What Does Maximum Medical Improvement Mean in a Connecticut Workers’ Comp Claim?

Disabled on wheelchair talking to his lawyer and doctor.

After a work-related injury, reaching maximum medical improvement (MMI) means your doctor expects that further treatment will not substantially improve your conditions. Once your injuries have stabilized, you can accurately gauge how they will impact you in the short and long term. Unfortunately, your employer may not agree with your doctor’s MMI assessment, which can complicate your claim.

The Connecticut workers’ compensation lawyers at Jainchill & Beckert, LLC know how vital your benefits are to your recovery. We have the in-depth insight and understanding of Connecticut workers’ compensation law you need to help you fight for your rightful benefits. Contact us for more information about maximum medical improvement in workers’ compensation cases and how our team can protect your rights.

How Is Maximum Medical Improvement Determined?

Doctors determine whether an injured worker has reached MMI through careful evaluation. Here’s how they do it:

  • Ongoing evaluation – Doctors continually assess the injured employee’s condition during treatment to see how they’re healing. They look at how well the injury responds to treatment and any changes in the worker’s condition.
  • Medical tests – Sometimes, doctors use X-rays, MRIs, or other diagnostic tests to see how an injury is healing. These tests can show whether there’s been any improvement or if the condition remains the same.
  • Functional assessments – Doctors may also look at how an injury affects what the injured worker can do. They might check things like how much the worker can move, whether they can do tasks on their own, or whether they still have a lot of pain.
  • Expert guidelines – Sometimes, there are set guidelines that help doctors figure out when someone has reached MMI for certain types of injuries. These guidelines are based on data and research.

What Happens After I Reach MMI?

Once your work injury reaches MMI, several things will happen. First, your doctor will evaluate any lasting effects of your injury. This could involve assigning a disability rating if you have a permanent disability. If you receive one, a disability rating impacts the type and amount of benefits you may receive in your workers’ compensation case.

Your lawyer and your employer or their insurance company will then discuss your ability to return to work. Depending on your condition, you might return to your previous job, take on different duties, or not be able to return at all. If you can’t go back to your old job, you might be eligible for vocational rehabilitation services so you can perform a different kind of work.

If you are permanently disabled from any type of work, you might start receiving permanent total disability benefits. These benefits are based on a percentage of your average weekly wage at the time of your injury and compensate you for your loss of earning capacity.

Can My Employer Request an Independent Doctor to Confirm My MMI?

Your employer or their insurance company has the right to request that an independent doctor confirm your MMI status. While you’re receiving workers’ comp benefits, you must agree to this examination if your employer requests it. The purpose is to evaluate the extent of your injury and confirm whether you’ve reached MMI status. It’s vital to remember that this exam must be reasonable, meaning it shouldn’t cause undue hardship for you. For instance, you should not have to travel a long distance for the medical exam.

If your doctor’s and your employer’s exams don’t agree, Connecticut law allows for a “Commission Medical Examination” (CME). The Administrative Law Judge in your case has the right to order an examination by an unbiased doctor to resolve the conflict. You must agree to be seen by this doctor or jeopardize your workers’ comp benefits.

How Does an MMI Classification Affect My Workers’ Comp Benefits?

An MMI classification can change your workers’ comp benefits in a few ways. If you still cannot work, you might start receiving permanent disability benefits instead of temporary ones. If you have a permanent impairment, you may receive a one-time payment of additional benefits based on the severity of your impairment.

Reaching MMI could also mean that your medical benefits change. While workers’ comp will likely continue covering medical treatments related to your workplace injury, the focus shifts from recovery to managing your condition. It’s crucial to understand how these changes affect you and to discuss them with your workers’ comp representative to ensure you’re receiving the correct benefits after reaching MMI.

What If the Doctor Issues an MMI But I Am Not Fully Recovered?

If your doctor says you’ve reached MMI but you feel you have not fully recovered, it’s crucial to act quickly. If you think you need additional treatment, discuss it with your doctor. Remember, MMI doesn’t mean you’re fully healed. It means your condition is stable and unlikely to improve with additional medical treatment.

Next, talk to your lawyer about your concerns. You might be able to get a second opinion from another doctor if you disagree with the MMI diagnosis. A different doctor may have another opinion about whether additional treatment will be helpful. Your lawyer will know whether you can obtain a second opinion in a way that won’t look like “doctor shopping” and harm your workers’ compensation case.

Can an MMI Determination Be Challenged?

You have the right to challenge an MMI determination if you believe you received an inaccurate assessment or that you have not yet reached MMI. You can request a reevaluation or seek a second opinion from another medical professional. You may need to go through your workers’ compensation insurance to facilitate this process, but your lawyer will know how to accomplish it.

Contact a Connecticut Workers’ Compensation Lawyer

Your workers’ compensation benefits are crucial to your recovery after a work-related injury, and reaching MMI status has a notable effect on your benefits. If you need help challenging an MMI classification, Jainchill & Beckert, LLC can help. Call us today for a free consultation with a Connecticut workers’ compensation attorney.

Author Bill Beckert

For over three decades, Bill has dedicated his career to helping injury victims throughout Connecticut secure justice and accountability for injuries sustained at little to no fault of their own. In all cases, he places the best interest of his clients above all else. Describing the services we provide here at the firm, he explains, “We are fighters who work to ensure that our clients are informed and empowered so that we can achieve an outcome that provides peace of mind.”

After graduating from the University of Connecticut in 1989, he then earned his law degree in 1993 from the Western New England University School of Law. Since then, he has striven to make sure every client who steps into his office gets the high-quality representation and undivided attention they deserve. In recognition of his work, Bill has been listed in The National Trial Lawyers Top 100.