How Maximum Medical Improvement (MMI) Affects Your Auto Accident in a Personal Injury Case

What Is Maximum Medical Improvement (MMI)?

When making a personal injury claim following an accident, claimants will often hear the term “maximum medical improvement,” or “MMI” used. This term means that the party filing the claim has fully recovered from sustained injury and has reached maximum medical improvement.

Additionally, during the claims process, the treating physician of the injured party will have stabilized the medical condition, provided details regarding future medical treatment, how much that medical treatment will cost, and what potential setbacks that person may face moving forward. This allows the claimant to pursue appropriate compensation from the insurance company.

While the goal is to get patients fully healed, sometimes serious injuries prevent that from happening. Depending on the final medical examination, the treating physician will identify permanent/partial disability.

Although still eligible for reimbursement of medical bills and other losses, partial impairment with minor injuries will not require a long recovery time. Conversely, a catastrophic injury may qualify for disability benefits if the damage is so severe that it has affected the injured person’s wellbeing. For instance, if the injured victim cannot return to work, then he or she can be compensated for lost wages from the liable party’s insurance carrier.

Reaching MMI Is Not Always Possible

Plenty of victims do not fully recover from their injuries or make slow progress, meaning reaching MMI in a timely manner might not be possible.  It is quite possible you will reach a point where you have maxed out your potential recovery and ongoing medical benefits are unlikely to lead to additional improvement.  As an example, if you suffer a 20% loss of use of your right shoulder as a result of a personal injury in Victorville and ensuing treatment does not elevate your right shoulder above 80% of its previous functionality, additional treatment might not be likely to improve the shoulder’s condition or functionality.

However, it must be noted in the doctor’s disability rating that there is still the potential for further improvement and additional treatment options. This is done in order to provide benefits even if that medical treatment does not improve the body site’s functionality.  Ongoing treatment can mitigate pain and also help personal injury victims in Victorville better manage limitations stemming from the injury.  Therefore, it might make sense to continue with treatment as it has the potential to improve one’s quality of life.

Did You Reach Maximum Medical Improvement?

Typically, after a claim is filed and the claimant has begun to seek out disability benefits, insurers will order an independent medical examination to be conducted. This is an evaluation that is completed by an unbiased third party to accurately assess the injured person and establish a disability rating.

These steps, in addition to completing maximum medical improvement, is important because it establishes your claim value and how much compensation you may recover.

Therefore, do not negotiate a settlement for your personal injury until the final MMI assessment has been completed. Agreeing to a payout too early will not account for potential medical treatment that may be needed in the future, as recommended by a treating physician. The damage can worsen or become infected as time goes on and will require more medical attention. However, once you agree to a settlement, the at-fault party can no longer be held accountable for future damages.

There is also the potential that a full recovery will not occur in a timely manner, meaning additional medical treatment including durable medical devices will be necessary for months, years, or even across posterity.  Such serious injuries sometimes do not fully heal, leaving victims saddled with lifelong pain and physical limitations that necessitate ongoing treatment. Therefore, if you are currently undergoing treatment or have recently been involved in an accident, consult with an attorney. A personal injury lawyer can explain the benefits you’re entitled to, as well as what legal options to pursue against the liable party.

Determining MMI Has Been Reached

Let’s shift our attention to the party that determines whether a personal injury accident victim in Victorville has reached MMI.  Solely the treating doctor determines whether MMI is reached.  However, the treating doctor’s opinion is only one point of view regarding the injured party.  Another doctor who provides a second opinion might have a completely different opinion of the victim’s status, meaning one doctor might believe MMI has been reached while another believes MMI has not been achieved.  You have the legal right to obtain several opinions from medical doctors pertaining to your injury, the optimal treatment modalities, and whether MMI has been reached.

There is also the potential for the insurance company to disagree with the doctor’s opinion that MMI has or has not been reached.  The insurance provider might request that the victim have an IME performed.  IME is an acronym short for an independent medical exam.  An IME is performed by an unbiased, objective doctor who has not treated the victim in the past.

The insurer selects its own physician to perform the IME in an attempt to understand whether the victim has fully recovered from the injury causally related to the accident in Victorville. With that said, do not speak to the other involved party or their insurance adjusters, and do not answer questions they ask unless an attorney is present. The only person who should be discussing case details is your legal representative. Otherwise, your compensation can be dramatically reduced or even rejected.

Elective Procedures in the Context of MMI

There is also the potential that a full recovery will not occur in a timely manner, meaning additional medical treatment including durable medical devices will be necessary for months, years, or even across posterity.  Such serious injuries sometimes do not fully heal, leaving victims saddled with lifelong pain and physical limitations that necessitate ongoing treatment. Therefore, if you are currently undergoing treatment or have recently been involved in an accident, consult with an attorney. A personal injury lawyer can explain the benefits you’re entitled to, as well as what legal options to pursue against the liable party.

Determining MMI Has Been Reached

Let’s shift our attention to the party that determines whether a personal injury accident victim in Victorville has reached MMI.  Solely the treating doctor determines whether MMI is reached.  However, the treating doctor’s opinion is only one point of view regarding the injured party.  Another doctor who provides a second opinion might have a completely different opinion of the victim’s status, meaning one doctor might believe MMI has been reached while another believes MMI has not been achieved.  You have the legal right to obtain several opinions from medical doctors pertaining to your injury, the optimal treatment modalities, and whether MMI has been reached.

There is also the potential for the insurance company to disagree with the doctor’s opinion that MMI has or has not been reached.  The insurance provider might request that the victim have an IME performed.  IME is an acronym short for an independent medical exam.  An IME is performed by an unbiased, objective doctor who has not treated the victim in the past.

The insurer selects its own physician to perform the IME in an attempt to understand whether the victim has fully recovered from the injury causally related to the accident in Victorville. With that said, do not speak to the other involved party or their insurance adjusters, and do not answer questions they ask unless an attorney is present. The only person who should be discussing case details is your legal representative. Otherwise, your compensation can be dramatically reduced or even rejected.

Elective Procedures in the Context of MMI

Personal injury victims often worry that their refusal to undergo a surgical procedure might change the physician’s decision in regard to whether MMI has been reached.  There is no clear-cut answer to this question.  Rather, turning down a suggested procedure might affect the MMI decision in one case yet not another.

A physician is allowed to state a patient has reached MMI if he or she refuses treatment in the form of an elective procedure that has the potential to improve his or her condition.  As an example, if a patient chooses pain management over surgery, the doctor might determine that patient has reached MMI.

MMI in Terms of the Demand Letter and Settlement

There is plenty of debate as to whether it is prudent to wait to send the demand letter and agree to a settlement until MMI is reached.  Some attorneys believe it is in their clients’ benefit to wait until MMI is reached to transmit the demand letter and agree to a settlement as MMI reveals the true worth of the claim.

However, if the damage is especially serious, it is difficult to reach MMI in a timely manner and it is also challenging to get a sense of the claim’s value.  In the end, the nuances of the victim’s case will ultimately determine if it makes sense to send the demand letter right away and agree to a settlement before MMI is reached. Consulting with an experienced personal injury law firm will clarify all of these details and more.

Contact Us if You Have Questions About Your Personal Injury Accident

Our law firm, Rockview Accident Lawyers, has helped injured victims recover the compensation that is owed to them after being injured in an accident caused by a negligent party. The benefits of working with an attorney are very helpful, especially to those who are recovering from serious injury.

We believe in establishing a strong attorney-client relationship from the start, so we will remain transparent and honest throughout the case.

Contact us to discuss your claim and how we can get you the compensation you deserve. We offer a free consultation to get started.