The Right Credential
for Your Jurisdiction.
AAEME's certification exams each issue their own credential: CIRS™ AMA Guides 5th Edition (Certified Impairment Rating Specialist) for the most widely used AMA Guides edition, NIRSAT™ for Nevada-required certification under NV Rev. Stat. 616C.110, and CIRS AMA Guides 6th Edition for jurisdictions that have adopted the current edition. Pass the exam matched to your jurisdiction; earn your credential, with certificates issued twice monthly.
What Credentials Do AAEME Exams Issue?
AAEME exams issue the following credentials: CIRS AMA Guides 5th Edition (Certified Impairment Rating Specialist) for AMA Guides 5th Edition methodology, NIRSAT for Nevada-required certification under NV Rev. Stat. 616C.110, and CIRS AMA Guides 6th Edition for the AMA Guides 6th Edition. Each exam maps to its own credential, with one exception: passing the NIRSAT exam earns both NIRSAT and CIRS AMA Guides 5th Edition in a single sitting, since the NIRSAT exam covers the full AMA Guides 5th Edition content plus a Nevada legal section.
One credential per jurisdiction. One exam to earn each.
Whether you need national certification for workers' compensation and liability cases under the AMA Guides 5th or 6th Edition, or you are required by Nevada statute to hold NIRSAT, each AAEME exam follows the same proven format: 4 hours, single sitting, open book, 75% to pass. Certificates are issued twice monthly after you pass.
Which Exam Should I Take?
The right exam is the one matched to the jurisdiction and AMA Guides edition you actually use in practice. Most U.S. workers' compensation jurisdictions use the AMA Guides 5th Edition. Nevada physicians performing impairment ratings are required by statute to hold NIRSAT. A smaller number of jurisdictions have adopted the AMA Guides 6th Edition. The most common path is the CIRS AMA Guides 5th Edition.
CIRS AMA Guides 5th Edition Exam
NIRSAT Exam
CIRS AMA Guides 6th Edition Exam
What About the Nevada PTSD, TBI & Stress Disorders IR Seminar and NPIRS?
Two AAEME seminars do not require a standalone certification exam: the Nevada PTSD, TBI & Stress Disorders IR Seminar and the Neuro-Psych IR Seminar. Their assessments are bundled into the courses themselves. Complete the seminar, and the assessment is included. There is no separate exam to register for.
Two programs that include their own assessment.
For these programs, the assessment is part of the course. You enroll once, complete the curriculum, and pass the embedded assessment to satisfy the requirement. No separate exam fee or registration.
- Nevada PTSD, TBI & Stress Disorders IR Seminar. Required by Nevada statute for physicians who perform impairment ratings. Covers psychological and PTSD impairment evaluation methodology. The assessment is bundled with the course; no separate exam.
- Neuro-Psych IR Seminar. Covers neuropsychological impairment assessment methodology. The assessment is bundled with the course; no separate exam.
Common Rules: CIRS AMA Guides 5th Edition, NIRSAT, and CIRS AMA Guides 6th Edition
All AAEME certification exams share the same delivery format, scoring rules, materials policy, retake terms, and price. The only structural difference is question count. The AMA Guides 6th Edition exam has 50 questions instead of 100. The CIRS AMA Guides 5th Edition and NIRSAT exams each earn 4 AAFP-accredited CME credits; CME credit for the CIRS AMA Guides 6th Edition exam is pending.
- Online, self-scheduled; sit when you are ready
- 4 hours total, completed in a single sitting (no save-and-resume)
- One question at a time; cannot return to previous after answering
- Open book with the AMA Guides edition matched to the exam, plus calculator and notes
- Honor system; activity is logged but no video proctoring
- 75% passing score required, calculated automatically
- Result displayed at the end of the exam
- Digital certificate issued twice monthly after you pass
- Physical certificate available by mail for an additional fee
- E-Eval Provider Network listing is optional, not automatic
- 90-day window from purchase to sit the exam
- Up to 3 attempts; re-register to retake if you do not pass
- Waiting period between attempts: 7 days after the first, 30 days after the second
- Original exam fee non-refundable regardless of result
- Register when ready; the 90-day window is fixed
- CIRS AMA Guides 5th Edition: $995
- NIRSAT: $995; issues both NIRSAT and CIRS AMA Guides 5th Edition
- CIRS AMA Guides 6th Edition: $895
- No volume discounts; one exam, one fee
Exam Comparison at a Glance
A quick reference comparing the AAEME certification exams. The differences are in question count, what's tested, and what credentials each issues. Format, duration, scoring, materials, retakes, and price are identical across all of them.
