When an employee suffers a workplace injury, workers' compensation provides financial and medical support while they recover. However, at some point in the recovery process, doctors must determine whether the injured worker has reached Maximum Medical Improvement (MMI). This designation can significantly impact a workers’ compensation claim, affecting continued benefits, settlement options, and an employee’s ability to return to work.

Understanding MMI is important for any injured worker receiving workers' compensation benefits or in the midst of a workers’ comp claim. If you’ve been injured on the job, knowing what MMI means and how it affects your case can help you make informed decisions about your treatment, benefits, and legal options.

While learning more about this topic will benefit you, it is not a substitute for professional legal advice. Consult with an experienced workers comp attorney, like Brandon J. Broderick, Attorney at Law, for specific advice

What Is Maximum Medical Improvement (MMI)?

Definition of MMI

Maximum Medical Improvement (MMI) is the point at which a doctor determines that an injured worker’s condition has stabilized and is unlikely to improve further, even with continued medical treatment. This does not mean that the worker has fully recovered but that their medical condition is as good as it is expected to get.

How MMI Affects Treatment and Benefits

Once MMI is reached, doctors may recommend maintenance care rather than curative treatment. At this stage:

• Additional medical treatment may no longer be required, though pain management or therapy might continue.
• Temporary disability benefits may stop, potentially leading to a new phase of the claim.
• Permanent impairment ratings may be assigned, affecting the worker’s eligibility for further compensation.

How MMI Impacts Workers' Compensation Claims

Transition from Temporary to Permanent Benefits

Before reaching MMI, an injured worker may receive temporary total disability (TTD) or temporary partial disability (TPD) benefits. However, once MMI is determined, one of the following scenarios is likely:

• If the worker can return to their job, benefits may stop.
• If the injury results in lasting impairments, the worker may qualify for permanent partial disability (PPD) or permanent total disability (PTD) benefits.

Impairment Ratings and Permanent Disability Compensation

When an injured worker reaches MMI but still has limitations, a permanent impairment rating is assigned. This rating determines whether they are entitled to continued benefits, which can be paid out as a lump sum or ongoing payments.

For example, in states like New Jersey and New York, permanent disability benefits are based on a percentage of impairment, with compensation varying based on the severity of the injury.

Navigating the Legal Challenges of MMI

Employer or Insurance Company Challenges

Employers and insurance companies may push for an MMI determination earlier than necessary to limit benefit payments. In some cases, they may:

• Dispute medical evaluations.
• Pressure injured workers to return to work before they are ready.
• Offer settlements that do not adequately cover long-term needs.

Workers have the right to challenge an MMI determination and seek a second medical opinion if they believe their condition has not truly stabilized.

Settlement Considerations

Reaching MMI is a critical factor in workers’ compensation settlements. Before accepting a settlement, injured workers should consider:

• Future medical expenses that may not be covered post-MMI.
• Potential loss of income if they cannot return to their previous job.
• The long-term impact of the injury on their quality of life.

Once a settlement is accepted, reopening the claim for additional benefits can be difficult, making legal guidance essential.

State-Specific Laws on MMI and Workers' Compensation

Each state has different rules regarding MMI and workers’ compensation. Some key considerations include:

• New Jersey: Workers can request an independent medical examination if they disagree with the MMI determination.
• New York: Impairment ratings impact benefit amounts, and workers may be eligible for Scheduled Loss of Use (SLU) awards.
• Connecticut: MMI findings influence Permanent Partial Disability (PPD) benefits, which compensate workers based on a statutory schedule of body part impairments.

Understanding your state’s specific laws can help you make the best decisions regarding your claim.

What to Do If You Disagree with an MMI Determination

If you believe you have not yet reached MMI or that your impairment rating is inaccurate, you have options:

1. Request a Second Opinion – You may have the right to see another doctor for an independent evaluation.
2. Seek a Workers’ Compensation Hearing – If a dispute arises, you can present evidence before a workers' compensation judge.
3. Consult an Attorney – Legal professionals can help challenge premature MMI determinations and negotiate better settlements.

Call Brandon J. Broderick For Legal Help

Navigating workers’ compensation claims can be challenging. Fortunately, you don't need to do it alone. The experienced workers’ comp lawyers at Brandon J. Broderick, Attorney at Law, are available 24/7 to help you understand your legal options, gather necessary evidence, and build a strong case to secure the settlement you deserve.

Contact us now for a free legal review.