Maximum Medical ImprovementÂ
Maximum Medical ImprovementÂ
What MMI means
Under the Act, a disability is temporary while you're still recuperating and unable to work for medical reasons. It becomes permanent when your condition has stabilized and isn't expected to improve. That stable point is what's called maximum medical improvement.
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MMI is not the same as recovered. Plenty of workers reach MMI with real, permanent limitations. It means the medical picture has stopped changing, not that it's back to normal.
Why the date matters
The MMI determination changes what you're paid and how. Temporary benefits give way to permanent ones, and permanent partial disability is evaluated from that point. It's a medical determination, and it belongs to your treating physician.
Scheduled awards
The Act contains a schedule Section 8(c) assigning a set number of weeks of compensation to permanent impairment or loss of use of specific body parts: the arm, hand, fingers, leg, foot, toes, hearing, and vision. This is called scheduled permanent partial disability, and it's payable once you've reached MMI and are found able to return to work.
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Scheduled awards don't depend on proving lost earnings. They're paid for the impairment itself.
Unscheduled awards
For permanent impairment to parts of the body that aren't on the schedule. The back is the common example around the ports. For that the compensation works differently. It's based on permanent loss of wage-earning capacity, calculated on the difference between what you earned before the injury and what you're able to earn after, and it's payable as long as the disability continues.
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This is why documentation of what you can still do matters so much for back injuries. The award depends on earning capacity, not on a percentage.
Where the AMA Guides come in
The Act doesn't apply the AMA Guides to the Evaluation of Permanent Impairment uniformly to every claim. DOL identifies them specifically for permanent partial disability in cases of occupational disease diagnosed after retirement, where the rating is based on a percentage of impairment determined under the Guides. Hearing loss claims also have their own evaluation rules.
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Practically, ratings are often prepared with reference to the Guides. If a rating matters in your case, that's a conversation to have with your physician and, if you have one, your attorney.
Hearing loss
Worth its own mention around a working port. Hearing loss is covered, it's on the schedule, and it has distinct rules. Including how the filing clock runs once you receive an audiogram with an accompanying report showing loss.
What we do
We determine MMI on medical grounds when the record supports it. Not early because a carrier is pushing, and not late by inertia. When there's permanent impairment, we prepare a rating and explain it in the report rather than leaving a number without reasoning.
Have questions about your claim or need a medical evaluation?