Maximum Medical Improvement (MMI)

Injured workers often contact our Minneapolis office after they receive a letter from their workers’ compensation insurance company notifying them that they have reached Maximum Medical Improvement, or MMI. Clients are confused and don’t understand how the insurance company could possibly make this determination when they are still experiencing symptoms that their doctor assures them will improve with time.

With workers’ compensation in Minnesota, Maximum Medical Improvement has a specific definition with legal consequences. MMI means the date after which “no further significant recovery from or significant lasting improvement to a personal injury can reasonably be anticipated, based upon reasonable medical probability, irrespective and regardless of subjective complaints of pain.” Minn. Stat. §176.011, Sub.d 13 (a). MMI does not mean you aren’t still suffering from the effects of your injury, it means that the workers’ compensation insurance company believes that your recovery has reached a stage where it’s as good as it’s going to get. In other words you’ve reached a plateau in your medical condition.

Insurance companies generally make this determination after sending you to an “Independent Medical Examination” (IME), which is an evaluation of your medical condition performed by their doctor. Despite its name, this evaluation is not independent. Thus, the doctor’s evaluation of your medical condition almost always supports the best interest of the workers’ compensation insurance company, not your own. Many times, in the IME doctor’s written report the doctor will note in their medical opinion you have reached MMI. A work comp attorney can assist you in making sure you consult with an independent doctor.

When a doctor determines you have reached MMI, your workers’ compensation claim is impacted in a variety of ways. First, you may now qualify for Permanent Partial Disability (PPD) benefits. PPD benefits compensate injured workers for the permanent loss of use or function for a particular body part or function. Your own Minnesota doctor assigns a percentage in accordance with the statute, or a PPD rating. which allows. Depending on the rating, the percentage assigned by your doctor is then multiplied by a monetary figure. This sum is the amount due to you from the insurance company.

Second, if you were receiving ongoing temporary total disability benefits or “TTD,” the insurance company can now stop paying you, even though you may not be fully recovered or be back to work. If you were receiving TTD benefits, the work comp insurer will stop your weekly checks 90 days after sending you notice that you’ve reached Maximum Medical Improvement or MMI.

Even if the insurance company determines you’re at MMI, that may not actually be the case. Most of the time, it’s in the work comp insurance carrier’s best interest to deem you at Maximum Medical Improvement as soon as possible in order to limit the amount of Temporary Total Disability benefits they must pay you. A workers’ compensation attorney can help you contest this determination. If your doctor is recommending additional testing, treatment, or surgery, you may not be at MMI. You might have been deemed at MMI years ago for a prior injury and now as a result of the same injury you may now require surgery. By definition, you then are no longer at MMI and may even have a claim for Temporary Total Disability benefits while you are completely off of work recovering from surgery.

Being deemed at MMI does not mean the work comp insurance company is not still responsible for your ongoing medical treatment designed to cure or relieve the effects of the injury you sustain in the course and scope of your employment. After being deemed at MMI you might now be eligible for Temporary Partial Disability benefits, which can even be a larger benefit than the TTD benefit, if you were reaching the earning cap as a result of your high average weekly wage.

While it’s best to contact a lawyer early in the stages of your workers’ compensation claim, it’s never too late to start the process if you’ve been given notice of MMI by the workers’ compensation insurance carrier. Contact the attorneys at Meuser Law Office, P.A. today for a completely free case evaluation.