When involved in a personal injury case, people often receive compensation for any damages they suffered due to an accident. This compensation usually reflects the extent of their medical damages. However, there is a limit to how much compensation someone can receive after an accident.
Once your injury has improved as much as possible, you reach Maximum Medical Improvement. At this point in your recovery, it’s wise to partner with a Century City injury law firm to find a trusted and experienced medical professional to ascertain your damages and the permanent changes an accident has had on you.
What is Maximum Medical Improvement?
Maximum Medical Improvement (MMI) is the point at which an injured person reaches a state where their condition cannot be improved upon. It can mean that the patient has either fully recovered or reached a point where their injury will not get better with further treatment. Once an injured person meets this mark, the state starts to look at the patient’s health and wellbeing before determining if they qualify for disability payments.
Common Injuries Related to MMI
The most common injuries that can cause disability or impairments are:
- Bone fractures
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Who Determines the End of MMI?
If someone suffered injuries after an accident, it’s likely that they were on temporary disability benefits. When the patient hit MMI, those temporary benefits end. The primary treating physician (PTP) makes the initial call. Depending on the case, your PTP may not be your primary physician. In some cases, a PTP may be:
- A doctor chosen through your employer’s medical provider network
- A doctor you chose after switching from the doctor your employer recommended
In cases where you may disagree with the findings of the doctors above, you can meet with an independent medical evaluator to get a second opinion. However, an insurance company can also schedule an Independent Medical Examination (IME) to get an additional and objective report on the extent of your injuries.
What are the Qualifications to End MMI?
A PTP or an independent medical evaluator will usually look at three factors.
- Stability. Determining if your condition will improve with further treatment.
- Functional limitations. Permanent restrictions on your ability to work and perform daily activities.
- Response to treatment. How your injuries react to treatment, therapy, and medications.
Your PTP may do additional tests and consult with other experts to make sure they are making an informed decision. After this, you’ll receive a Permanent Impairment Rating (PIR) which is an overall rating that shows the severity of your new disability, if any. The scale for PIR goes from 0 (full recovery) to 100 (total loss). This rating helps your Century City injury law firm calculate the amount of compensation you’re owed in a personal injury case.
Settlement Negotiations
Once MMI is reached, settlement negotiations and/or worker’s compensation resolutions can begin. Potential settlements include:
- Permanent disability payments. These are payments for a specific time or for life depending on the severity of the disability.
- Vocational rehabilitation. If someone cannot return to their old job, they can receive training in a new field.
- Stipulated award. If you and the insurance company agree that you require medical care, you can continue getting that care with permanent disability payments.
- Compromise and release. When you agree to this settlement, you receive a lump-sum payment, but you relinquish the right to obtain future medical care via worker’s compensation.
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How to Strengthen Your Claim
After the end of MMI, you will be considered for permanent disability or workers’ compensation. This depends on the extent of the changes to your body. Determining the exact compensation you’ll receive depends on how persuasive and consistent your doctors’ reports are with your injuries and medical knowledge.
When presenting your case, there are three things your medical reports must have for the best results.
- Honesty. It’s recommended to be honest about your pain, complications, and any other factors related to your injuries.
- Documentation. When you report your injuries, it’s important that your PTP writes detailed reports about your pain and where it is instead of a broad statement such as, “The client is in pain.” Reporting your physical and mental limitations in your files will help prove your case to the reviewers.
- Supporting evidence. The evidence of your pain and injuries must align with medically proven knowledge.
When it comes to determining permanent disability, your PTP must provide a persuasive and well-supported case with evidence that is consistent with their claims for you to qualify. However, in a worker’s compensation case, the opinion of your PTP is automatically considered correct unless proven otherwise. This can be challenged if someone notices your PTP isn’t detailed and loose with the details. Avoid this by reviewing the documentation of your pain and recovery.
Necessary Paperwork
When presenting supporting evidence, doctors must present certain documents. Your injury lawyer will also send a letter to your doctor requesting the following information:
- Medical Source Statement. This report is done by your attorney that tells the judge how your medical condition affects your ability to work.
- Narrative Medical Report. This is a report written by your doctor that summarizes your injuries, recovery, and their final thoughts on your overall state moving forward.
- Medical Records. This includes records from appointments, X-rays, MRIs, CT scans, and any other tests, visits, and/or surgeries to support your doctor’s claims.
FAQ
How Long Does It Take to Reach MMI?
That depends on the extent of your injuries and your recovery progress. Reaching MMI after a broken arm is a lot faster than reaching MMI after a brain injury. Speak to your doctor to learn more about your timeline.
What Do I Do If an Insurance Company Wants an IME?
If an insurance company asks for an IME, you have the right to bring a representative, record the visit, and get a copy of their report. Make sure to bring all your medical records and be honest about your condition. Remember, exaggerations can hurt your case if they don’t align with what medical experts know to be true.
How Does MMI Affect a Personal Injury Case?
MMI affects a personal injury case as it showcases the lasting damage an accident had on a client. A Century City injury law firm will use the findings provided by the medical experts in your case to argue for compensation on your behalf.
What Damages Can Be Recovered in a Personal Injury Case?
In a personal injury case, clients can be compensated for medical expenses, lost wages, out-of-pocket expenses related to your injury such as home renovations, and psychological damage. This includes the development of PTSD, loss of enjoyment of life, and disabilities.
Should I Keep a Lawyer After I Reach MMI?
It’s recommended to have legal representation throughout your case, especially if you’re pursuing a personal injury claim. This helps centralize all your documents and makes it easy for your attorney to make a case for you since they’ll be aware of your initial damages and have a record of all your medical visits prior to reaching MMI.
Can I File Both a Worker’s Compensation Case and a Personal Injury Case?
If your injury happened at the workplace but also involved a third party, yes. For example, if you were at work and you were run over by a customer or a commercial truck driver, then you can file both cases.
How Do I Know Which Case to File?
That depends on the circumstances of the accident and the amount of evidence you collect at the scene. If you experienced an injury at work, you must provide your employer with written notice of the accident within 30 days of the injury. If you’re unsure of what to do, schedule a consultation with a personal injury attorney to learn more about your case.
Should I Settle My Case Before Reaching MMI?
That is not recommended. Once you’ve agreed to a settlement, it’s final. MMI serves as a final evaluation of the extent of your injuries. Settling before knowing the full extent of an injury’s lasting effects on your body is a gamble that can cost you compensation for future medical costs.
What If the Insurance Company Rejects My Claim?
If an insurance company rejects your claim, your lawyer can file a lawsuit and go to court.
How Much is a Personal Injury Lawyer?
A Century City injury lawyer typically works on a contingency fee. This means that they will take your case, but if they win, they will take a percentage of the winnings. In California, the average is anywhere between 30 and 40 percent.
Meet with a Century City Injury Law Firm Today!
If you find yourself needing a Century City injury law firm after an accident, our team at Vaziri Law, LLP, is here to help you file your case and at every step of your recovery journey. Our attorneys serve clients all over California, and we’re familiar with resources in the area. Contact us today to learn more!
