Not every licensed physician in Nevada can perform Permanent Partial Disability (PPD) impairment ratings. To rate PPD in Nevada, an MD, DO, or DC has to be designated as a PPD rater by the Nevada Division of Industrial Relations (DIR) and placed on the state’s approved list of PPD raters. A license alone isn’t enough.
What does it take to become a Nevada PPD rater?
Five things, and they’re the same whether you’re an MD, DO, or DC: a Nevada license, three or more years of industrial health experience in private practice, proof you’ve taken an approved AMA Guides 5th Edition course, a passing NIRSAT™ score of 75% or higher, and proof you’ve taken the Nevada PTSD, TBI & Stress Disorders IR Seminar.
The exam is NIRSAT™, the Nevada Impairment Rating Skills Assessment Test. AAEME developed it with a team of clinicians who know the Guides, led by Christine G. Caldwell, CEO & Founder, and AAEME is the sole administrator of the exam. The PTSD, TBI & Stress Disorders seminar covers Nevada’s mental impairment worksheet, the D-9c form. Once you have your certificates, you apply to the DIR. The DIR’s Rating Panel page lists the current steps, and the Nevada hub on AAEME’s website links to the DIR and to the relevant courses and exam.
Which AMA Guides edition does Nevada use?
The AMA Guides 5th Edition, for every PPD rating. Nevada law (NRS 616C.110 and NAC 616C.002) requires it, and a rating built on any other edition doesn’t meet Nevada’s requirement.
If you rate in more than one state, the edition may change when the jurisdiction does. The AMA Guides by jurisdiction page keeps track of what each state uses. And if you’d like the basics behind any rating, start with what WPI means.
How are PPD raters assigned to cases?
You don’t pick your own cases. Since SB 274 was passed in 2023, the DIR assigns raters at random from its list, unless the insurer and the injured worker agree on one. The insurer starts the process within 30 days of getting a report that the worker is “stable and ratable,” and asks the DIR for a PPD rater using the D-35 form.
If the difference between an impairment rating and PPD is new to you, impairment rating vs. PPD explains who decides what.
Do designated raters have to keep taking courses?
Yes, and it’s worth putting on your calendar. Every designated PPD rater, whether an MD, DO, or DC, completes an approved AMA Guides rating course every two years (even years). That’s the biennial requirement. The NIRSAT™ exam itself is a one-time requirement. Certificates go to the DIR Medical Unit ([email protected]) by December 31 of every even-numbered year, and the next deadline is December 31, 2026.
What if you rate without being designated?
Then the work simply won’t come to you. The DIR assigns raters from its panel, so a physician who isn’t designated receives no assignments, and a physician who isn’t on the DIR’s list may not perform compensable PPD ratings. Confirm your listing before you accept any work.
Frequently Asked Questions
Can a physician licensed only in another state perform a Nevada PPD rating? No. Panel designation requires a Nevada license. A worker who lives outside Nevada but has a Nevada claim is still assigned a rater from the Nevada list through the D-35 process.
Can a treating physician rate their own patient? Generally no. Nevada’s rules bar a PPD rater from rating a patient the physician has already examined or treated. The DIR assigns a designated rater instead.
How often does a Nevada PPD rater have to renew? Every two years (even years). That’s the biennial requirement, and all designated raters complete an approved rating course on that cycle. You don’t have to retake the NIRSAT™ exam.
Do I need both a course and the NIRSAT™ exam? Yes. You complete an approved AMA Guides 5th Edition course first, and then take NIRSAT™. AAEME’s AMA Guides 5th Edition Advanced course is one that qualifies, and it isn’t included as part of the NIRSAT™ exam. Passing NIRSAT™ also issues the CIRS™ AMA Guides 5th Edition credential.
Ready to start? Begin your Nevada PPD rater path.
CIRS™ certification through AAEME covers AMA Guides methodology, defensible documentation, and the full impairment rating process, with AAFP-accredited CME credit included.
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