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What Is MMI and Why Did It Stop My Workers’ Comp Benefits?

The concept of MMI is one of the thorniest issues in workers’ compensation. Even if you’ve suffered a back, knee or foot injury on the job, determining MMI can be a pain in the neck (not to mention a kick in the gut if your workers’ comp benefits are stopped).

MMI stands for Maximum Medical Improvement. It is defined as the point at which an injured worker’s medical condition has stabilized and further functional improvement is unlikely, despite continued medical treatment or physical rehabilitation. In other words, you reach a plateau in your treatment and your recovery is as good as it’s going to get. No other reasonable treatment can be done to help you improve.

The impact of MMI on the injured worker’s benefits can sometimes be confusing (another pain in the neck). It can worrisome and even scary to think that your benefits will be totally cut off and your medical treatment discontinued once MMI is established.

Who determines MMI?

The treating physician is the only person who can determine MMI; however, an employer can also request an Independent Medical Examination (IME) by a qualified physician to make this determination after reviewing the patient’s medical records and examining the patient. In addition, the Bureau of Workers’ Compensation can perform its own exam.

If the treating physician agrees to the MMI determination by the IME, then total temporary compensation is terminated effective on the date of the examination or the date when the treating physician gives approval. If the treating physician disagrees, the claim is forwarded either to the Industrial Commission or to a workers’ compensation judge for a hearing and judgment.

What if I have to return to work but can’t do my regular job?

Reaching MMI doesn’t mean that you can now do what you could before you were injured. Even though your treatment options have been exhausted, you may not be 100% better, so you will have to adjust. For instance, if you suffered a back injury but are able to return to work, your doctor may medically advise you to perform sit-down or sedentary tasks. Since the back tends to get stiff after sitting for long periods of time, he may also advise you to hold a job position where, if necessary, you are able to stand up and work. Obviously, depending on your condition, it may be hard to hold a job position in which you can do both. Your employer may not even have a position where this is possible. Therefore, you should contact a lawyer as there are other programs in place that might be able to help you. This help might include finding a job or possibly replacing some of your lost wages while you are searching for a job you can do with your restrictions.

Keep getting treatment, as needed

Your workers’ compensation payments may stop but this does not mean that your treatment has to stop. Keep getting treatment if you need it because discontinuation of treatment once MMI is determined may result in regression or deterioration of your medical condition. Even after MMI is achieved, your the medical condition that is directly related to your injury may worsen in the future and additional treatment may be necessary.