Medical Examiners' Handbook and Certification Test

This publication contains guidelines, sample reports, and billing procedures for preparing and conducting impairment ratings and independent medical exams (IME) in Washington's Workers' Compensation system. The activity was planned and produced in accordance with the WSMA Essential Elements, Criteria, and Standards of Accreditation of Continuing Medical Education.

Disclosure: None of the faculty involved with developing this handbook has any financial relationship to disclose nor do they financially benefit from this product.

Impairment ratings use 2 systems

  • To rate impairment of extremities for workers covered by L&I, use the 5th Edition of the AMA Guides.
  • To rate impairment of the spine, mental health, and other systems, use the category rating systems in the Medical Examiners' Handbook.

Questions? Contact the IME program’s Occupational Nurse Consultant at  or 360‑902‑6818.

Medical Examiners' Handbook and Certification Test

How do I start?

To prepare for the Medical Examiners' Handbook Certification Test, please read the 196-page "Medical Examiners' Handbook".

This examination is "open book".  You may find it helpful to print the handbook for reference, as you will be referring to it throughout.

How much time will it take?

After reading the handbook, it should take approximately 30 minutes to complete the activity (24 questions).

NOTE: You will not be able to return to this page once you've landed on the My Secure L&I page. You'll need to login to begin the test. If you do not already have a secure login, click on the "Sign up" button to register and follow the prompts from there.


    Once you've logged in, you'll need to click on the "Add L&I Services to My List" button, which will open a page that lists all the services available to choose from. Select the Medical Examiners Handbook Certification Test. Add Services
    Then click on "Back to My Secure L&I". The Medical Examiners' Handbook test should now show up in your list of L&I services. MySecureLI
    Click on the "Launch" button to begin the test. Launch


    Questions? Contact the IME program's Medical Program Specialist at or 360-902-6815.


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