What Does MMI Mean in Minnesota Workers’ Compensation? The 90-Day Rule Explained

What Does MMI Mean in Minnesota Workers’ Compensation? The 90-Day Rule Explained

If a doctor says you have reached maximum medical improvement, commonly called MMI, it can have major consequences for your Minnesota workers’ compensation claim.

But MMI does not necessarily mean that you are healed, pain-free, able to return to your old job, or finished receiving workers’ compensation benefits.

MMI is a legal and medical concept used in Minnesota workers’ compensation cases to describe the point at which no further significant recovery or lasting improvement can reasonably be anticipated.

One of the most important consequences is that temporary total disability benefits may end 90 days after a valid written MMI report is received or served, depending on the circumstances.

Because that 90-day period can materially affect wage-loss benefits, injured workers should understand exactly what MMI means—and what it does not mean.

What Is Maximum Medical Improvement?

Minnesota workers’ compensation law defines maximum medical improvement as the date after which no further significant recovery from or lasting improvement to the work injury can reasonably be anticipated, based on reasonable medical probability.

In practical terms, MMI generally means that the employee’s medical condition has stabilized.

The employee may still:

• have pain;
• have permanent work restrictions;
• need ongoing medical treatment;
• have permanent partial disability;
• be unable to return to the pre-injury job; or
• need vocational rehabilitation.

MMI does not require a complete recovery.

Does MMI Mean I Am Healed?

No.

This is perhaps the most important misconception about MMI.

An employee can be at maximum medical improvement and still have substantial permanent limitations.

For example, someone with a serious shoulder injury may reach MMI after surgery and rehabilitation but still have:

• limited range of motion;
• permanent lifting restrictions;
• chronic pain;
• weakness; and
• permanent partial disability.

MMI simply means that additional significant recovery or lasting improvement is not reasonably anticipated at that time.

It does not mean the employee has returned to the same physical condition that existed before the work injury.

Who Decides Whether I Have Reached MMI?

MMI is a medical determination.

Your treating physician may conclude that you have reached MMI.

An independent medical examination physician hired by the employer or insurance company may also give an opinion about MMI.

Sometimes the doctors agree.

Sometimes they do not.

For example, your treating doctor may believe you still need treatment and have not reached MMI, while the insurance company’s IME physician says your condition has stabilized.

If the competing medical opinions affect your benefits, the dispute may ultimately have to be resolved through Minnesota’s workers’ compensation system.

Why Is MMI So Important for Temporary Total Disability Benefits?

MMI can trigger the end of temporary total disability, commonly called TTD.

TTD is the wage-loss benefit generally paid when a work injury prevents an employee from working.

Under Minnesota law, TTD ordinarily ceases 90 days after the employee reaches maximum medical improvement, subject to important statutory exceptions and timing rules.

The 90-day period does not simply begin because a doctor wrote “MMI” somewhere in a chart.

A written medical report indicating MMI must be received or properly served.

When Does the 90-Day MMI Period Begin?

Under Minnesota workers’ compensation law, the 90-day period generally begins when the employee receives or is properly served with a written medical report stating that the employee has reached MMI.

This distinction matters.

For example, a doctor may internally conclude that you reached MMI months earlier.

That does not necessarily mean the 90-day TTD period began months earlier.

The statutory timing depends on receipt or service of the written MMI report.

Does TTD Stop Immediately When I Reach MMI?

No.

MMI does not ordinarily cause temporary total disability benefits to stop immediately.

Instead, Minnesota law generally provides a 90-day period after the MMI report is received or served before TTD ends on that basis.

During that period, other events may also affect benefits.

For example, TTD may potentially cease earlier if the employee:

• returns to work;
• is released to work without restrictions caused by the work injury;
• withdraws from the labor market;
• fails to make a diligent job search when required;
• refuses appropriate work; or
• reaches another statutory basis for discontinuance.

MMI is only one of several possible grounds affecting TTD.

Can the Insurance Company Stop My TTD Without Giving Me Notice?

If the insurer is already paying wage-loss benefits and seeks to discontinue them, Minnesota’s workers’ compensation discontinuance procedures generally apply.

That commonly involves a Notice of Intention to Discontinue Workers’ Compensation Benefits, or NOID.

The notice should identify the reason the insurer believes benefits can be stopped.

If you disagree with the discontinuance, strict deadlines may apply for requesting an administrative conference.

An MMI opinion therefore often leads directly to an NOID and a possible discontinuance dispute.

Does MMI End All of My Workers’ Compensation Benefits?

No.

MMI primarily has significance for certain wage-loss benefits, especially TTD.

Reaching MMI does not automatically terminate every other benefit available under Minnesota workers’ compensation law.

Depending on the case, an employee may still have rights involving:

• temporary partial disability;
• permanent partial disability;
• permanent total disability;
• medical treatment;
• vocational rehabilitation;
• retraining;
• mileage reimbursement;
• prescription medication;
• future surgery; and
• settlement.

That distinction is extremely important.

An employee should not assume that “MMI” means “the case is over.”

Can I Still Receive Medical Treatment After MMI?

Yes.

Medical treatment does not automatically stop because you have reached MMI.

Minnesota workers’ compensation medical benefits are generally based on whether treatment is reasonable, necessary, and causally related to the work injury.

A person at MMI may still need treatment to:

• manage chronic symptoms;
• maintain function;
• control pain;
• prevent deterioration;
• monitor a permanent condition;
• receive medications;
• undergo injections; or
• potentially undergo additional treatment if circumstances change.

