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The Medical Impairment Manual (MIM) gives guidance on suggested debits and credits for various medical impairments. In discussions with underwriters and medical directors, it is surprising how few understand the origin and mortality significance of debits and credits and their relationship to life expectancy and premiums. This article, the first of a two-part series, will discuss how debits and credits are derived, numerically what they represent and their relationship to life expectancy. The second part will discuss how the applicant’s premium, if the final rating is substandard due to assessed debits, is calculated.