What Is Maximum Medical Improvement?

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When determining how much a workers’ compensation or personal injury claim is worth, one of the key terms used is “maximum medical improvement,” or MMI. Maximum medical improvement is when you have reached the maximum possible level of recovery from your injury.

Maximum Medical Improvement Defined

You reach maximum medical improvement when your doctor determines that you are unlikely to get any better in terms of recovery from an injury. In other words, you’ve completely stabilized. In workers’ compensation and personal injury law, that means the worth of your case can be tallied up since it’s then possible to determine:

  • The total cost of your medical bills.
  • Your ability to return to work.
  • The impact your injury will have on your income and earning capacity.
  • Whether lifelong treatments will be needed to keep you stable

It’s worth noting that maximum medical improvement is not the same as making a full recovery. Some injuries leave people disabled for life, but getting to a point where no further recovery is possible or likely means maximum improvement has been reached.

MMI in Workers’ Compensation Claims

In some workers’ compensation claims, it may take some time before MMI is reached. Once you’ve reached that point, benefits will end and you’ll get back to work.

Some workers’ compensation claims settle for a lump sum amount. This is particularly common in cases involving lasting disabilities. In those cases, settling means you relinquish your right to future workers’ compensation benefits in connection with your work injury, so you need to make sure you’re at MMI before settling.

Sometimes, disability benefits from a work injury can last for life. You can opt to continue receiving those benefits, but there is still the option to settle. In that case, you’ll want to wait until you’ve reached MMI before agreeing to any settlement offers. Otherwise, your benefits could be prematurely cut short.

MMI in Personal Injury Cases

Most personal injury cases settle outside of court. In those cases, it’s vital to wait until you’ve reached MMI before you settle your claim. Once it’s settled, you can’t sue for anything more, even if you end up with extra medical bills later on in connection with your injury.

Once you’ve reached MMI, however, it will be easier to determine how much your case is worth. At that point, you’re safe in pursuing settlement negotiations.

Determining MMI

Only your treating physician can determine whether you’ve reached MMI. The insurance company, your employer, and your attorney have no say in the matter, though in the case of workers’ compensation claims, your employer’s insurance provider may prescribe an independent medical examination (IME) to verify—or in some cases contradict—what your treating physician decides.

In the event of a conflict regarding a work injury, your claim may be brought to the Illinois Workers’ Compensation Commission (IWCC) for a hearing.

In personal injury claims, the deciding party is the same. Your physician determines whether you’ve reached MMI, and once you’ve gotten to that point, you’ll be able to pursue settlement negotiations.

That said, your attorney still plays a significant role when seeking damages or benefits from an injury. They’ll be able to safeguard your rights as you recover from your injury and represent you during settlement negotiations afterward. For more information, contact Hart David Carson LLP today.

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