Edition timeline
- 4th Edition (1993): still used in some jurisdictions and by New Zealand's ACC (User Handbook to AMA4)
- 5th Edition (2000): California's standard under LC 4660(b)(1); taught through courses like AAMVI's 5th Edition Impairment Rating
- 6th Edition (2008): standardized methodology; adopted by PA (2nd printing 2009), TN, MT and others
- 6th 2023 / 2025 updates: revised upper limb, lower limb, spine, and nervous system content; training offered by ACOEM and AMA
5th vs 6th — the real difference
The 6th replaced much of the 5th's diagnosis-based approach with impairment classes and grades, a consistent whole-person impairment calculation, and a stronger functional focus aligned with the WHO ICF. The DRE vs ROM distinction remains central to spine rating in both.
Which states use what
California: 5th. Pennsylvania: 6th (2nd printing 2009). Tennessee: 6th (approved training). Montana: 6th statutory. Florida: its own 1996 schedule. New York: its own SLU guidelines. Texas: commissioner-adopted edition. Always verify the current edition per state — this is the highest-error-risk fact in impairment rating.
The companion treatises
- AMA Guides to the Evaluation of Disease and Injury Causation (2nd ed., 2014): work-relatedness, methodology, apportionment, report writing
- AMA Guide to the Evaluation of Functional Ability: requesting and interpreting FCEs
- AMA Guides to the Evaluation of Work Ability and Return to Work
Training landscape
AMA Guides training platforms offer ~200 modules; ACOEM and state-approved providers (TN list) offer edition-specific courses; ABIME CIME and AADEP CEDIR certify the examiners. This hub maps those courses to free guides.
