MMI in Workers' Comp: What Maximum Medical Improvement Means for You

MMI in workers' comp stands for maximum medical improvement: the point where your doctor says your condition has leveled off and isn't expected to get much better with more treatment. It doesn't mean you're healed. It means the temporary phase of the claim is ending, a permanent rating comes next, and the numbers for a settlement can finally be worked out.

	Before MMI	At and after MMI
Medical care	Treatment to get better	Care to maintain, if the claim keeps it open
Weekly checks	Temporary disability while you can't work	Temporary checks often stop or change
Rating	None yet	Doctor rates permanent impairment or loss of use
Work	Off work or on light duty	Return to work, new restrictions or retraining
Settlement	Hard to value	Can be figured from the rating

The details differ by state, including what the temporary benefits are called and when they stop. Some states use other terms for the same point, such as "permanent and stationary."

From the rating to a number

Once you're at MMI, the doctor gives a rating. In states with a schedule, the award is the weeks for that body part times the rating times your weekly benefit. Put your own numbers in:

With the defaults, a $900 wage, a 200-week schedule and a 20% rating come to about $24,000 in award plus about $4,800 for 8 weeks off work. New York's schedule is in the body part list if you want to compare, such as 312 weeks for an arm (Workers' Compensation Law § 15(3)).

Who decides you're at MMI

Your treating doctor usually makes the first call. The insurer can ask its own doctor to examine you, often called an independent medical exam, and that doctor may say you reached MMI earlier or rate you lower. Most states have a way to resolve that: a state-appointed examiner, a hearing before a comp judge, or both. If you disagree, ask your doctor to put the reasons in the report, since the written record is what a judge reads.

What MMI doesn't end

• Medical care for the injury. In many states the insurer still pays for care you need to stay at MMI, such as medication or follow-up visits, unless a settlement closes it.
• Your right to reopen. If the condition gets worse later, many states let you ask to reopen the claim within a set time.
• Your job protections. Federal and state laws on leave and disability may still apply when you go back with restrictions.

Mistakes to avoid at MMI

1. Signing a settlement before you have the final rating in writing.
2. Assuming MMI means the insurer can stop all medical care.
3. Missing the deadline to dispute the insurer's doctor's report.
4. Going back to full duty against your restrictions because the checks stopped.
5. Not asking whether the rating used your state's guidelines or another edition.