Have your benefits been denied? Wondering what is maximum medical improvement (MMI)? Call MOTTAZ Law Today at (855) 354-2667.
The Legislature created MMI to serve two essential functions. So, what is Maximum Medical Improvement or MMI? MMI is defined as “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.” Stated otherwise, MMI essentially means an injured worker is as good as they are going to get. An analogous concept is that of a healing plateau.
MMI serves two basic purposes:
- First, it constitutes a defense to payment of additional temporary total disability benefits (TTD).
- Second, it serves as a place marker, so that where appropriate, a permanent partial disability (PPD) rating can be assigned.
In order for MMI to be used as a defense to payment of further TTD, it is not enough that the injured worker has attained MMI; rather, the injured worker must also be advised about reaching MMI. This is usually accomplished by the insurer mailing a medical report to the injured worker – indicating MMI has been reached. In legal terms, this is known as service of MMI. Service can be accomplished by mail, fax, email or in person. The latter could arise if an injured worker’s physician provided a report of work ability to the injured worker indicating MMI at an office visit.
As a general rule, 90 days after the injured worker receives notice of MMI, no additional TTD is payable. Exceptions can occur if the injured worker later becomes medically unable to continue to working or participates in an approved retraining plan. Those, however, are fairly limited circumstances.
Attainment of MMI does not act as a defense to payment of temporary partial disability benefits (TPD) nor permanent total disability benefits (PTD). Rather; it only constitutes defense to payment of additional TTD. Moreover, although it appears counterintuitive, MMI does not constitute a defense to claims for further medical treatment.
Under Minnesota law, MMI occurs upon proof that the employee’s condition has stabilized and will likely show little further improvement. Moreover, an injured worker may reach MMI regardless of further flare-ups or worsened symptoms. Factors to be considered by the court when dealing with the issue of MMI include history of improvement, current treatment, pre-existing conditions and proposed treatment. An injured worker can be at MMI even if still disabled and unable to work. Moreover, a worsening condition does not preclude a finding of MMI because the issue is whether the employee has reached a point where substantial lasting improvement is unlikely.
Attainment of MMI gets decided by a compensation judge – if disputed. The judge decides MMI based upon the medical opinions, the medical records and the employee’s testimony. The opinion of the treating physician does not necessarily govern. Sometimes, insurers will hire independent medical examiners to render opinions on MMI.
If you have questions about whether you have reached MMI, or would like to speak with a lawyer, contact MOTTAZ Law Today.
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“I was injured on Dec 17th 1980 on the job 12500 volts and David Kempston took on the job for me along with the Mottaz team’ I feel they put 100% into the case with out cutting any corners And I believe they are one of the best Attorney groups out there It was an experience and a great ending All though the pain will never go away they got the best settlement they could for me and so I thank the team at the office of the Mottaz Attorney’s THEY ARE THE BEST Thank You David Kempston for a job well done.”Ray K.Client
“Mr. Sisk took our case a few years ago not long after my wife was in a serious accident. Her employer’s insurance took insolvency and the employer was resolved to be no help at all. Despite the extremely out of the ordinary nature of our case, and regardless of impediments and hurdles, he has relentlessly fought for what was right on our behalf and been very successful doing so. Still today he continues to stand for us and what rightfully should be done. I simply can’t thank him enough. In troubled times this is the guy you want in your corner.”Linda and Joe A.Client
“Jerry was very responsive to all my questions, concerns and showed compassion in this very difficult time of my life. He took time by email, phone and in person to help me understand the process, the time frame, and all the possibilities. Persevering in the duration of all the doctor visits, working with my employer, and my work related injury was not easy. Jerry handled all of it from our initial meeting to the final resolution with confidence, encouragement, and high integrity. I would strongly recommend Jerry to my family, my friends, and all of my acquaintances. I would without a doubt trust Jerry in the future, if a situation would occur that needed legal representation. I appreciate all he did in helping me get my life back on track and making a positive difference in my life.”Michael Z.Client
“Since injuring my back in 1978 I had multiple issues and problems with the employer and insurer. This led to many disputes over the years. Having been told to live with pain for the rest of my life, I reached a point when I could no longer continue working. At that time I hired David Kempston and he took on my case and worked out for me a settlement that I was very comfortable with. He was always attentive to my calls and responded quickly when I would whine about things which he would assure me it would all come together. He was right and I am so grateful for his hard work. He goes the extra mile for me as a client, and is the type of person you could leave your wallet and checkbook with and no it is safe. Again, I am extremely grateful for David Kempston’s work and highly recommend him to someone who has a work injury and needs the finest representation. If you want to hire somebody with excellent work ethics hire David Kempston.”Robert H.Client