NIRSAT™
Certification Exam.
The NIRSAT™ exam is required for PPD raters performing workers' compensation PPD 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 CIRS 5th Edition credentials in a single sitting.
Who Is the NIRSAT Exam For?
The NIRSAT exam is required by Nevada statute (NV Rev. Stat. 616C.110) for any PPD rater performing workers' compensation PPD 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 CIRS 5th Edition credential in a single sitting, since the NIRSAT exam covers the full 5th Edition content plus a Nevada legal section.
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.
- 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; you cannot review your answers before submitting
- 75% passing score required across the full exam (5th Edition + Nevada legal combined)
- Online, self-scheduled; take it when you are ready
- 90-day window from purchase to sit the exam
- The AMA Guides 5th Edition; the exam is open book, physical or digital copy permitted
- The AAEME Quick Reference Guide for the 5th Edition; you can purchase a copy here
- 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 not allowed: assistance from another person. The exam tests your competency
Additional details, including how to prepare, a preparation checklist, and the rules for taking your exam, are available in your exam portal.
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 CIRS 5th Edition exam with an added Nevada legal section.
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 AMA Guides 5th Edition Advanced course, paired 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.
Physicians who prepare thoroughly consistently outperform those who don't. The physicians who score best on the NIRSAT are those who complete all of the IR Eval Fundamentals free courses, take the AMA Guides 5th Edition Advanced course, and review the QRG Study Guide before sitting. We strongly recommend completing all three before scheduling your exam.
Before the paid course, work through AAEME's free IR Eval Fundamentals series: short, self-paced lessons built on AMA Guides 5th Edition methodology. They cover impairment rating basics, spine DRE and ROM methods, upper extremity evaluation, and an introduction to Nevada workers' compensation law, which is the exact content tested in the NIRSAT's Nevada legal section. There is no cost and no account fee. The physicians who score best on the NIRSAT consistently complete all of these first, so they are the strongest place to begin your preparation.
Explore the free IR Eval Fundamentals coursesBringing 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 CIRS 5th Edition credential) will be issued to you via email, usually within two weeks. You will need to submit this to the Med Panel directly, using your personal email address. For more details on the full process, see the Nevada requirements page.
- Two credentials in one sitting: NIRSAT and CIRS 5th Edition both issued upon passing
- Certificate emailed usually within two weeks
- Physical certificate available by mail for an additional fee
- 4 AAFP-accredited CME credits earned upon passing
- Submit your certificate directly to medpanels@dir.nv.gov. AAEME submits to the Med Panel twice monthly. The Med Panel Directory of PPD Raters is updated quarterly
- E-Eval Provider Network access: optional listing in AAEME's certified provider referral network
Your score is displayed at the end of the exam. If you do not achieve 75%, you will need to re-register to sit again. There is no free retake. Use the time to prepare: the AMA Guides 5th Edition Advanced course and QRG Study Guide are strongly recommended. The original exam fee is non-refundable regardless of result.
Once you've passed your NIRSAT exam and completed the Nevada IR Stress Disorders Seminar, you'll need to submit your certificates to the Med Panel. See our Nevada requirements page for the full step-by-step process.
View Nevada RequirementsHow Do I Register for 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.
Frequently Asked Questions
Common questions about NIRSAT certification, including statutory requirements, dual credentialing, the Med Panel Directory listing process, and how NIRSAT relates to the CIRS 5th Edition.
Do I really need to take the NIRSAT to perform PPD ratings in Nevada?
Yes. NV Rev. Stat. 616C.110 requires any PPD rater performing workers' compensation PPD ratings in Nevada to hold a current NIRSAT credential issued through AAEME. AAEME is the sole authorized provider. The Med Panel has stated there is no grace period for non-certified PPD raters. For a complete description of Med Panel requirements, see our Nevada requirements page.
I already hold the CIRS 5th Edition. Do I need to take NIRSAT separately to practice in Nevada?
Yes. The CIRS 5th Edition alone does not satisfy the Nevada statutory requirement. You must hold NIRSAT specifically. Passing the NIRSAT exam will issue NIRSAT and reaffirm CIRS 5th Edition.
Do I need to take an AAEME course 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, so AAEME's courses are strongly recommended preparation rather than a registration prerequisite. NIRSAT does require that you have completed a course on the AMA Guides 5th Edition, but that can be any qualifying 5th Edition course. AAEME's AMA Guides 5th Edition Advanced course meets the requirement.
How long does it take to appear in the Med Panel Directory of PPD Raters after I submit my application?
The Med Panel Directory of PPD Raters is issued on a quarterly basis, so how long it takes to appear depends on how close your completed application is to the next release. We recommend submitting your application as soon as you have met all the requirements (which you can confirm here); we are not privy to the Med Panel's internal timelines.
Can I perform PPD ratings while waiting for my Med Panel Directory listing to process?
This is a question for the Med Panel directly, not AAEME. We cannot advise on what Nevada law permits during the listing process. What we can tell you is that the Med Panel has stated there is no grace period for non-certified PPD raters, and we recommend having your listing confirmed before performing PPD ratings.
Is the exam open book?
Yes. You may use the AMA Guides 5th Edition (physical or digital), the AAEME Quick Reference Guide, 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.
Ready to Earn Your NIRSAT Credential?
Match Nevada's statutory requirement. Earn NIRSAT and CIRS 5th Edition in one sitting. Certificates are issued twice monthly after you pass.