Maximum medical improvement (MMI) is the point in your recovery when your doctor determines further treatment will not make your condition any better, though you may still need ongoing care. In an Oklahoma personal injury case, settling before you reach MMI risks leaving your future medical costs, lost wages, and pain and suffering uncounted.
Reaching MMI does not mean your treatment is finished. You may still need medication, physical therapy, or assistive devices to maintain your current level of function, even though further care will not improve it further. That is why it is usually a mistake to settle a personal injury case before you have either fully recovered or reached MMI. A few examples make the concept easier to understand.
Examples of Maximum Medical Improvement
Example 1: Steve is hurt when a distracted driver rear-ends him on an Oklahoma City highway and suffers a herniated disc in his lower back. The herniation causes pain and occasional numbness in his legs. Steve has surgery to repair the disc, which resolves the numbness but leaves him with ongoing pain. Six months after the surgery, Steve’s doctor concludes that another operation would not relieve his pain and that Steve is as good as he is going to get. Steve will need pain medication for the foreseeable future, along with stretching exercises, and he is restricted from activities that could re-injure his back. At this six-month, post-surgery point, Steve is at MMI. He is not as healthy as he was before the crash, and he never will be, but his doctor has concluded that Steve has reached the maximum level of recovery medicine can provide.
Example 2: Ann slips and falls in a grocery store and tears her rotator cuff bracing her fall. She has surgery to repair it, but six months later she still has significant shoulder pain and limited range of motion. Ann continues physical therapy and takes her medication as directed, but she is not improving. It turns out scar tissue formed around the surgery site, a common complication, and her doctor recommends a second surgery to remove it. Ann is not yet at MMI, because her doctor still believes her pain and range of motion will improve after that second procedure (and Ann has no objection to going through surgery again).
Example 3: Joe strains his lower back slipping on spilled grease at a fast food restaurant. His pain improves over eight months of treatment but never disappears entirely. His doctor does not expect Joe to ever be pain-free from this injury, and Joe will need over-the-counter medication, a heating pad, and occasional muscle relaxers to manage his back pain going forward. At the point Joe’s pain level stopped improving and leveled off, Joe reached MMI.
Why MMI Matters for Your Personal Injury Claim
MMI matters because it lets your attorney predict your future damages: medical costs, lost wages, and non-economic losses like pain and suffering. Until you reach MMI, a fair settlement value or jury verdict is nearly impossible to determine. Because Oklahoma requires every driver to carry auto insurance, the adjuster handling your claim will also want confirmation that you have reached MMI before making a final settlement offer. Consider Ann in Example 2: if she had settled her case before her second surgery, she would not have accounted for the additional medical costs, pain, and lost work time it caused.
When you reach MMI, your doctor will sometimes assign a permanent impairment rating, a percentage representing the reduced functioning of your body. There are two types: one for the injured body part and one for your whole body. For example, you could have a 15 percent impairment rating for your right arm and a 6 percent whole-body impairment (these are illustrative figures only, not drawn from the official guidelines, most often the AMA Guides to the Evaluation of Permanent Impairment, that your doctor would actually use). If you have injuries to more than one body part, each is assigned its own rating, and the guidelines show how they combine into a whole-body number. A permanent impairment rating lets lawyers and insurers compare the value of different injuries, but it is not an exact science, and it will not be assigned until you reach MMI.
Who Decides When You’ve Reached MMI?
Your doctor decides when you reach MMI, not your lawyer. It is a maximum medical improvement, not a legal improvement.
Does Reaching MMI Mean Your Condition Won’t Get Worse?
No. People at MMI are often expected to get worse as time passes. The most common example is someone developing arthritis in an injured joint years later. Being at MMI, though, makes it easier for your doctor to predict how your condition will decline over time, so your claim can account for that expected downturn.
When Will You Reach MMI?
Every person’s treatment, and every case, is different, but most doctors will not consider placing you at MMI until at least six months after your injury. This varies widely. Someone younger may recover significantly faster, and cases with complications can take much longer, sometimes years. That can be frustrating when you want to be compensated quickly, but waiting until you reach MMI is usually the best way to make sure you are fully compensated. Reaching MMI does not pause the clock on your case, though: Oklahoma’s statute of limitations generally still requires a personal injury lawsuit to be filed within two years of the incident under 12 O.S. § 95, so if your treatment is taking a long time, talk to your attorney about that deadline well before you reach MMI. Learning what happens once you reach MMI after a crash can help you understand the long-term impact of your injuries, since only after MMI can you know the full extent of your recovery and any ongoing medical needs.
If your treatment is still ongoing and you are not sure how MMI will affect your claim, an attorney at Hasbrook & Hasbrook can review your medical records and help you decide when the time is right to settle.
