What Is Maximum Medical Improvement?

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Some injuries may only require a few days or weeks to fully heal while others lead to long-term or permanent complications. Despite the major advances in medical technology over the past several decades, there is only so much that medical professionals can do. When a patient reaches the point where no further treatment will improve the patient’s injuries, or there is no way for a patient’s condition to improve on its own, the patient has reached “maximum medical improvement.”

Maximum medical improvement is a vital part of any type of insurance claim or personal injury lawsuit resulting from an accident caused by one party’s negligence. The plaintiff in a personal injury suit can claim any and all medical expenses resulting from a defendant’s negligence, so it is vital for the plaintiff to know the full scope of his or her damages.

Additionally, insurance coverage can fluctuate based on the patient’s total medical expenses after an injury. The concept of maximum medical improvement may also come into play with a claim for workers’ compensation benefits after a work-related injury so speaking with a qualifed Long Beach workers’ compensation attorney can prove to be beneficial.

Determining a Patient’s Maximum Possible Improvement

Doctors use a complex process of differential diagnosis to ascertain a patient’s condition. Attending physicians must not only account for a patient’s current condition but also future complications that could arise from an injury. For example, a patient suffered a crushing hand injury at work from a defective machine. The doctor may be able to mend the broken bones, fix a cast, and offer prescription medication for pain management at first. The doctor must also account for future problems like nerve damage, loss of function, infection risk, and lost range of motion.

The doctor prescribes different treatments and therapies to aid the healing process and help the patient recover lost function and sensation. After several months and additional tests, the doctor confirms the patient suffered permanent nerve damage and will only have partial use of the injured hand in the future. At this point, the doctor can assess the maximum medical improvement possible for the patient and address his or her concerns about the future.

Maximum Medical Improvement and Benefits/Damages

Any type of long-term or permanent damage can drastically change the outcome of a workers’ compensation claim or personal injury lawsuit. In the event a work-related injury causes a permanent or long-term disability, the injured employee may be able to secure benefits for much longer than initially expected. Some employers even offer additional disability benefits that go beyond the scope of workers’ compensation benefits, but this varies from employer to employer.

In a personal injury lawsuit, the defendant is responsible for any and all medical expenses resulting from the defendant’s negligence. In this situation, the concept of maximum medical improvement is very important. If a plaintiff settles with a defendant, both parties will reach a speedier end to the issue and save time and money on legal fees, but the plaintiff’s acceptance of a settlement is usually contingent upon the plaintiff’s agreement to release the defendant from any future liability for the claimed incident.

Based on the previous example, imagine the patient with the injured hand filed a lawsuit and settled with an at-fault defendant after receiving treatment but before receiving confirmation of nerve damage. In this situation, the plaintiff would have likely lost the right to pursue medical expense compensation for treating his or her nerve damage upon accepting the defendant’s settlement offer.

Plaintiffs who settle too quickly or before determining their maximum possible medical improvement risk missing out on significant compensation for future medical treatment. If you or a loved one recently suffered severe injuries that may have resulted in any type of permanent damage, it is very important to speak with an experienced personal injury attorney before accepting an insurance payout, filing for workers’ compensation, or agreeing to settle with a negligent defendant who caused your injuries.