Your patient or injured worker has reached MMI. But what does MMI mean when we’re talking about California workers’ compensation?
MMI is shorthand for Maximum Medical Improvement, defined on pg. 2 of the AMA Guides to the Evaluation of Permanent Impairment 5th Edition as the following:
An impairment is considered permanent when it’s reached Maximal Medical Improvement, meaning it’s well stabilized and unlikely to change substantially in the next year, with or without medical treatment.
The date of MMI is important: it’s the date when a patient is ready for an impairment rating, and for decisions about future care and permanent work restrictions.
How Do You Know if a Patient is MMI?
How can you tell when a work injury has “stabilized” and is “unlikely to change substantially in the next year, with or without medical treatment”?
To find out what goes into determining MMI, keep a few key questions in mind:
1. Is there any on-going medical treatment that will change the injured worker’s functionality?
For instance, imagine a case where a patient has a back injury, and can only lift 25 pounds.
Physical therapy helped improve the patient’s condition in the past, and they still have six more physical therapy visits authorized by the insurance carrier.
In this scenario, the patient may be able to lift more weight after completing all their physical therapy visits.
Why declare a patient MMI if they are in the midst of ongoing treatment that may improve their condition?
2. Is the impairment rating going to change?
Another example: a worker with a shoulder injury is improving their range of motion with physical therapy, but they cannot improve their ability to lift more weight.
Until their range of motion remains the same, they will not be eligible for MMI.
As soon as the claim is filed, MMI becomes the ultimate goal for treatment. Patients obviously want to get bet better after a work injury, but sometimes they continue to have pain. MMI does not mean that the patient is no longer experiencing pain. It’s the doctor’s responsibility to communicate this to the patient, and to everyone involved in the case.