Medical Impairment Rating (MIR) Registry

MIR Logo with a background of a doctor's shoulder with stethoscope around her neck.


The Medical Impairment Rating (MIR) Registry is a Bureau of Workers' Compensation-maintained listing of qualified and approved physicians who are specially trained to conduct impairment rating medical evaluations and who have applied to serve on the Registry.

The program is designed to assist parties in settling a workers' compensation claim when the only item being disputed is the impairment rating. 

The program is available only for dates of injuries on/after July 1, 2005.

Request Dispute Resolution

To request the MIR evaluation by a registered physician, one of the parties must submit a Request for Medical Impairment Rating (MIR) form to the Bureau. But, before the parties can request a MIR evaluation, there must be a dispute about the current impairment rating. 

Submit MIR Requests to or 615-253-5263.

A dispute occurs when: 

  • There are competing impairment ratings issues by different physicians, and the parties disagree as to which rating is correct (dueling doctors), or 
  • The treating physician has placed permanent restrictions on the claimant, but has issued a rating of "zero," or states that there is "no permanent impairment," or
  • The employer and employee both wish to access the Medical Impairment Rating Registry.

AdMIRable Review

AdMIRable Review is a seasonal newsletter that addresses topics of special interest to MIR Registry Physicians, including training opportunities, proper application of the AMA Guides, MIR Physician biographies, and case law updates. 

How it works

The program provides the names of physicians, listed on the Registry, who are specifically trained in the techniques of performing impairment rating evaluations on the body part(s) involved in the workers' compensation claim. The parties choose a physician from the list provided to perform an evaluation to determine an appropriate impairment rating. The rating produced is utilized to help determine any Permanent Disability Benefits due in the matter. An MIR evaluation may be requested by either party. Regardless of which party requests it, the cost of the evaluation is borne by the employer. The report provided by the MIR physician will provide only the impairment rating. It will not address causation, apportionment, job restrictions or modifications, or the appropriateness of treatment. 

Accurate, Objective, Impartial

Unlike most other physicians who practice within the Tennessee workers’ compensation system, MIR Physicians are formally trained to conduct impairment evaluations according to the AMA Guides. They are also required to cite the AMA Guides in their reports to show exactly how their impairment rating was obtained. Since the MIR Physician has no affiliation with either the employer or employee, and neither party may communicate with the MIR Physician prior to the evaluation, the whole process is designed to be objective and impartial.  Once the MIR Report is completed, it is submitted to another independent physician for “peer review” to ensure AMA Guides methodology has been properly applied.  Finally, and most importantly, MIR Reports are legally presumed to be accurate. Since a much higher standard of evidence must be used to refute an MIR Report, they usually supersede all other impairment rating opinions.

Impairment Ratings: by the book

Injuries occurring on or after January 1, 2008 must be rated by the AMA Guides to the Evaluation of Permanent Impairment, 6th Edition. Injuries occurring prior to January 1, 2008, must be rated by the applicable version of the AMA Guides, as determined by the Tennessee Workers' Compensation Act. 

Physician Support

Register for the Registry

Interested physicians must request an appointment to the MIRR by filling out the Physician Application for Appointment to the Medical Impairment Rating Registry and submitting it to the Program Coordinator, along with proof of medical licensure board certification, approved AMA Guides training, and malpractice insurance. Meeting the minimum qualifications does not guarantee an appointment.

To meet minimum requirements for appointment to the MIR Registry, physicians must:

  1. Possess an active and unrestricted license to practice medicine or osteopathy in Tennessee
  2. Be board-certified by a board recognized by the American Board of Medical Specialties, the American Osteopathic Association or another organization acceptable to the Bureau Administrator
  3. Have successfully completed a training course, approved by the Administrator, dedicated to the proper application of the American Medical Association Guides to the Evaluation of Permanent Impairment. 6th Edition 
  4. furnish satisfactory proof of carrying the minimum medical malpractice insurance
  5. Meet the administrative needs of the Bureau Administrator

Submit Physician Applications to the MIR Registry to or 615-253-5263.

MIR Evaluation Report Form

Use this file to generate a report for the MIR program.

AMA Guides, Sixth Edition MIR Report 

For dates of injury before January 1, 2008, download the AMA Guides, Fifth Edition MIR Report.

Contact Information

If you have any questions about the MIR Program, contact or call (615) 253-5616.

Approved Medical Impairment Rating Training

For appointments to the (MIR) Registry or the Certified Physician Program (CPP) Registry, we require certification in the AMA GuidesTM to the Evaluation of Permanent Impairment, Sixth Edition. Certification may be from either the Bureau or an approved vendor.