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 the evaluation of causation and workability.

The AMA Guides are now digital. The gold standard methodology for the assessment of permanent impairment for over 50 years, 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 2007, used in 19 states / jurisdictions and Federal cases) The Sixth Edition is now available as digital for 2021 and 2022.
  • 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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Training on the AMA Guides®

The American Medical Online resources,, and will assist you in learning to accurately assess impairment, and you can get a training certificate after completion of online training. Combined with the monthly subscriber virtual meetings, this is the most cost-effective approach to mastering the AMA Guides.

For further information:

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. Open book and superb learning experience. Distinguish yourself.

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.


Online 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.

More information:

Impairment Check

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

Technology solutions such as ImpairmentCheck 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 is now digital.

Browse “Guides Impairment” on Amazon.

A Guides Newsletter

Keep abreast of the latest developments in assessment, with authoritative guidance. It is authoritative and provides guidance on the assessment of impairment, causation, workability, and other critical issues. Published bi-monthly.


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

All the Resources You Need to Use the AMA Guides

AMA Guides® has been the accepted standard for impairment and disability 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 are a collaboration of the latest scientific research and evolving medical opinions of nationally and internationally recognized physician and non-physician impairment and disability experts. This comprehensive collection is truly a one-stop-shop for all impairment, disability, and training needs.

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.