AMA Guides®

AMA Guides Sixth 2023: Current medicine for permanent impairment ratings


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 most current impairment rating information online. AMA Guides Digital hosts AMA Guides Sixth (2008), AMA Guides Sixth updates for 2021 and 2022, the all-new AMA Guides Sixth 2023 as well as the AMA Guides Newsletter. AMA Guides updates are 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, 2023 (AMA Guides Sixth 2023) updates and reinforces the international standard for the assessment of permanent impairment first published in 2008. AMA Guides Sixth 2023 is delivered via a transparent editorial process and a new interactive digital platform—AMA Guides Digital.

Effective Jan. 1, 2023, AMA considers the updated AMA Guides Sixth 2023 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 2023.

The AMA Guides Sixth Edition (2008) is considered the foundation for updates to the AMA Guides, and all annual updates to the AMA Guides build upon the changes that precede them. AMA Guides Sixth 2023 builds upon the changes issued in AMA Guides Sixth 2022.

The 2023 update applies current practices and standards to the nervous system content (Chapter 13), which received unanimous support during the 2022 public comment period. Additional updates were made specific to evaluation of the ear, nose and throat (Chapter 11) and range of motion methodology in the upper extremities content (Chapter 15).

The nervous system updates will create changes to impairment ratings.

The AMA has developed resources to help stakeholders understand these changes in more detail. Learn more about the updates and what’s new to AMA Guides Sixth 2023 and AMA Guides Sixth 2021. Visit AMA Guides Education on the AMA Ed Hub™ to browse all learning.

AMA Guides Sixth 2023 available online

Subscribe to AMA Guides Digital for AMA Guides Newsletter, AMA Guides Sixth (2008) and all subsequent updates including the 2023 update 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].