Frequently Asked Questions.

CIRS stands for Certified Impairment Rating Specialist. It is the national credential AAEME issues to physicians who pass a certification exam demonstrating applied command of AMA Guides impairment rating methodology. The credential is edition-specific: CIRS AMA Guides 5th Edition and CIRS AMA Guides 6th Edition match the two AMA Guides editions in current use. The CIRS™ designation signals to courts, insurers, and referral sources that a physician's impairment ratings follow the Guides correctly.

Both exams cover the same AMA Guides 5th Edition impairment rating methodology and carry the same format, duration, and passing score. The NIRSAT exam additionally includes Nevada-specific legal questions covering workers' compensation law and statutory compliance under NV Rev. Stat. 616C.110. Nevada physicians required to hold NIRSAT certification should sit the NIRSAT exam; passing it satisfies both the state requirement and the national CIRS credential simultaneously. Physicians outside Nevada sit the CIRS exam.

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.

Match the exam to the AMA Guides edition your jurisdiction has adopted. Most U.S. workers' compensation jurisdictions use the AMA Guides 5th Edition; sit the CIRS AMA Guides 5th Edition 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 AMA Guides 6th Edition, sit the CIRS AMA Guides 6th Edition exam. The AMA Guides by Jurisdiction reference lists which edition each state uses.

None of the 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 strongly recommended but optional. For the NIRSAT exam, you must have completed a course on the AMA Guides 5th Edition; any qualifying AMA Guides 5th Edition course meets this requirement, including AAEME's AMA Guides 5th Edition Advanced course.

Yes. Passing the NIRSAT exam issues both the NIRSAT credential and the CIRS AMA Guides 5th Edition credential at the same time. NIRSAT is essentially the CIRS AMA Guides 5th Edition exam with an additional Nevada legal section appended. One sitting earns both.

No. The AMA Guides 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.

Each U.S. jurisdiction adopts a specific edition of the AMA Guides by statute or regulation, and they do not all use the same one. Our AMA Guides by Jurisdiction reference tracks the required edition for all 50 states, the District of Columbia, U.S. territories, and federal programs, verified against official statutes. Check your state on the interactive map before producing a rating.

There is no single national mandate. Each jurisdiction sets its own impairment rating standard through its workers' compensation statutes and regulations, so some require the 4th Edition, some the 5th, some the 6th, and a few mandate no specific edition at all. That is why confirming your jurisdiction's current requirement matters before you produce a rating. The AMA Guides by Jurisdiction reference lists each one.

The AMA Guides 5th Edition uses body-region methodology, including the DRE and ROM methods for the spine, while the AMA Guides 6th Edition uses a more compact, diagnosis-based framework. They apply different methodologies and are not interchangeable; use the edition your jurisdiction has adopted. AAEME offers certification for both, through the CIRS AMA Guides 5th Edition and CIRS AMA Guides 6th Edition exams.

Yes. All six courses in the IR Eval Fundamentals library are free. A free AAEME account is required to access them; account creation collects your professional credentials for certification tracking purposes and takes less than two minutes. CME/CE credit is not offered on Foundations courses; if you need formal continuing education credit, see our certification courses.

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.

No. CME/CE credit is not offered on the free Foundations library. The Foundations library is intentionally open educational content. If you need formal continuing education credit, AAEME's paid certification courses include credit eligibility in the enrollment fee.

No. The IR Eval Fundamentals series is foundational education, not a certification program.

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. The edition is noted on each individual course page where it differs.

No. Completing a paid course such as the AMA Guides 5th Edition Advanced course earns CME/CE credit but does not issue a credential on its own. The CIRS credential is issued upon passing the CIRS certification exam, and the NIRSAT credential is issued upon passing the NIRSAT exam. The exams are priced separately.

Course access is granted for six months from the date of purchase.

The clinical content is identical. The Nevada PTSD, TBI & Stress Disorders IR Seminar uses Nevada's official course title, includes the Nevada legal framework, and produces the certificate accepted by the Nevada Med Panel. The Neuro-Psych IR Seminar is the national version for providers outside Nevada or in jurisdictions that do not require the Nevada-specific certificate. Only the title, framing, and certificate differ. The Neuro-Psych certificate is not accepted in Nevada.

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 IR Eval Fundamentals series.

