AMA Guides to the Evaluation of Permanent Impairment® (AMA Guides®) is published by the American Medical Association. It is used in workers’ compensation systems, federal systems, automobile casualty, and personal injury cases to rate impairment, not disability. It is used internationally. The AMA also offers the best standards for evaluating causation and workability.

The AMA Guides are now also digital. The gold standard methodology for assessing permanent impairment for over 50 years is now providing 24/7 access online.

book covers: AMA Guides, 5th and 6th editions

The use of the AMA Guides in workers’ compensation varies by jurisdiction (see Guide adoption lists by the state in the United States). The Editions are:

  • Sixth Edition (published in 2008, used in 19 states/jurisdictions and Federal cases) The most current version is Guides 6th 2023.
  • Fifth Edition (published in 2000, used in 12 states).
  • Fourth Edition (published in 1993, used in 7 states).
  • Third Edition, Revised (published in 1988, used in 2 states).

Read about exciting developments with the AMA Guides.

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Learning the AMA Guides®

To evaluate impairment, you must know how to use the AMA Guides correctly. It is challenging to achieve this learning by simply reading the book. High-quality virtual learning experiences are the best and most cost-effective way to master the Guides. eMedicoLegal provides the resources that will empower you to succeed.

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Certified Impairment Rater

CIR® was created in 2006 to establish and maintain professional standards for the knowledge, skills, and abilities required to perform expert impairment evaluations using the Fifth or the Sixth Edition of the Guides. Distinguish yourself by achieving this status.

Assess your knowledge and skills now with a 10-item mini-assessment at no cost.  If you do well, proceed with the CIR® examination with confidence. If not so well, we can assist you with online training and resources. Take action; take either or both mini-assessments now:

Fifth Edition Mini-Assessment – No Cost

Sixth Edition Mini-Assessment – No Cost

Learn about certification.


Virtual medicolegal training for physicians, attorneys, and claim professionals at

eMedicoLegal courses are designed to provide you with high-quality training on medicolegal issues. The knowledge and skills you acquire are essential to your professional success.

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Impairment Check

Most impairment assessments are performed by independent medical evaluators (IMEs). Assessments should be unbiased and accurate.

Technology solutions such as ODG Impairment Check that integrates with ODG by MCG can help to ensure accuracy.

AMA Guides® Publications

The American Medical Association provides a solid platform of publications focusing on best practices in assessing impairment, causation, workability, and other critical issues.

AMA Guides digital.

Browse “Guides Impairment” on Amazon.

Guides Newsletter

Keep abreast of the latest developments in assessment, with authoritative guidance, published by the American Medical Association and edited by Christopher R. Brigham, MD. Published bi-monthly and available online with full achieve to 1995.


The AMA Guides® are the world’s most widely accepted standard for impairment assessment.

All the Resources You Need to Use the AMA Guides

AMA Guides® has been the accepted standard for impairment assessment since 1958. With these products, the AMA aims to provide relevant training resources, user-friendly tools, and essential references for physicians and other healthcare workers with a professional investment in impairment and disability evaluation, particularly those who perform—or need to understand—independent medical examinations (IMEs).

These tools collaborate with the latest scientific research and evolving medical opinions of nationally and internationally recognized physician and non-physician impairment and disability experts.

This site provides access to AMA publications and resources related to the use of the AMA Guides. It is provided as a service of Brigham and Associates, Inc. and was prepared by Christopher R. Brigham, MD, Editor of the Guides Newsletter and Senior Contributing Editor of the AMA Guides, Sixth Edition.

This site,, and Brigham and Associates, Inc. are independent of the American Medical Association (AMA). The training program and resources provided are neither endorsed nor sponsored by the AMA, and the opinions and content of the training presentations and learning content represent the views of the presenters and are not necessarily the views of the AMA, particularly on matters of medical policy.