Maximum Medical Improvement 

Maximum Medical Improvement

As you progress with your personal injury or workers’ comp case, you will soon learn that there are certain terms of art. One of these is maximum medical improvement, or MMI. This is an important milestone in your case and can impact the amount of financial compensation you can recover. This article will explain what this term means and how it may impact your case. 

What Is Maximum Medical Improvement?

What Is Maximum Medical Improvement?

Maximum medical improvement is the point a person reaches when they have recovered as much as possible. The Texas Department of Insurance defines MMI as when an employee is as well as they are going to be after they receive treatment. 

Why Does Maximum Medical Improvement Matter?

Maximum medical improvement is an important milestone in some types of civil claims. MMI represents a point where a person is no longer expected to further improve medically. Therefore, it is easier to determine how the victim’s injuries will impact their future, including their ability to return to work. Specifically, the Texas Department of Insurance uses MMI to determine if an injured worker is eligible for long-term benefits. 

Who Determines Maximum Medical Improvement? 

A healthcare provider determines MMI. Under Texas law, injured employees are required to see an “approved doctor” from a list provided by the Texas Workers’ Compensation Commission. They can select any doctor on the list initially. However, if they decide to switch doctors after beginning treatment, they will need the Commission’s approval. The injured worker’s treating doctor determines MMI. 

Application of MMI To Different Case Types

Cases that may be influenced by an MMI rating include:

Workers’ Compensation 

Once the treating doctor has determined that you have reached MMI, a healthcare provider can conduct an exam and give you an impairment rating based on how your work-related illness or injury affects your body as a whole. This rating is expressed in a percentage, and each percentage point equals three weeks of income impairment benefits. For example, if you are given an impaired rating of 20%, you would receive 60 weeks of income impairment benefits. 

Impairment income benefits are equal to 70% of your average weekly wage, subject to state maximum limits. Impairment income benefits usually begin the day after you reach MMI. Benefits end after you have received three weeks of income impairment benefits for each percentage point of your impairment rating. 

The impairment rating you receive has a significant impact on your case and, ultimately, how much workers’ compensation benefits you can receive. If you believe the impairment rating is inaccurate, your lawyer can help get another opinion to challenge its validity.

Personal Injury Cases

Another important area where the concept of MMI may be relevant is in personal injury cases. Your personal injury lawyer may advise you not to settle your claim until you have reached MMI. This is because once you accept a settlement in a personal injury case, you cannot later go back and demand more money if your injuries were more severe than you initially thought. 

Your lawyer knows that once you reach MMI, you can better assess the situation, including determining:

  • The full extent of your injuries
  • Whether you will be able to return to work full-time
  • Whether you will have to take a lower-paying job
  • Whether you are considered permanently disabled
  • The medical expenses you will likely incur in the future
  • Any additional lost wages you may suffer in the future
  • The extent of pain and suffering and other harm you may suffer as a result of the injuries

Once you reach MMI, your lawyer will be better positioned to estimate the value of your claim.

What Happens When I Reach Maximum Medical Improvement? 

If you have reached MMI, this can impact your claim in numerous ways. Some possibilities may include: 

  • You are assigned an impairment rating of 0%, and your temporary workers’ compensation benefits end.
  • You are assigned an impairment rating, agree with the rating, and begin collecting impairment income benefits.
  • You are assigned an impairment rating but do not agree with it and challenge the rating.

Your lawyer will also be in the position of being able to settle your claim after you have reached MMI.

An Attorney Can Assist With Your Claim

If you have further questions about MMI or how the concept might affect your case, feel free to contact an attorney from Stephens Law at (817) 420-7000 for legal advice. Most personal injury lawyers offer a free initial consultation to review your situation.