials, retakes, and what the credential signifies once earned.
Do I need to take the 5th Edition Advanced course before sitting the exam?
No. The CIRS exam is open to any physician confident in their AMA Guides 5th Edition methodology. The 5th Edition Advanced course is strongly recommended preparation, but it is not a registration prerequisite. Candidates may also prepare independently or with the QRG Study Guide.
Can I save my progress and finish the exam later?
No. The exam must be completed in a single sitting. Once you begin, the 4-hour timer runs continuously and there is no pause or resume function. Block out a continuous 4-hour window before launching the exam.
Is the exam open book?
Yes. You may use the AMA Guides 5th Edition (physical or digital), a calculator, and any personal reference notes during the exam. The exam tests applied methodology, not memorization. What is not permitted is assistance from another person; your competency is what is being assessed.
How long do I have to sit the exam after purchasing?
You have 90 days from the date of purchase to sit the exam. Because the window is fixed, AAEME recommends purchasing the exam when you are ready to take it rather than registering far in advance.
What happens if I fail the exam?
You are eligible for one free retake within 90 days of your first attempt. The retake follows the same format: 100 questions, 4 hours, single sitting, 75% to pass. The original exam fee is non-refundable regardless of result. Use the QRG Study Guide and the 5th Edition Advanced course to prepare before retaking.
Is the exam proctored?
The exam uses an honor system supported by session activity tracking: time spent, answer pattern, and overall session integrity are recorded. AAEME does not currently use video proctoring or browser lockdown software. The exam is designed around applied judgment, which is why it is open book.
When will I receive my certificate?
Your digital CIRS certificate is emailed to you the same day you pass, typically within minutes of completing the exam. A printed physical certificate is available by mail for an additional fee. Order details are included with your digital certificate.
Does the CIRS credential expire?
The CIRS credential itself does not require renewal. Note, however, that some jurisdictions impose their own continuing education or recertification requirements separate from CIRS. Most prominently Nevada under NV Rev. Stat. 616C.110, where DCs must renew the AMA Guides course every two years. Check your state's workers' compensation regulations for specifics. See the AMA Guides by Jurisdiction reference for state-by-state rules.
I practice in Nevada. Should I take this exam or NIRSAT?
If you perform workers' compensation impairment ratings on Nevada cases, you are required under NV Rev. Stat. 616C.110 to hold NIRSAT certification. The NIRSAT exam covers the same 5th Edition content as the CIRS exam plus Nevada-specific legal questions, and passing it issues both NIRSAT and CIRS credentials simultaneously. See the NIRSAT Exam page or the Nevada requirements page for details.
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 Earn Your CIRS Credential?
Register when you are ready to sit. The 90-day window begins at purchase. Your certificate is issued the same day you pass.