DWC plans to transition to the American Medical Association “Guides to Evaluation of Permanent Impairment” (AMA Guides) 6th edition (2025). Moving to this edition will help DWC administer the workers’ compensation system more effectively.
For over 20 years, DWC has been using the AMA Guides 4th edition, published in 1993 (1st, 2nd, 3rd, or 4th printing, including corrections and changes as issued by the AMA prior to May 16, 2000). Transitioning to the 6th edition (2025) allows system participants to use modern medical standards and clearer methodologies, improving ease-of-use, precision, and reliability among evaluating doctors for critical exams.
Doctors use the AMA Guides to assign impairment ratings to injured employees in workers’ compensation claims. These ratings help set the duration of income benefits an injured employee may receive.
In April 2026, the Workers’ Compensation Research and Evaluation Group (REG) released the AMA Guides Study, developed under the Office of the Medical Advisor’s Medical Quality Review, 2024 Audit Plan. The study compared impairment ratings calculated using the AMA Guides 4th edition and the AMA Guides 6th edition (2024). REG noted that the AMA Guides were updated again in December 2025 and that those updates did not change impairment ratings. As a result, DWC plans to transition to the AMA Guides 6th edition (2025), as it is the most current edition.
DWC references
- Labor Code Chapter 408.124
- 28 Texas Administrative Code Section 130.1
- Medical Quality Review, 2024 Audit Plan
- Medical Quality Review, 2025 Audit Plan
External references
- AMA Guides Digital
- ODG by MCG
- Advancements in AMA Guides Musculoskeletal Impairment Evaluations: Improved Reliability and Ease of Use
- Comparative Analysis of Upper Limb Impairment Rating Processes in the American Medical Association Guides Sixth Edition 2024 Versus 2008: Impact on Stakeholders
- Reliability and Methodological Advancements in the 2024 AMA Guides for Rating Lower Limb Impairment
- Reliability of the 2024 AMA Guides' Enhanced Methodology for Rating Spine and Pelvis Impairment
REG studies
- AMA Guides Study, Impairment Rating Comparison of the Fourth and Sixth Editions, 2026 | snapshot
- Comparison of the AMA Guides: 4th, 5th and 6th Editions, 2011
Rule project
- DWC accepts comments on AMA Guides informal draft rule (memo)
- Submit any written comments on the informal working draft rule to RuleComments@tdi.texas.gov
The deadline to submit all comments is 5 p.m., Central time, on August 13, 2026.
Stakeholder meeting
DWC held a stakeholder presentation on August 12, 2026, to review the project timeline and discuss the implementation of training, testing, and any other potential changes.