Understanding Maximum Medical Improvement In a Workers Comp Claim

Maximum medical treatment means an injured employee has reached a state where his or her condition cannot be improved any further or when the treatment has reached a plateau in the healing process.

When you are injured at work or become sick because of your work environment, worker’s comp laws in Missouri allow you to access adequate health care and benefits without needing to cover these costs yourself.

How many benefits you receive, as well as for how long generally depends on the type of injury or illness you have, but that’s the sort of thing your treating doctor has a say in. And in Missouri, your employer (or the insurance company) will choose the doctor who will be treating you. If your employer agrees, you may see your own doctor for treatment, but this is unlikely.

Your doctor is also the one who will decide whether you’ve reached maximum medical improvement, which could potentially be the end of your benefits.

What Is Maximum Medical Improvement?

The terms maximum medical improvement (MMI) refers to your medical state, specifically that your injury or illness can reasonably no longer improve. After a work injury or illness, you will start your treatment, but the benefits in your worker’s comp claim will not last forever.

Some injuries can completely heal with the right treatment, so much so that you can totally recover and not see any signs there was a problem in the first place. Others, however, can leave a lasting mark. Maximum medical improvement generally means you have finished your treatment, as the injury and illness were addressed, healed, and all the other consequences it may have caused can reasonably no longer be treated.

This usually happens when a worker becomes disabled. For instance, if you injure your spine, and as a result lose motor functions from the waist down, you can reach maximum medical improvement once your spine has healed, even if you still cannot walk. Though the two are connected, if there is no medical treatment that can be done to help you regain control of your motor functions, then the doctor can say you’ve reached MMI.

What Does It Mean for Your Claim?

Since your worker’s comp doctor can’t help you anymore, you will not receive any more benefits. However, if the injury or illness left you with permanent damage, you can apply for disability benefits which, depending on your condition, can be total disability or partial disability benefits.

This may allow you to continue physical therapy or other forms of treatment that could help your condition. However, in some cases workers may not agree with a doctor’s MMI decision, in which case they may ask for a second opinion.

Questions Regarding Your Work Comp Claim

Missouri Workers’ Comp enables an injured worker to receive medical benefits as well as income benefits. You should be receiving treatment for ALL of your injuries, not just the ones the insurance company wants to accept. Do not let the carrier deny you benefits.

When injured, you need answers and money quickly. You have bills to pay, a family to take care of, and a job to go back to. At the Law Office of James M. Hoffmann, our attorneys will work with you, regardless of where you are in the process. We will strive to resolve your claim quickly.

Call us today at (314) 361-4300 or fill out our online case evaluation form to request a FREE consultation.

Updated: December 31, 2019