What Is Medical Maximum Improvement (MMI) in Workers' Comp?

In a workers’ comp case, whenever someone refers to maximum medical improvement (MMI), they are referring to the status of an injured worker and the progress of their recovery. MMI means the employee's recovery has reached a plateau and they are unlikely to continue to improve more than they have already, despite continued treatment or rehabilitation.

Who Determines MMI?

When an injury occurs and an employee has reached a state where his or her condition can’t be further improved, the doctor will inform the patient that he or she has reached MMI. Once this point has been reached, the treating physician is essentially saying no other treatment can be done to help the patient improve apart from time.

What Happens if I Reach MMI?

If you are receiving workers’ compensation benefits and reach MMI, your condition will be assessed by your treating doctor. Your doctor will then give you a disability rating. Depending on the rating, your doctor will advise your employer on what you should and should not be required to do at work in order to avoid exacerbating your injury. For example, if you have a back injury, you should avoid sitting down for extended periods of time or avoid lifting heavy items.

Likewise, if your case has not been settled and your injury worsens within 2 years after reaching MMI, you should return to your doctor for assessment. The physician will determine whether your condition has deteriorated and if further treatment is necessary.

What Does an MMI Report Contain?

An MMI Report will generally contain the following:

  • A detailed history of the employee's injury, illness, or disability
  • A summary of the employee's treatment, test results, and studies performed
  • The treating doctor's conclusion and recommendations for future impairment

MMI reports typically also contain information about the level of pain and suffering and/or limitations that an injury or illness places on an individual, as well as impairment ratings of specific body parts. Injured employees have a right to receive a copy of an MMI report and may challenge its findings by obtaining a second medical opinion from a Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME).

How Does MMI Affect My Benefits?

If your physician determines you have reached MMI, or if your physician agrees with an employer-requested independent medical examination (IME) which concludes you have reached MMI, your total temporary compensation will be terminated effective on the date that your physician's approval. If your physician concludes that you are not fully healed and likely never will be, they may declare you have a permanent functional impairment which may entitle you to receive permanent disability benefits.

If you need help applying for worker’s compensation or your application was denied, talk to one of our skilled Santa Ana workman's comp attorneys at Ufkes & Bright. Our firm is dedicated to providing hands-on service for injured workers, and we are proud to provide each client with personal attention and qualified counsel. Our attorneys have more than 50 years of combined legal experience to offer your case. Let us see how we can help you today.

Contact us at (714) 909-2609 or fill out our online form to schedule a free case consultation with us today.

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