Exams · Nevada · NV Rev. Stat. 616C.110

NIRSAT™
Certification Exam.

100 questions including a Nevada legal section · 4 hours · Single sitting · Open book · 75% to pass

The NIRSAT™ exam is the Nevada-required impairment rating certification for physicians performing workers' compensation impairment ratings on Nevada cases. It is written into Nevada law under NV Rev. Stat. 616C.110, and AAEME is the sole authorized provider. Passing the exam issues both NIRSAT and 5th Edition CIRS™ credentials in a single sitting.

Exam Specifications

FormatOnline, self-scheduled

Questions100, incl. Nevada legal section

Duration4 hours, one sitting

Passing score75%

MaterialsOpen book + calculator

Access window90 days from purchase

RetakesOne free, within 90 days

Credentials issuedNIRSAT + 5th Edition CIRS

Exam Fee $895

Who Is the NIRSAT Exam For?

The NIRSAT exam is required by Nevada statute (NV Rev. Stat. 616C.110) for any physician performing workers' compensation impairment ratings on Nevada cases. It is also taken by out-of-state physicians who handle Nevada-jurisdiction matters. Passing NIRSAT issues both the NIRSAT credential and the 5th Edition CIRS credential in a single sitting, since the NIRSAT exam covers the full 5th Edition content plus a Nevada legal section.

Nevada · Required by Law

Nevada-Licensed Physicians

MDs, DOs, and DCs licensed in Nevada who perform permanent impairment ratings in workers' compensation cases. NIRSAT certification is required by statute; physicians cannot perform compensable ratings without it.

Out-of-State · Nevada Cases

Out-of-State Physicians Handling Nevada Work

Out-of-state physicians who handle Nevada workers' compensation impairment ratings (including consulting and IME work that touches Nevada cases) are subject to the same statutory NIRSAT requirement.

Dual Credential

Physicians Wanting Both NIRSAT & CIRS

Physicians who want both the Nevada-required NIRSAT and the national 5th Edition CIRS in one sitting. NIRSAT is the only AAEME exam that issues two credentials simultaneously.

One Sitting: Plan Accordingly

The exam must be completed in a single sitting. You cannot save your progress and resume later. Once you begin, the 4-hour timer runs continuously. Schedule a block of uninterrupted time before launching the exam.

How Is the NIRSAT Exam Structured?

The NIRSAT exam is delivered online and self-scheduled. It contains 100 questions in mixed formats (multiple choice, calculation, and case-based) drawn from the AMA Guides 5th Edition methodology, plus an additional section of Nevada-specific legal questions drawn from NV Rev. Stat. 616C.110. Candidates have 4 hours to complete the exam in a single sitting and must achieve 75% to pass.

The Exam

100 questions covering 5th Edition methodology plus a Nevada legal section
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 across the full exam (5th Edition + Nevada legal combined)
Online, self-scheduled; sit when you are ready
90-day window from purchase to sit the exam

What You May Use

The AMA Guides 5th Edition; the exam is open book, physical or digital copy permitted
NV Rev. Stat. 616C.110 and related DIR reference materials
A calculator; physical, on-screen, or web-based
Personal notes from your course preparation
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

What Does the NIRSAT Exam Cover?

The NIRSAT exam tests applied knowledge of AMA Guides 5th Edition impairment rating methodology across all major specialties and body systems, plus Nevada workers' compensation statutory requirements under NV Rev. Stat. 616C.110. It is structured as a 5th Edition CIRS exam with an added Nevada legal section.

Foundations & Combined Values

Whole person impairment, the Combined Values Chart, and the methodology framework that underlies every rating.

Spine: DRE & ROM Methods

Diagnosis-Related Estimates and Range of Motion methods, when each applies, and documentation requirements.

Upper & Lower Extremities

Joint motion, peripheral nerve involvement, amputation, and converting regional impairment to whole person values.

Cardiovascular, Respiratory, Neurological

Functional class assessment, objective testing requirements, and impairment classification across systems.

Nevada Workers' Comp Law

NV Rev. Stat. 616C.110, the DIR's role, statutory compliance under Nevada workers' compensation. This is the section unique to NIRSAT.

Reporting & Defensibility

Producing written evaluations that hold up in workers' compensation hearings, depositions, and DIR review.

The Nevada legal section is fully integrated into the 100-question total. The 75% passing score applies to the entire exam, not separately to the AMA Guides and Nevada legal sections.

How Should I Prepare for the NIRSAT Exam?

AAEME strongly recommends the NIRSAT Course Bundle, which combines the 5th Edition Advanced course with the free Introduction to Nevada Workers' Comp Law course covering the statutory content tested in the Nevada legal section. The QRG Study Guide adds structured review for the AMA Guides 5th Edition methodology.

Recommended Bundle

NIRSAT Course Bundle

$998 · 5th Edition Advanced + Nevada Legal content included

The complete preparation path: AMA Guides 5th Edition methodology across all specialties, plus the Nevada workers' compensation statutory content tested in the Nevada legal section. Online and self-paced.

View the Course Bundle

Recommended Study Aid

QRG Study Guide

$75 · Print on demand

Quick Reference Guide with sample exam questions across AMA Guides 5th Edition content domains. Useful as standalone preparation or alongside the NIRSAT Course Bundle.

