What is maximum medical improvement (MMI) or Medical Fixity?
I refer to L&I work injury claim or workers’ compensation claims in general as being in the open and active phase when they are allowed and open. During this phase, the injured worker is actively receiving treatment for claim related conditions. Under the Industrial Insurance Act, injured workers are entitled to receive proper and necessary health care services for the diagnosis and treatment of any condition causally related under the L&I claim. Proper and necessary services may be either curative or rehabilitative. Curative treatment is treatment intended to produce permanent changes to eliminate or lessen the clinical effects of the condition. Rehabilitative treatment is treatment intended to allow injured workers to regain functional activity on a long-term basis.
Maximum Medical Improvement
Injured workers are entitled to proper and necessary health care services until the condition reaches and maintains a state of maximum medical improvement (MMI). Maximum medical improvement occurs when no fundamental or marked change in the condition can be expected, with or without treatment. The term “maximum medical improvement” is equivalent to “fixed and stable” and is sometimes referred to as “medical fixity”.
The Courts have held that the term “fixed” does not mean “static”. Moreover, when an injured worker’s condition is deteriorating or further medical treatment is contemplated, additional treatment can be provided under the work injury claim. However, if a claimant’s condition has stabilized to the point where no further medical treatment is required, the injured worker is considered to have reached “maximum medical improvement”. This milestone is important for wrapping up the open and active phase of the claim and assessing the injured workers 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 will be instrumental in assessing whether an injured worker has reached maximum medical improvement. As always, if injured workers disagree with their medical providers regarding medical fixity, I encourage them to discuss the issue with the provider. Such conversations allow to gain better understanding of the opinion and to determine if there are additional treatment options that may have been overlooked.