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20 NOVEMBER 2018


Boxing Severity Index (BSI)

By Flip Homansky, MD

(This concept was first presented at the Association of Boxing Commissions in St. Louis on 24th July 2003). This index is modeled after the Glasgow Coma Scale used internationally for scoring trauma patients. The purpose is to objectively identify those boxers that should be evaluated in a more in-depth manner. They may still be licensed, but a Commission should document that they have been cleared in an appropriate manner.

In Nevada we initially approached this problem by looking more closely at any fighter over the age of 35. We also included any fighter with over 250 rounds of “ring age”. The rounds proved too low and we raised them to 325, and recently increased them again to 450. In this same manner, the BSI can be a living document that can be modified as we collect information. I welcome input and suggestions.

My goal is to develop a simple mechanism to objectively identify the boxer who should raise some concern on the part of the State Commission when he comes for licensure.

1) ACTIVITY (fights in last 2 years)

1 (or less) +1


Lost 5 or more in a row +2

Lost 3 of last 4 +1

Won 3 of last 4 -1

3) KO or TKO

More than 4 in last 2 years +3

3 or less in last 2 years +2

Last fight by KO +1

4) AGE

Greater than 44 +2

Greater than 35 +1


(To include amateur experience, each amateur fight will be counted as one pro round).

Greater than 500 rounds +1

{+3} indicates a fighter that needs further evaluation

Remember….a license to box is a privilege – not a right.

If your State regulations don’t allow this process, then you should work to change them.

Note: this index is just a start. I would welcome your thoughts and ideas on keeping it simple, but enabling Commissions to identify fighters that may be in trouble. This is not meant as a substitute for common sense, but is instead designed to improve and conform our safety standards. Please forward responses to

Flip Homansky, MD


Dr. Flip Homansky is currently Commissioner of the Nevada State Athletic Commission (NSAC). For over twenty years, he served as Chairman of the Medical Advisory Board and Chief Ringside Physician for the NSAC.

Dr. Flip Homansky practices in Las Vegas, Nevada, where he had been a licensed ringside physician and Chairman of the Medical Advisory Board for the Nevada State Athletic Commission for over twenty years. His medical specialty is in the field of Emergency Medicine. Dr. Homansky was appointed by Nevada’s Governor, Kenny C. Guinn, in 2000, to serve as a Commissioner of the Nevada State Athletic Commission. Although he is currently a Commissioner of the Nevada State Athletic Commission, all of the views, opinions, and/or recommendations contained herein are solely his own and do not necessary reflect those of Nevada’s Commission. All readers are strongly cautioned that the information contained herein is not intended to, and never should, substitute for the necessity of seeking the advice of a qualified medical professional whenever a boxer or his/her representatives have specific questions regarding the best course of action that a boxer should take. Furthermore, since it is possible that general information herein may pertain only to a law, regulation, rule or acceptable standard of practice for a particular jurisdiction, a boxer or his/her representatives must always inquire with the appropriate licensing jurisdiction to determine the applicable laws, regulations, rules, and acceptable standards of practice for each jurisdiction.

All readers are advised that the information herein is intended solely as a general reference source, and to the fullest extent permitted by law, the information is provided “AS IS” without any warranties of any kind, whether express or implied, including without limitation, warranties of merchantability, fitness for a particular purpose and non-infringement. No one may rely on the accuracy, integrity, quality or completeness of the general information herein. Accordingly, neither the authors, editors nor anyone else affiliated with this website may be held liable for damages of any kind whatsoever allegedly caused or resulting from any such claimed reliance.

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