AMA Guides to the Evaluation of  Permanent Impairment

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 and international systems, automobile casualty, and personal injury cases to rate impairment, not disability.

AMA Guides, Mastery – the best way to learn!

Your best solution to truly master the AMA Guides. Over two hundred modules and over one hundred seventy hours of content for each of the training courses for 5th and 6th Editions. Yearly enrollment is less than the average fee most physicians receive for a single evaluation. Rave reviews. Learn more.

Enroll in the entire course, or choose courses specific to your needs, including musculoskeletal, medical, and mental and behavioral disorders.

Fifth Edition
Sixth Edition

Independent Medical Evaluations - Best Practices!

This course focuses on best practices when performing an Independent Medical Evaluation (IME), including pre-evaluation, evaluation, post-evaluation, and high-quality report writing.

Learn More About Performing IMEs

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.

We offer comprehensive courses and focussed courses with AMA Guides, Sixth Edition - Mastery. 

We also offer comprehensive courses and focussed courses with AMA Guides, Fifth Edition - Mastery.

Learn what learning experience is best for you

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.

Learn About Certification


Virtual training focussing on technologies and artificial intelligence for physicians, attorneys, and claim professionals at

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

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Impairment Check

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

Learn More

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.


Visit AMA Guides Digital

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 for nearly three decades. Published bi-monthly and available online with full achieve to 1995.



It's great connecting with you. I'm Chris Brigham, MD

Whether you are starting your journey or seeking a new destination, I am pleased to be there with you – empowering you to “captain your ship” while navigating challenging medicolegal “seas.” As a board-certified occupational medicine physician, who entered the medicolegal field over four decades ago, I realized that there was much to learn to succeed. I look forward to sharing knowledge, skills, experiences, and insights that will contribute dramatically to your success and benefit society. I served as Senior Contributing Editor for the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition and Guides Casebook, and for nearly three decades served as the Editor of the Guides Newsletter.  I have been blessed by the opportunity to be surrounded by talented colleagues, have many unique learning experiences, write over 300 peer-reviewed articles and several books, speak at hundreds of events, and consult throughout the United States and internationally. I sincerely appreciate my colleagues representing many domains and life’s “learning experiences.” I want to help you succeed and provide those injured or ill with accurate assessments. I also want this to be enjoyable for you. My involvement in virtual learning systems began five decades ago; therefore, I hope you find the learning experiences here the finest. (By the way, in assisting you to “navigate,” please be assured that I am also a licensed USCG captain.)

"I am thrilled I subscribed. It is excellent and a real cost saver. It provides more information, training, and assistance than a 3-4 day course elsewhere at two to three times the cost. "

- Ronald Fadel, MD, Orthopedic Surgeon (Louisville, KY)

"This note is to personally thank you for your brilliant teaching. I learned how to be an IME expert from your teaching. It made me a much more precise and I hope an effective physician."

- Noel Kerin, MD, (Toronto, Ontario)

"Several words come to mind describing this site: valuable, creative, painless, authoritative, unique, and accessible 24/7. What you have developed is so needed."

- Lorne Direnfeld, MD, Neurologist (Maui, HI)

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, who was the 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.



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AMA PRA Category 2 Credit

Physicians may claim AMA PRA Category 2 Credit™. Category 2 Credit is self-designated and self-claimed by individual physicians for participation in educational activities not certified for AMA PRA Category 1 Credit™ that meet the following criteria:

  1. Comply with the AMA definition of continuing medical education (CME)
  2. Comply with relevant AMA ethical opinions
  3. Are non-promotional
  4. Are a worthwhile learning experience related to a physician’s practice, as determined by the physician

AMA Guides Required

This site is 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. 

All participants in AMA Guides training must have access to the AMA Guides, either digitally or printed edition.  Visit AMA Guides Digital.