After a work injury in Washington State, the first step if for the Department of Labor and Industries (L&I) to allow your claim. Then, your workers’ compensation claim enters the open and active phase. During this phase, you receive treatment for medical conditions that relate to your workplace injury or industrial disease.

Medical treatment under a workers’ comp claim

Under the Industrial Insurance Act, work injury claimants receive proper and necessary health care services. Moreover, these services include both diagnosis and treatment for any condition causally related to the L&I claim. Additionally, proper and necessary services may be either curative or rehabilitative in nature. Curative care is treatment to produce permanent changes, to eliminate or lessen the clinical effects of the condition. Rehabilitative care is treatment to allow work injury claimants to regain functional activity on a long-term basis.

Maximum medical improvement in an L&I claim

Work injury claimants can receive health care services until they reach maximum medical improvement. In other words, until their condition reaches and maintains a state of medical fixity. Maximum medical improvement occurs when doctors do not expect more changes in medical conditions, with or without treatment. Therefore, the term “maximum medical improvement” is equivalent to “fixed and stable” or “medical fixity”.

Work injury medical treatment under the law

The courts have held that the term “fixed” does not mean “static”. Moreover, when the condition of a work injury victim is deteriorating, then L&I can provide additional medical treatment under the claim. However, if a claimant’s condition is stable to the point where there is no need for further medical treatment, then the work injury claimant reaches maximum medical improvement. This milestone is important for wrapping up the open and active phase of the workers’ compensation claim. It’s also important in assessing the worker’s permanent abilities.

Talk to your doctor

Therefore, the question of medical fixity is largely a medical question. The opinions of the attending provider and any other treating providers are instrumental in assessing whether the worker is at maximum medical improvement. As always, if you disagree with your medical providers regarding medical fixity, then you must discuss the issue with the provider. Such conversations allow everyone to gain better understanding of the opinion. They also help to determine if there are additional treatment options to consider.