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Who Determines Maximum Medical Improvement?

Updated: Nov 5, 2021

The workers' compensation process has many complicated working parts. From submitting medical reports and independent medical exams to dealing with the insurance company, it can be tough to navigate if you aren't familiar with workers’ compensation laws. One of the most critical components to a workers' compensation claim is the doctor's determination of maximum medical improvement. Here's what every injured worker needs to know.


What is Maximum Medical Improvement (MMI)?

Maximum medical improvement is used to determine if a work-related injury is not likely to improve significantly within the next year. After maximum medical improvement is established, the insurance company will calculate your benefits and compensation. Insurance companies will often try to settle workers' compensation claims with a low settlement offer. Having an experienced workers' compensation attorney on your side can ensure you get the proper amount of compensation that you deserve.


Who is Responsible for Determining Maximum Medical Improvement?

The doctor treating you will usually determine MMI. However, your insurance company may require you to have an IME (independent medical exam) to compare your treating physician's opinion to that the IME doctor. It's not uncommon for doctors to have different views about a patient's disability. This can hold up your case, and your workers' compensation attorney will know how to handle any discrepancies so your case can continue to move along.


What is Included in the MMI Report?

The MMI report will have necessary information such as your occupation, date of injury, and other pertinent information related to your case. The MMI will also include the following information:


  • Cause of injury

  • Degree of pain caused by the injury

  • Mobile capabilities

  • Work restrictions or limitations

  • Suggested future medical treatments

  • The condition of the body parts that were injured


If you've suffered a work-related injury or illness, and need assistance with filing a workers' compensation claim or appealing an unfavorable decision, we can help. We can even help for general personal injury cases. Contact Spellen Law, LLC today at (205) 820-9474 for a free case evaluation. Our experienced workers' compensation attorneys will fight for the benefits you deserve.

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