View the QRG

Bringing the AMA Guides 5th Edition and the text of NV Rev. Stat. 616C.110 to the exam is allowed and expected. Candidates without ready access should plan to obtain copies 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 NIRSAT certificate (which also confers the 5th Edition CIRS credential) is issued the same day. AAEME submits your certification to the Nevada DIR on the next scheduled twice-monthly submission cycle. If you do not pass, you are eligible for one free retake within 90 days.

If You Pass

NIRSAT + 5th Edition CIRS Credentials Issued

Two credentials in one sitting: NIRSAT and 5th Edition CIRS both issued upon passing
Digital certificate emailed immediately upon passing
Physical certificate available by mail for an additional fee
AAEME submits to the Nevada DIR twice monthly; your name appears in the DIR directory after both your submission and AAEME's are processed
e-Eval network access: optional listing in AAEME's certified physician referral network

If You Don't Pass

One Free Retake Within 90 Days

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: NIRSAT Course Bundle and QRG Study Guide are recommended
Original exam fee is non-refundable regardless of result

Retake policies are subject to change. Current policy is disclosed at the time of registration.

How Do I Get Listed in the Nevada DIR Physician Directory?

After passing your NIRSAT exam, both you and AAEME must submit your certification to the Nevada Division of Industrial Relations. AAEME submits twice monthly. Your name appears in the DIR directory after both submissions are processed.

Pass the exam and receive your certificate

Your NIRSAT certificate (also conferring 5th Edition CIRS) is emailed to you immediately upon passing. The name on your certificate must exactly match the name on your Nevada medical license; the DIR uses your medical license name for the directory listing.

AAEME submits your certification to the DIR

AAEME submits a formal notification to the Nevada DIR twice monthly. You do not need to request this. It happens automatically. There may be up to two weeks between your exam passing and AAEME's next submission cycle.

You also submit your certificate to the DIR

In addition to AAEME's submission, you are required to submit your certificate to the DIR yourself. Contact the DIR directly for current submission instructions. Both submissions are required before the DIR will list you.

Confirm your listing in the DIR directory

Verify your name appears correctly in the DIR's physician directory after both submissions have been processed. If your name does not appear within a reasonable time, contact the DIR and let AAEME support know through our contact form.

How Do I Register and Sit the NIRSAT 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.

Purchase the exam ($895)

Pay through the AAEME enrollment system. The 90-day window begins on the date of purchase, so register when you are ready to sit within that period.

Schedule your sitting

Block out 4 uninterrupted hours. Have the AMA Guides 5th Edition, NV Rev. Stat. 616C.110, a calculator, and reference notes within reach. Use a stable internet connection.

Sit the exam in one continuous session

Once you begin, the 4-hour timer runs without pause. One question at a time; you cannot return to a previous question after answering. The exam cannot be saved and resumed.

Receive your result and certificate

Your score is displayed at the end of the exam. If you pass, your NIRSAT and 5th Edition CIRS certificates are emailed the same day. AAEME submits to the Nevada DIR on the next scheduled cycle.

Frequently Asked Questions

Common questions about NIRSAT certification, including statutory requirements, dual credentialing, the DIR directory listing process, and how NIRSAT relates to the 5th Edition CIRS.

Do I really need NIRSAT to perform impairment ratings in Nevada?

Yes. NV Rev. Stat. 616C.110 requires any physician performing workers' compensation impairment ratings in Nevada to hold a current NIRSAT credential issued through AAEME. AAEME is the sole authorized provider. The DIR has stated there is no grace period for non-certified physicians.

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 credentials, at no extra cost.

I already hold the 5th Edition CIRS. Do I need to take NIRSAT separately to practice in Nevada?

Yes. The 5th Edition CIRS alone does not satisfy the Nevada statutory requirement. You must hold NIRSAT specifically. Passing the NIRSAT exam will issue NIRSAT and reaffirm 5th Edition CIRS.

Do I need to take the NIRSAT Course Bundle before sitting the exam?

No. The NIRSAT exam is open to any physician confident in their AMA Guides 5th Edition methodology and Nevada workers' compensation law. The NIRSAT Course Bundle is strongly recommended preparation but not a registration prerequisite.

I am a DC practicing in Nevada. What are my ongoing requirements?

Under NV Rev. Stat. 616C.110, DCs must renew the AMA Guides course every two years, though the NIRSAT exam itself is required only once. MDs and DOs complete NIRSAT once with no renewal required. The Nevada IR Stress Disorders Seminar is required for all license types by July 1, 2026. See the Nevada requirements page for full details.

How long does it take to appear in the DIR directory after I pass?

In most cases physicians are listed within two to four weeks of passing, assuming both AAEME's submission and your personal submission to the DIR have been received and processed. If you have not appeared after four weeks, contact the DIR and let AAEME support know through our contact form.

Can I perform impairment ratings while waiting for my DIR listing to process?

This is a question for the DIR directly, not AAEME. The DIR has stated there is no grace period for non-certified physicians, and we recommend having your listing confirmed before performing rated evaluations. Contact the Nevada DIR for guidance on your specific situation.

Is the exam open book?

Yes. You may use the AMA Guides 5th Edition (physical or digital), the text of NV Rev. Stat. 616C.110, a calculator, and any personal reference notes during the exam. Assistance from another person is not permitted; your competency is what is being assessed.

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 NIRSAT Credential?

Match Nevada's statutory requirement. Earn NIRSAT and 5th Edition CIRS in one sitting. Your certificate is issued the same day you pass.

NIRSAT™Certification Exam.