Hi this is Brian Wiklendt from Garfinkel Schwartz.
I just wanted to talk to you a little bit today about the term MMI and what that means
in a Defense Base Act in a longshore case because I’ve had a lot of clients and potential
clients calling me wondering what that means.
And there is a differing opinion as to what MMI really really means and the insurance
company and I obviously differ greatly as to what MMI is.
I’ll just give you an example as to what the kinds of things that I get on the phone.
Hello.
I was placed at MMI and the insurance company cut me off because they say I’m at MMI and
I can go back to work but I don’t think I can go back to work because I’m still
in terrible pain.
Why that happens is the insurance company has kind of interpreted MMI meaning Maximum
Medical Improvement to mean that you’re OK.
You’re done.
You’re at maximum medical improvement.
You don’t need any more treatment and a lot of adjusters who are not doctors and are
not lawyers either tend to use that term to try to get people to go back to work.
Well that’s not what that means.
MMI doesn’t mean your treatment is finished and you can go back to work.
What that means is there’s nothing else that a particular physician can think of to
do that’s going to make you any better.
Let me give an example.
I had a client that suffers from PTSD.
He also broke his tailbone and has a lower back injury.
He also had a leg injury but I’ll just focus on those two.
Well the insurance company cut him off because his orthopedic surgeon said he’s at MMI.
Well all that means is the surgeon is basically saying that I can’t think of anything more
to help this person.
He’s at maximum medical improvement but they don’t say on an orthopedic standpoint.
The only thing that that doctor can testify to in court is anything orthopedically wrong
with my client.
Nothing else.
They use that and say hey he can go back to work.
He’s fine now.
Well no.
The only reason he’s at MMI maximum medical improvement is because there’s no surgery
that can be recommended to help his cracked tailbone.
He’s going to have to live with that.
There’s no direct surgery that can be done.
He’s already gone through all the conservative therapies in terms of physical therapy epidural
injections all that kind of stuff and the doctor just put up his hands and said there’s
nothing more I can do for this gentleman.
That doesn’t mean he’s still not in terrible pain and he’s going to need pain management
for the rest of his life and he’s going to need injections basically on and off.
He’s going to need a TENS unit.
These things are not necessarily medical in nature in terms of having to do surgery and
other manipulations of your body but it certainly isn’t a fact that, “oh I’m at MMI, that
means I’m OK.”
And that’s the difference that we have in terms of that definition.
Now in terms of that client you’d wonder OK, well he’s at MMI orthopedically.
He’s OK.
Well what about his PTSD?
He was off work because of his PTSD as well and there’s no MMI for that.
He’s still being treated for that by a psychiatrist.
So it’s a very tricky term and a lot of people don’t understand and they just accept
the insurance company’s definition of what MMI is and you should not do that and you
should definitely hire or talk to an attorney that can understand what the claimant’s
definition of MMI should be and it’s not okay you can go back to work.
That’s just not what that means.
I hope this help and again thanks for listening.
I hope I clarified that issue for you.