If your doctor has told you that you have reached maximum medical improvement (MMI) you may be unsure what this means for your personal injury case. Reaching MMI is a critical turning point in your case. The physician treating you has determined that your condition has stabilized and that you no longer will benefit from medical treatment.
Reaching MMI is an essential phase of any personal injury case, as your attorney can begin the process of determining what damages you are owed. Even so, the insurance company will likely use various strategies to minimize or deny your claim.
Understanding the complexities involved with MMI is essential so that you can make confident legal and financial decisions. This article serves as a guide to help you understand what happens after you reach MMI and what you can expect as your case continues to move forward.
What Is Maximum Medical Improvement (MMI)?
Maximum medical improvement (MMI) is the point where the injury victim’s condition has stopped showing substantial improvement and unlikely to improve with further medical treatment. Reaching MMI does not mean that a person has fully recovered from their injuries. Instead, it simply means that the condition has plateaued with no expected improvement.
MMI is a medical determination made by the accident victim’s treating physician. The insurance company or attorney does not make an MMI determination. MMI is a legal concept that applies to both personal injury or workers’ compensation cases. Although workers’ comp cases are overseen by ORS Chapter 656 but the same principle applies in personal injury claims.
How Does a Doctor Determine MMI?
One of the most common questions injury victims ask is how a doctor decides that MMI has been reached. To make this decision, your treating physician will thoroughly review any ongoing symptoms you may have, your response to treatment, and then make their prognosis.
Common indicators that you have reached MMI include:
- Your symptoms have stabilized.
- Medical treatment stops producing measurable improvement.
- You have completed all recommended medical procedures.
Using the AMA Guides to the Evaluation of Permanent Impairment, your doctor may assign a permanent impairment rating at MMI. Based on the facts of your case, you may have suffered numerous injuries that can reach MMI at different times. For example, MMI for soft tissue injuries often ranges between 3 and 6 months, fractures 6 to 12 months, and spinal cord or traumatic brain injuries (TBIs) 12 to 24+ months. Depending on the extent of your injuries, you may never reach maximum recovery if you require ongoing treatment.
Why MMI Matters for Your Personal Injury Claim
In many personal injury cases, the insurance company will reach out and try to offer the claimant a quick settlement. Even though the thought of a quick settlement may seem tempting, settling before you have reached MMI may be a costly mistake.
One of the most important reasons to wait is to determine the full extent of any future medical costs and allow your attorney to calculate the full value of damages you are owed. In addition to past and future medical expenses, a personal injury attorney will assess lost wages, loss of earning capacity, and pain and suffering. Oregon law (ORS 31.705(2)(a)) allows personal injury victims to seek future damages, but they must be proven with medical certainty backed up by MMI documentation.
Knowing your MMI status is one of the best ways to protect yourself during a personal injury claim. The insurer may pressure you into accepting a quick settlement to avoid paying the full value of your claim.
MMI and Settlement Timing
Once MMI is reached, your attorney can put together a detailed settlement demand package. One of the most strategic advantages of waiting for MMI before entering negotiations is that it allows your attorney to determine your long-term medical care needs and limitations.
Still, under Oregon’s two-year statute of limitations (ORS 12.110), you must balance waiting to reach MMI with the risk of missing the filing deadline. Even though it is rare, your attorney may need to file a personal injury lawsuit to ensure that you do not lose your right to seek compensation.
What Happens If You Disagree with the MMI Determination?
If you disagree with your MMI determination, you have the right to seek a second opinion from another physician. Suppose the insurance provider’s Independent Medical Examination (IME) doctor determines that you have reached MMI prematurely. In that case, your doctor’s opinion may carry more weight.
If your personal physician is unsure about your MMI, or your disagree with the determination, you can seek a second opinion with an independent physician. Your attorney can make arrangements for you to be evaluated by a neutral-third party specialist. The specialists will review your medical history and provide an impartial opinion as to whether further treatment could result in further improvement.
Because MMI disputes are common in personal injury cases, they often need to be resolved at trial by medical experts.
MMI in Oregon Workers’ Compensation vs. Personal Injury
If your case involves an Oregon workers’ comp claim. Under (ORS 656.268), MMI will initiate the claim closure process and permanent disability determination. In contrast, in personal injury cases, MMI is not a formal step in the legal process but is instead treated as a settlement strategy.
If you were injured on the job and in a car accident, you may have overlapping claims that are best handled by a qualified attorney.
If you have questions about the legal definition of maximum medical improvement or need help with a Portland personal injury case, contact Tillmann Law today at (855) 503-5035 to schedule a free consultation.
