Understanding Maximum Medical Improvement (MMI) in Personal Injury Cases

When dealing with a personal injury case, the term “Maximum Medical Improvement” (MMI) is crucial for determining when a person’s injuries have stabilized and are unlikely to improve further with additional treatment. It’s a concept that plays a significant role in how personal injury claims are handled, though it’s often misunderstood. While MMI is essential in workers’ compensation cases, it’s not a legal requirement in personal injury claims, but it does have an important influence on when claims are settled and what damages can be pursued. Here’s a breakdown of what MMI means in the context of personal injury and how it affects claims.

What is Maximum Medical Improvement (MMI)?

MMI refers to the point at which a person’s medical condition has stabilized. In simple terms, it’s when the person’s injury is no longer expected to improve with additional treatment, although they may still require palliative care to manage symptoms. Reaching MMI doesn’t mean the person is fully healed, but it signifies that further medical intervention is unlikely to provide additional benefit.

MMI and Its Role in Personal Injury Claims

In personal injury cases, MMI becomes essential when assessing the full extent of a person’s injuries. It helps determine whether the injury is permanent, which is crucial for making claims related to non-economic damages such as pain and suffering. Typically, the insurance company will only take a claim seriously once it’s clear that the injury is permanent, which usually happens once the client reaches MMI.

Why MMI Matters for Injury Settlements

While MMI is not a legal requirement to proceed with a personal injury case, it plays an important role in when the claim is presented to the insurance company. The goal is to ensure that the full extent of the injury, including its permanency, is known before making a claim. Doctors are often reluctant to offer opinions on the permanency of an injury or provide an impairment rating until the patient reaches MMI. As such, obtaining these opinions and ratings is essential for securing fair compensation.

Key Takeaway:

Waiting for MMI helps avoid prematurely settling the case for less than what it’s truly worth. It allows personal injury lawyers to present a comprehensive claim, factoring in the full extent of the injury, any future treatment needs, and long-term implications.

Who Determines MMI?

The determination of MMI is made by the treating physician, typically someone who has been involved in the patient’s care over time. This could be a chiropractor, a physiatrist, or another specialist who has been actively treating the injury. The insurance company generally does not get involved in selecting the doctor for this process unless litigation is underway. However, once litigation begins, the defense may have the option to have their own doctor evaluate the client.

Important Note:

MMI doesn’t mean the injured person will no longer require care, but it does imply that their condition is unlikely to improve further. Additional treatments or surgeries may still be necessary, but they won’t change the prognosis significantly.

Can You Settle Before MMI is Reached?

In personal injury cases, there is no legal requirement to wait until MMI is reached before settling. However, it is strongly recommended that attorneys wait for this point to ensure they are accurately assessing the injury. Settling too early can mean leaving compensation on the table or accepting less than what the injury is truly worth.

Special Circumstances:

In cases with low insurance policy limits, lawyers may choose to settle before MMI if the policy limits will not be exceeded and further treatment is unlikely to alter the settlement amount.

The Impact of MMI on Future Treatment and Damages

Once MMI is reached, the treating physician will assess the need for future medical treatment, such as surgeries or ongoing therapies. If future medical care is necessary, it can be included in the claim, but it must be backed by a reasonable degree of medical certainty. The key here is proving that the future treatment is a likely consequence of the injury, not a speculative one.

What Happens if a Client’s Condition Worsens After MMI?

It’s possible for a condition to worsen after MMI has been determined. In such cases, the injured party can seek further treatment if necessary, including surgery. However, once the case is settled, the client cannot return to the defendant for additional compensation for the same injury. This is why it’s crucial to ensure that all potential future treatment needs are considered during the settlement process.

Misconceptions About MMI Medical

One of the most common misconceptions about MMI is the belief that it is a legal requirement to reach it before filing a personal injury claim. This is not the case. The reality is that while reaching MMI is crucial for accurately assessing the injury, it’s not a formal requirement in the legal process. Settling a case before reaching MMI can result in significant financial losses for the injured party, as the full extent of the injury might not be understood.

Key Advice:

Don’t rush into a settlement. Injured individuals should avoid settling their case too quickly, as doing so without fully understanding their injury and future needs can lead to regret.

The Importance of Waiting for MMI in Personal Injury Cases

Maximum Medical Improvement is a vital concept in personal injury cases, ensuring that a client’s condition has stabilized and that all potential medical needs have been accounted for before settlement. While it’s not a legal requirement, waiting for MMI ensures that the full extent of the injury is understood, helping to secure fair compensation for both current and future damages.

In contrast, MMI is a more rigid requirement in workers’ compensation cases, where reaching this stage triggers specific legal and procedural actions. By understanding the MMI process, personal injury clients can avoid the pitfalls of rushing to settle their cases and ensure they receive the compensation they deserve. Working closely with experienced legal professionals is essential to navigating this complex process effectively.