Impairment Rating Goal

Medical Impairment Ratings are required in many states to help determine loss of function and financial settlements. This applies to federal and state workers compensation, disability, auto accidents and personal injury cases.
Certification proves Competency in the field of Impairment Ratings.

Impairment Rating Specialist, Testing

Certification for 6th Edition AMA Guides

The AMA created the 6th edition Guides based on a new concept of DRE: diagnostic related estimates.

The creators of our sixth edition test, Dr. Mendez, MD, Dr. Olin, MD and Dr. Pirrucelli, DC were also educators and reviewers for the 6th edition of the AMA Guides.

Each has provided an in-depth guide on how to approach interpretation and creating an Impairment Rating using the 6th edition of the AMA.



NIRSAT Impairment Rating Certification

AMA Guides 5th edition for Permanent Impairment Ratings

The Nevada Legislature’s mandate is “to strengthen education and testing requirements for the Nevada PPD raters, thereby providing accurate Impairment ratings for the injured worker and reduce requests for subsequent impairment raters.”

The NIRSAT is the State of Nevada mandated Impairment Rating Certification and education program.

The NIRSAT is the exclusive provider of the Certification program created specifically for the State of Nevada to test the doctors on their competency to perform an Impairment Rating. The State requested two certification programs, one for Chiropractors and one for Medical Doctors.

Any doctor who requests to perform an Impairment Rating for an injured worker in the State of Nevada must take and pass the NIRSAT certification test with a 75%.

The NIRSAT (Nevada Impairment Rating Skills Assessment) program was requested and implemented. The program was based on the success of the TWCC TIRSAT (Texas Impairment Rating Skills Assessment Test) which AAEME implemented in the early stages of the TWCC Designated Doctor program in Texas.




Registration Information
  • Register on line by clicking the red test button.
  • Once your credit card is processed, the test will added to your online account.
  • The test is 2 4 hours long, multiple choice answers.
  • Tests were created by MD’s and DC’s.
  • A Quick Study Guide with sample questions and answers is available to purchase in the store.
  • A CIRS certificate of completion will be emailed to you.
  • ​The passing score for the NIRSAT is 75%. The passing score for the CIRS is 70%.
  • If you fail, the cost for retaking the test is 50% off. You have 3 months to retake the test for the reduced price.

CIRS Study Guide


Credentials Count as a CIRS

Credentials Count as a CIRS

There are four AMA Guides to the Evaluations of Permanent Impairment (3, 4, 5, and 6) used throughout the US and the world. These books were intended to help you, the physician, have an objective process to evaluate and determine an Impairment Rating for an injured...