The AMA Guides to the Evaluation of Permanent Impairment provide a reliable, repeatable measurement framework for assessing permanent impairment and have been the trusted gold standard by physicians, patients, and the legal and regulatory communities.

AMA Guides Digital is a dynamic, digital platform that provides access to the latest impairment rating information online.  AMA Guides Digital hosts AMA Guides Sixth (2008), the AMA Guides Newsletter and the all-new AMA Guides Sixth 2021 update, which is available exclusively on the digital platform.

The new digital format of the AMA Guides reduces physician burden by allowing easy and secure access to materials and ease of access and continual updates to improve the quality and consistency of evaluations.

The Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2021 (AMA Guides Sixth 2021) updates and reinforces the international standard for the assessment of permanent impairment first published in 2008 in the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition (AMA Guides Sixth Edition [2008]). AMA Guides Sixth 2021 is the first version of AMA Guides® delivered via a new, transparent editorial process and a new interactive digital platform—the AMA Guides Digital.

Effective July 1, 2021, AMA considers the updated AMA Guides Sixth 2021 the most recent edition of the AMA Guides and the most current version of AMA Guides Sixth. The update is based on the most current medicine as adopted by the AMA Guides Editorial Panel.  

More than 40 states and several countries recognize the AMA Guides as the authority on evaluating permanent impairment and require raters in their jurisdiction to use the AMA Guides. Physicians and other qualified health care professionals who perform permanent impairment evaluations should review the state and jurisdictional requirements regarding use of AMA Guides Sixth 2021.

AMA Guides Sixth 2021 was updated to provide clarification and updated terminology around mental and behavioral health concepts to improve interrater reliability. Overview of updates to mental and behavioral health content include:

  • Change from DSM IV to DSM 5 terminology and methodology 
  • Removal of GAF results in more accurate mental and behavioral health impairment ratings
  • Newer editions of assessment tools and tests
  • Descriptions of Malingering and Motivation 
  • Removal of summaries of psychiatric diagnoses and conditions from the glossary to mitigate discrepancies in a forensic setting.
  • Minor editorial corrections to Lower Extremities and Spine and Pelvis content

Learn more about What’s New to AMA Guides Sixth 2021.

Learn about the changes and how to apply them on the AMA Ed Hub™. CME credit is available.

AMA Guides Sixth 2021 available online

Subscribe to AMA Guides Digital for AMA Guides Newsletter, AMA Guides Sixth and the 2021 update and future updates to the AMA Guides.


The AMA Guides Newsletter provides updates, authoritative guidance and interpretations of rationales for those using the fourth, fifth and sixth editions of the AMA Guides®. It also features peer-reviewed articles on overarching topics and issues regarding disability evaluation.

If your organization would like to engage in a discussion with the AMA, please contact us at [email protected].

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