| Attribute | CIRS AMA Guides 5th Edition | NIRSAT | CIRS AMA Guides 6th Edition |
|---|---|---|---|
| Who it's for | National; jurisdictions using AMA Guides 5th Edition | Nevada physicians (required by statute) and out-of-state physicians handling Nevada cases | National; jurisdictions using AMA Guides 6th Edition |
| Question count | 100 | 100 (incl. Nevada legal section) | 50 |
| Duration | 4 hours, one sitting | 4 hours, one sitting | 4 hours, one sitting |
| Passing score | 75% | 75% | 75% |
| Open-book reference | AMA Guides 5th Edition | AMA Guides 5th Edition | AMA Guides 6th Edition |
| Credentials issued | CIRS AMA Guides 5th Edition | NIRSAT and CIRS AMA Guides 5th Edition | CIRS AMA Guides 6th Edition |
| Recommended prep | AMA Guides 5th Edition Advanced course; QRG Study Guide | AMA Guides 5th Edition Advanced; free Introduction to Nevada Workers' Comp Law course; QRG Study Guide | AMA Guides 6th Edition (course in development) |
| Retake policy | Up to 3 attempts; re-register each time | Up to 3 attempts; re-register each time | Up to 3 attempts; re-register each time |
| CME | 4 CME credits | 4 CME credits | Pending |
| Price | $995 | $995 | $895 |
Frequently Asked Questions
Common questions about choosing between the AAEME exams, what's bundled and what's separate, and how the credentials relate to each other.
What does CIRS stand for?
CIRS stands for Certified Impairment Rating Specialist. It is the national credential AAEME issues to physicians who pass a certification exam demonstrating applied command of AMA Guides impairment rating methodology. The credential is edition-specific: CIRS AMA Guides 5th Edition and CIRS AMA Guides 6th Edition match the two AMA Guides editions in current use. The CIRS™ designation signals to courts, insurers, and referral sources that a physician's impairment ratings follow the Guides correctly.
Which exam should I take if I'm not sure?
Match the exam to the AMA Guides edition your jurisdiction has adopted. Most U.S. workers' compensation jurisdictions use the AMA Guides 5th Edition; sit the CIRS AMA Guides 5th Edition exam. If you perform impairment ratings on Nevada workers' compensation cases, you are required to hold NIRSAT under NV Rev. Stat. 616C.110; sit the NIRSAT exam. If your jurisdiction has adopted the AMA Guides 6th Edition, sit the CIRS AMA Guides 6th Edition exam. The AMA Guides by Jurisdiction reference lists which edition each state uses.
Do I need to take a course before sitting any of these exams?
No. None of the exams require an AAEME course as a registration prerequisite. The exams are open to any physician confident in their applied knowledge of the relevant AMA Guides edition. Course preparation is recommended but optional.
If I pass NIRSAT, do I also get the CIRS AMA Guides 5th Edition?
Yes. Passing the NIRSAT exam issues both the NIRSAT credential and the CIRS AMA Guides 5th Edition credential at the same time. NIRSAT is essentially the CIRS AMA Guides 5th Edition exam with an additional Nevada legal section appended. One sitting earns both.
If I pass the CIRS AMA Guides 6th Edition, do I also get the CIRS AMA Guides 5th Edition?
No. The AMA Guides 5th and 6th Edition exams test different methodologies and issue separate credentials. Physicians who need both credentials must sit both exams. Only NIRSAT carries a dual-credential outcome.
Why doesn't the Nevada PTSD, TBI & Stress Disorders IR Seminar have a separate exam?
The Nevada PTSD, TBI & Stress Disorders IR Seminar and the Neuro-Psych IR Seminar both bundle the assessment into the course itself. You enroll, complete the curriculum, and pass the embedded assessment to satisfy the requirement. No separate exam fee or registration. This is a structural choice: these seminars cover specialty content where the assessment is most usefully tied directly to the learning module.
Do the exams earn CME credit?
The CIRS AMA Guides 5th Edition and NIRSAT exams each earn 4 AAFP-accredited CME credits. CME credit for the CIRS AMA Guides 6th Edition exam is pending; subscribe to the AAEME newsletter for updates. The exams do not carry CE credit for chiropractors.
Are the credentials issued by AAEME the same as ABIME or other certifications?
No. AAEME issues its own CIRS and NIRSAT credentials. These are distinct from credentials issued by other organizations such as ABIME. NIRSAT specifically is the credential written into Nevada law under NV Rev. Stat. 616C.110, and AAEME is the sole authorized provider. For other jurisdictions, the credential that matters is the one your state, employer, or counterparty recognizes; check your specific requirements before sitting any exam.
Can I register for more than one exam at once?
Yes. Each exam is purchased independently (CIRS AMA Guides 5th Edition and NIRSAT are $995 each; CIRS AMA Guides 6th Edition is $895), and each carries its own 90-day access window starting from the date of purchase. AAEME recommends sitting one exam, receiving your result, and only then registering for the next. The 90-day window is fixed and starts the day you pay, not the day you sit.
What is the refund policy?
All exam fees are non-refundable, regardless of result, change of mind, or failure to sit within the 90-day window. If you have questions before registering, please use our contact form.
Ready to Pick Your Exam?
Match the exam to your jurisdiction. Register when you are ready to sit. Certificates are issued twice monthly after you pass.