Yes. All AAEME exams are open book. You may use the relevant edition of the AMA Guides (physical or digital), a calculator, and any personal reference notes during the exam. The CIRS AMA Guides 5th Edition and NIRSAT exams additionally permit the AAEME Quick Reference Guide (an AMA Guides 5th Edition guide), and the NIRSAT exam permits the text of NV Rev. Stat. 616C.110. The exams test applied methodology, not memorization. What is not permitted is assistance from another person, because your individual competency is what is being assessed.

No. The exam must be completed in a single sitting. Once you begin, the timer runs continuously and there is no pause or resume function. Block out a continuous window before launching the exam.

Any current version of a major web browser: Chrome, Firefox, Safari, Edge, or Opera. Update your browser before you start the exam, and make sure JavaScript and cookies are enabled (they are on by default in modern browsers). Mac and iPad users can take the exam in Safari without issue.

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.

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.

If you do not pass, you may re-register to sit the exam again. Each attempt requires a new registration and exam fee; there is no free retake. You may make up to three attempts. A second attempt is available 7 days after the first, and a third attempt 30 days after the second. There is no deadline on retakes; the 90-day window applies only to sitting an exam after you purchase it. If you do not pass on the third attempt, you are no longer eligible for CIRS or NIRSAT certification and will be notified by email. The retake follows the same format as the original exam. The exam fee is non-refundable regardless of result.

AAEME processes certificates twice monthly, and your certificate is emailed to the address we have on file for you.

Yes. Each exam is purchased independently, 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.

Because the AMA Guides 6th Edition uses a more compact diagnosis-based framework than the AMA Guides 5th Edition, it is more complex and its questions take longer to answer. Its question count is sufficient to test applied competency across the major body systems and the new framework's diagnostic grids. Both exams allocate the same 4-hour window, so candidates have ample time per question on the AMA Guides 6th Edition exam.

The Nevada PTSD, TBI & Stress Disorders IR Seminar and the Neuro-Psych IR Seminar both bundle the assessment into the course itself. You enroll, complete the curriculum, and pass the embedded assessment to satisfy the requirement, with no separate exam fee or registration. This is a structural choice: these seminars cover specialty content where the assessment is most usefully tied directly to the learning module.

The NIRSAT and CIRS AMA Guides 5th Edition exams each earn 4 AAFP-accredited CME credits. CME credit for the CIRS AMA Guides 6th Edition exam is pending; subscribe to the AAEME newsletter for updates. The exams do not carry CE credit for chiropractors.

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.

It depends on which exam you passed. If you passed the NIRSAT exam, you already hold both NIRSAT and the CIRS AMA Guides 5th Edition; you are covered for Nevada. If you passed the AMA Guides 5th Edition exam only (not the NIRSAT specifically), you hold national CIRS but not the Nevada-specific NIRSAT credential, and you would need to take the NIRSAT exam to practice in Nevada. Reach out through our contact form if you are unsure which exam you sat.

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; we are not privy to the Med Panel's internal timelines.

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.

The AMA Guides do not address psychological impairment from stress or post-traumatic stress disorder. There is a gap in the standard methodology that Nevada has moved to address by statute. The Nevada PTSD, TBI & Stress Disorders IR Seminar covers the clinical and legal framework for evaluating psychological PPDs in workers' compensation cases. All Nevada PPD raters are required to complete it, regardless of specialty. Completing it satisfies the Seminar requirement, but there are additional requirements to be listed in the Med Panel Directory; see our Nevada requirements page for full details.

Always register using the exact name that appears on your Nevada medical license, not your preferred name, nickname, or shortened version. The Med Panel matches the name on your certificate against your medical license record. If the names do not match exactly, your directory listing may be delayed or rejected. You can enter a preferred name separately during registration, but your legal name field must match your license exactly. Name corrections after certificate issuance are subject to a reprint fee.

Nevada workers' compensation statutes use permanent partial disability (PPD) as the official term for what physicians clinically calculate as an AMA Guides impairment rating. The underlying methodology is the same, but Nevada documentation, DIR forms, and case law all use PPD. AAEME's Nevada materials use Nevada's terminology throughout so it matches what you will see in practice.

Yes. Credit-eligible AAEME courses and certification exams carry CME credit accredited through the American Academy of Family Physicians (AAFP). Credit hours vary by program; the current hours, approval numbers, and official statements for every credit-eligible program are listed on the continuing education page. Free courses never carry credit, and not every paid program does. CME credit for the CIRS AMA Guides 6th Edition exam is pending and will be announced once confirmed.

