How Reaching Maximum Medical Improvement Could Affect Your Injury Claim

woman speaking with doctor about medical improvements

Accidents can often cause life-altering injuries. If you sustained injuries in an accident, there might come a time during your treatment when your recovery plateaus. If this is the case, a doctor may decide that your injury has reached maximum medical improvement or MMI.

Personal injury attorneys typically do not recommend settling an insurance claim or even negotiating with the insurance company until you have reached MMI. Until your doctor has determined you are at MMI, it can be challenging to know exactly how much coverage you need to pay for medical expenses, lost income, and other costs.

If you suffered injuries in an accident in New York, contact the New York personal injury attorneys at Finz & Finz, P.C. to discuss your situation and determine the true value of your claim. We are committed to helping you seek the maximum possible compensation for your damages. We offer a free initial consultation to all of our clients.

Below, we will discuss the importance of waiting to settle an accident claim until a doctor determines that you have reached MMI.

What is Maximum Medical Improvement?

Injury victims have reached MMI when a physician decides that their injury is unlikely to improve with continued medical treatment.

For example, if you are 75% recovered from an injury and your medical provider determines that continuing the prescribed course of treatment will not increase that percentage, you are at MMI.

As a result, you may experience extended effects from the injury for the rest of your life. However, it is important to stress that many individuals who reach MMI may still benefit from treatment to manage pain and long-term disabilities. If a doctor has determined you have reached MMI, pain management may still enhance your overall well-being.

Who Decides When I Have Reached Maximum Medical Improvement?

Typically, the physician who has treated you throughout your recovery will decide when you have reached MMI. However, if you believe that your injury could improve further, you are entitled to pursue a second opinion from another physician or even multiple physicians.

The insurance company could also require you to see their own physician to determine if you have reached MMI or if your injury has completely healed. This is known as an Independent Medical Exam (IME). However, it’s important to stress that it isn’t exactly independent. The physician will be working with the insurance company’s interests (their bottom line) in mind.

In general, if the insurance company requests that you submit to an IME, you must comply with the request. If the insurance company requires you to undergo an IME, you should contact an attorney right away. There must be a good cause for the insurance company to request the exam. Finding a skilled personal injury attorney can ensure that the request is legitimate and walk you through what to expect during the IME.

Your attorney can even attend your exam with you to ensure that your rights are protected. In New York, a judicial precedent has determined that claimants are permitted to bring a legal representative to an IME as long as the representative does not interfere with the exam.

Suppose the results of your IME contradict your treating physician’s findings. In that case, your personal injury attorney can investigate the validity of the independent exam and try to ensure that the results do not impact your chances of securing compensation.

Following Your Doctor’s Recommended Treatment Plan

It is extremely important to follow your doctor’s orders. Abiding by your physician’s prescribed course of treatment can affect your ability to make a full recovery. It could also impact your settlement amount.

For example, if you fail to attend follow-up appointments or refuse to follow the recommended treatment plan, the insurance company might get the impression that you aren’t taking your injury very seriously. They could use this as an excuse to reduce or even reject your claim.

Should I Settle My Case Before Reaching MMI?

While it depends on the circumstances of your case, you should generally not accept a settlement offer until you have reached MMI. Insurance companies may make an early settlement offer just to get your case off their books. However, any initial offers will most likely be less-than-generous and may not account for all of your financial losses.

You can’t know the true worth of your claim until you have reached MMI. Once you are at a point where your injuries will no longer benefit from continued medical treatment, you will have a much clearer idea of how much you should be willing to settle for.

Remember, if you sign a settlement agreement, you will forfeit your right to claim additional compensation from the insurance company should you incur further costs down the road. If you accept a settlement offer before you reach MMI and then you later undergo further treatment, those costs may not be covered. You could be facing significant out-of-pocket medical expenses, with no way to obtain coverage for those costs.

That’s why our skilled personal injury attorneys recommend waiting to negotiate a settlement until your treating doctor determines that you have improved all you can. Once you have reached MMI, you will know:

  • The total cost of your medical bills
  • Whether you can go back to work in the same job
  • Whether your injury will impact your future earnings
  • Whether you will need to continue treatment to manage your disability, pain, and overall stability

Contact Finz & Finz, P.C. Today

Were you injured in an accident in New York? If so, contact a New York personal injury lawyer at Finz & Finz, P.C. right away. Our lawyers have extensive experience helping injured clients recover the financial relief they deserve. We can discuss the details of your case and treatment as well as your doctor’s determination of MMI.

We have the resources to document your damages and determine the total worth of your claim. We will handle all communications with the insurance company, negotiate a settlement on your behalf, and fight for your right to be fairly compensated. Contact us today for a free initial consultation.

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Finz & Finz, P.C. is a New York and Long Island personal injury law firm based out of Mineola, NY. It was founded in 1984 and is highly rated, with many honors and awards of excellence.