MMI And What Happens Next?

According to the New York Workers’ Compensation Board, the definition of Maximum Medical Improvement, otherwise known as “MMI,” is a finding based on a medical judgment that (a) the claimant has recovered from the work-related injury to the greatest extent that is expected and (b) no further improvements in his or her condition is reasonably expected. The need for palliative care or symptomatic treatment does not preclude a finding of MMI. In cases that do not involve surgery or fractures, MMI cannot be determined prior to six months from the date of injury or disablement, unless otherwise agreed to by the parties.”

Once MMI is determined, a medical report must be submitted to the Board indicating that MMI was reached. This report must include an examination of the injured body part, stating the percentage of the functional use that was permanently lost. Once the MMI report is produced, the opposing party will be given an opportunity to produce their own findings regarding permanency. The opposing party may also choose to agree to the submitted report. Once MMI is determined, the Court will make a decision to either stop or limit benefits to the claimant in the future. The claimant’s temporary Workers’ Compensation benefits will end after reaching MMI; however, the claimant may receive permanent partial or permanent total disability benefits. Alternatively, the parties may come to an agreement on a resolution, which may be in the form of an SLU agreement or a Section 32 settlement agreement.

If you have any questions or concerns regarding maximum medical improvement, in one of your Workers’ Compensation cases, please contact Bedoya & Hussain Law Firm, LLC, at (201) 880-9374.