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What is Maximum Medical Improvement?

On Behalf of | Jun 19, 2017 | Workers' Comp |

When you are injured on the job, your doctor will track your recovery progress and regularly report back to your employer and their insurance company. However, over time it may become more and more apparent that your injury will never fully heal and your condition is about as good as it’s going to get for the foreseeable future. When you have reached this point and can’t be expected to recover any further with reasonable treatment, your doctor will declare you have reached “maximum medical improvement,” and your claim will change significantly. Let’s take a closer look at what this means, including how it can impact your case.

What is Maximum Medical Improvement?

Maximum medical improvement, or MMI, is essentially your doctor saying that your recovery is not full or complete, but your condition won’t actually improve in the foreseeable future. In other words, it’s your doctor’s way of saying you’re about as good as you’ll ever be and that no other form of reasonable treatment will improve your condition in any substantial way.

How Does MMI Impact Your Case?

When your doctor informs you that you have reached MMI, your workers’ compensation case will change substantially. The biggest way is that your doctor will then assess you thoroughly one more time and assign you a disability rating. This disability rating will determine whether you can return to work in full capacity or need restrictions. In some cases, a disability rating may indicate that you need to be transitioned into another position that will allow you to work without pain or added risk of re-injuring yourself. And in severe cases, you may not be able to return to work in a gainful manner at all. Because you aren’t expected to improve, your disability rating will be a form of “permanent disability.”

There are two types of permanent disability: partial and total. Permanent partial disability means essentially means that you cannot work in the same capacity as you did before your injury, meaning there will be some tasks or job requirements you once had that you’ll no longer be able to fulfill. Most people think this means losing the ability to lift heavy things or bend and move in certain ways, but it can go further than that. For example, if your job required you to stand for hours each day and an ankle injury prevents you from standing for more than a couple of hours at a time without pain, you will be declared permanently partially disabled. The majority of disability awards are partial disability, since you may be able to work again, but might need to be moved to a different position or role that accommodates your restrictions.

Permanent total disability means you have completely lost your ability to work in any gainful capacity. In other words, no matter what position you hold, you’ll either be unable to fulfill your duties or cannot do so without pain. These awards mean you may be eligible to receive workers’ compensation benefits for the rest of your life. However, that can make these claims expensive, so be prepared for your insurance company to fight back if your doctor declares that you are permanently and totally disabled.

Worsening Conditions

Maximum medical improvement simply means that your condition is about as good as it’s going to get for the foreseeable future; it does not mean your condition can’t get worse or re-injured again. If your condition becomes re-aggravated or gets worse within two years of your doctor declaring you have reached maximum improvement, you should go back to your doctor. You may be able to seek further treatment to help you at least recover from your worsened condition and get back to the maximum improvement level you were at before.

You also have the ability to seek a second opinion if your doctor thinks all potential treatment options have been exhausted. If another doctor thinks an additional treatment option can help you improve further, you’re welcome to pursue it. However, you should consult with a San Jose workers’ compensation lawyer before proceeding. Because disability awards can be so complex, it’s important that you make sure you have someone looking out for your best interests and making sure your rights to compensation are preserved while you do your best to recover.

The Law Offices of Andrew B. Shin can help! Call us today at 408-341-6025 to request a free consultation and put a powerful ally on your side to help you receive the compensation you’re entitled to.