The American Academy of Family Physicians is one of the most widely accepted CME accreditors in the United States. AAFP-accredited credit is recognized across specialty boards, state medical board renewal requirements, and hospital privileging processes. For physicians, the practical question is whether their licensing authority and specialty board will accept the credit; AAFP accreditation answers that across the broadest possible range of contexts.

AAFP-accredited CME credit is generally accepted by specialty boards across medicine, including the American Board of Medical Specialties (ABMS) member boards. Specific category designation and acceptance depend on each board's current rules. Physicians should confirm acceptance with their specialty board's continuing certification requirements before relying on any single source for compliance.

Nevada-licensed DCs earn CE hours on the approved courses, currently the AMA Guides 5th Edition Advanced and the Nevada PTSD, TBI & Stress Disorders IR Seminar at 8 CE hours each. CE credit for DCs is offered on approved courses only, never on the certification exams, and is not available for DCs licensed outside Nevada.

Yes. AAEME courses are open to all licensed healthcare professionals. PA-Cs benefit directly from the existing accreditation: AAEME's CME is issued as AAFP Prescribed credit, which the NCCPA recognizes toward PA-C certification maintenance. Most state PT boards accept self-reported continuing education. AAEME does not hold profession-specific accreditation for nurses, OTs, or other professions and is not currently pursuing it; credit acceptance is determined by each profession's licensing authority.

Yes. Where a program carries credit, CME credit, and CE credit for Nevada-licensed DCs on the approved courses, is included in the enrollment fee. There is no separate processing fee. Credit eligibility and hours are listed on each course's enrollment page.

Each licensing board has its own self-reporting process for continuing education credit. AAEME issues a certificate of completion with a statement of credit availability that refers to this page for the full accreditation details. The certificate, together with the details published here, contains the documentation most boards require. Submission methods, deadlines, and any additional requirements are determined by each licensing authority.

The E-Eval Provider Network is a directory of CIRS-certified providers qualified to perform AMA Guides impairment rating evaluations and users of WPIRS software. The network connects attorneys, insurers, employers, and other referring parties with credentialed evaluators in their jurisdiction. Created by AAEME in 2024, the network is the only directory of providers whose impairment rating qualifications have been verified through formal certification.

MDs, DOs, and DCs who hold a current AAEME CIRS certification (AMA Guides 4th, 5th, or 6th Edition) are eligible for network membership. NIRSAT certification, which incorporates the CIRS AMA Guides 5th Edition requirements, and TIRSAT, which incorporates the CIRS 4th Edition requirements, also qualify a provider for membership. Eligibility is automatic upon certification with no separate application; listing in the directory itself is opt-in.

Network membership is currently free for AAEME-certified providers. There is no application fee and no annual membership fee at this time.

The searchable directory allows attorneys, insurers, employers, and claims administrators to filter by several factors, including jurisdiction, specialty, AMA Guides edition, credential held, and software used. Each provider's listing includes their verified certification, the jurisdictions they cover, and their specialty. Search the directory here.

Listings show the provider's name, specialty, location, the AAEME credentials they hold, and any AAEME-recognized software they use. Providers control whether they are listed and what information appears publicly.

Network listings are tied to active certification status. If an AAEME certification lapses, the corresponding network listing is suspended until the certification is renewed. Once renewed, the listing is reinstated automatically.

Create your new account with your current email address and mention both email addresses in your contact form message. We will search our records under both addresses.

Course completion records are not platform-dependent, but to access your AAEME dashboard, which lists all of your completed courses and exams, you will need to register for your AAEME profile. In short, if you completed a course previously and hold a valid certificate, your credential remains valid and you do not need to re-take the course or exam.

No. List all courses in a single contact form message and we will verify and grant access to all of them at once.

Yes. Include your name, the email address you used at the time of purchase, and approximately when you purchased, and we will search our records and identify which course or courses you purchased.

All AAEME sales are final. Course enrollment fees and exam fees are non-refundable, regardless of result, change of mind, or failure to sit an exam within its 90-day access window. If you have questions before enrolling or registering, please reach out through our contact form before you pay.

For questions about AAEME courses, exams, and certification, use our contact form. Please note that we are unable to answer questions about Nevada law, the Med Panel Directory, or what you are permitted to do under statute; contact the Nevada Division of Industrial Relations directly for those questions.