How Reaching Maximum Medical Improvement May Affect Your Injury Claim

man with a prosthetic leg in a clinicSome accident victims may never fully recover from their injuries. They reach a point in the recovery process when continued medical treatment is unlikely to improve their condition. For example, an injury victim may only be 80 percent of what he or she was before the crash and that percentage may be unlikely to increase, no matter how much treatment he or she gets.

It is important to note victims may still benefit from ongoing treatment. Doctors may be able to help patients better manage pain or physical limitations from the injury, which could help improve their quality of life.

Attorneys typically do not start negotiating for compensation until victims reach maximum medical improvement. That way the attorney can determine the future treatment needs of the victim.

Our Brunswick auto accident attorneys are prepared to review your claim to help determine what its true value may be. Our goal is to secure full compensation for your damages.

Below, we discuss why it is important to reach maximum medical improvement before settling a claim.

What Does Maximum Medical Improvement Mean?

Maximum medical improvement (MMI) could mean two different things.

For accident victims who suffered more serious injuries, it could mean they have received the necessary medical treatment and have recovered as much as they are likely to. They are not fully healed and will likely have ongoing problems related to the injury.  

Reaching MMI could also mean that a person has fully recovered from his or her injuries after undergoing necessary treatment.

Who Determines When a Person Has Reached MMI?

Your treating doctor is generally the only one who should determine whether you have reached maximum medical improvement. However, it is important to note that you have the right to seek multiple opinions about your injuries and how to treat them.

If the insurance company does not agree with your doctor’s designation of you reaching MMI, they may ask you to undergo an Independent Medical Exam (IME). This means they would contract their own doctor to examine your injuries and determine whether they are permanent or if you are fully recovered.

Do Elective Procedures Affect My MMI Designation?

Injury victims may be concerned about whether rejecting a procedure may affect the doctor’s decision about MMI. This is an issue that must be considered on a case-by-case basis.

A doctor may be within his or her rights to say you have reached MMI if you refuse to be treated with a surgical procedure that may or may not improve your condition.  

For example, a doctor may recommend an injury victim with a herniated disc undergo spinal fusion surgery, which might fix the problem. However, if the patient decides to forego surgery due to potential risks and instead opts for pain management procedures, that person could be classified as having reached maximum medical improvement without getting the surgery.

Should I Wait Until I Have Reached MMI Before Sending a Demand Letter?

Waiting until you have reached maximum medical improvement to send a demand letter is often the way to go. However, there are some situations that may call for sending a demand letter as soon as there is a diagnosis.

An attorney may recommend sending a demand letter before an accident victim reaches MMI if he or she suffered serious injuries and the policy limits on the insurance may not cover the full value of the claim.

For example, an accident victim who suffers a Traumatic Brain Injury (TBI) caused by a driver who has a $100,000 policy limit, may send a demand letter before MMI. Due to the high cost of care and the permanence of a TBI, the true value of the claim could easily surpass the insurance limits.

What About Settling a Claim?

The answer to this question is also generally decided on a case-by-case basis, but the same logic applies.

You would not agree to a settlement until you know how much your claim is truly worth, and the best way to do that is to determine the costs of past, present and future care. To do this, you would need to have a better understanding of where you are medically. Therefore, it is generally in an accident victim’s best interest to agree to a settlement after reaching maximum medical improvement.

Call an Experienced Attorney Today

Our attorneys have helped injury victims recover millions in compensation and are prepared to help you maximize yours after an accident caused by someone else’s negligence.

Whether you have already filed a claim or been denied, we may be able to help you. We know how to determine the full value of a claim and how to negotiate with insurers intent on denying or underpaying claims.