MMI addresses whether significant recovery or lasting improvement is anticipated.

It does not necessarily mean that no future medical care is appropriate.

Can I Still Have Permanent Work Restrictions After MMI?

Yes.

In fact, MMI is often the point when doctors can more confidently determine whether work restrictions are likely to be permanent.

Permanent restrictions may include limitations involving:

• lifting;
• overhead work;
• repetitive use;
• standing;
• walking;
• bending;
• twisting;
• reaching;
• sitting;
• climbing; or
• hours worked.

Those restrictions can be critically important to future wage-loss, rehabilitation, retraining, and settlement issues.

What Happens to TPD After MMI?

Temporary partial disability, or TPD, is different from temporary total disability.

TPD is generally paid when an injured employee is working but earning less because of the work injury.

MMI does not automatically terminate TPD merely because the employee has reached MMI.

Different statutory limits apply to TPD, including duration limits that depend on the employee’s date of injury.

For many current Minnesota claims, TPD may continue after MMI if the employee continues to experience a loss of earning capacity causally related to the work injury and otherwise meets the statutory requirements.

Does MMI Affect Permanent Partial Disability?

MMI and permanent partial disability are closely related, but they are not the same thing.

Permanent partial disability, or PPD, compensates an injured worker for permanent functional impairment.

A physician may assign a PPD rating when the worker’s condition has stabilized sufficiently to assess the extent of permanent impairment.

An employee can therefore reach MMI and still be entitled to PPD benefits.

In many cases, reaching MMI is actually when the permanent nature of the injury becomes clearer.

Does MMI Affect Vocational Rehabilitation?

Not automatically.

An employee who has permanent restrictions and cannot return to the pre-injury job may still need assistance from a Qualified Rehabilitation Consultant, or QRC.

Rehabilitation services may include:

• return-to-work assistance;
• job-placement services;
• vocational testing;
• transferable-skills analysis;
• job-search assistance; and
• retraining evaluation.

The vocational consequences of the injury may become especially important once a worker’s medical condition has stabilized.

What If My Doctor Says I Am at MMI but I Still Cannot Return to My Old Job?

That situation is common.

MMI and ability to work are separate issues.

A physician may conclude:

“The employee has reached MMI.”

while also concluding:

“The employee has permanent restrictions and cannot return to the pre-injury job.”

In that situation, the employee may need vocational rehabilitation, job placement, retraining, or other assistance.

The employee may also have ongoing claims for wage-loss or permanent disability benefits depending on the facts.

What If the IME Doctor Says I Am at MMI but My Treating Doctor Disagrees?

An insurer may rely on its independent medical examiner to claim that you have reached MMI.

Your treating doctor may believe that additional treatment could still result in significant improvement.

That creates a medical dispute.

The fact that an IME physician declares MMI does not automatically make the opinion legally controlling.

A compensation judge may ultimately consider:

• each physician’s specialty;
• treatment history;
• objective findings;
• proposed future treatment;
• response to previous treatment;
• diagnostic testing;
• the factual assumptions underlying the opinions; and
• the medical reasoning offered by each physician.

Sometimes a treating physician should provide a detailed report explaining why additional meaningful improvement remains reasonably anticipated.

Can MMI Change Later?

Yes, in limited circumstances.

A new period of MMI may arise in certain situations when an employee returns to work and later becomes medically unable to continue because of the work injury.

This can become important when an employee returns to work after MMI but later experiences worsening symptoms or becomes unable to continue.

The facts and timing matter.

Can TTD Ever Restart After It Ends Because of MMI?

Minnesota law places significant limits on recommencement of TTD after benefits have ceased because of MMI.

However, there are circumstances in which TTD may potentially recommence, depending on the employee’s work status, medical condition, timing, and applicable statutory requirements.

For example, an employee who returns to work and later becomes medically unable to continue because of the work injury may raise a recommencement issue.

Because these rules are highly fact-specific, legal advice can be particularly valuable.

How Does Retraining Affect the MMI 90-Day Rule?

Approved retraining can significantly affect the analysis.

Minnesota workers’ compensation law contains special provisions involving TTD during approved retraining.

When retraining is approved, the timing for cessation of TTD can differ from the ordinary 90-day MMI framework.

Because retraining cases involve additional statutory rules, injured workers considering retraining should evaluate the issue carefully before assuming MMI will automatically end wage-loss benefits.

Is There a Maximum Number of Weeks of TTD?

Yes.

Minnesota law places duration limits on temporary total disability, subject to statutory exceptions and date-of-injury rules.

MMI is therefore not the only potential limit on TTD.

A worker may encounter a duration limitation independently of the MMI 90-day rule.

What Should I Do If I Receive an MMI Report?

Do not ignore it.

When you receive a report stating that you have reached MMI:

1. Note the date you received it.
2. Save the envelope, email, or other evidence showing when it was received.
3. Read the entire medical report.
4. Determine whether your treating doctor or an IME physician issued it.
5. Look at whether the physician imposed permanent restrictions.
6. Check whether permanent partial disability was addressed.
7. Discuss the report with your treating physician if you believe additional improvement is still expected.
8. Watch carefully for an NOID or other notice from the insurer.
9. Consider speaking with a Minnesota workers’ compensation attorney promptly.

The receipt of an MMI report can start a legal clock affecting TTD.

Should I Hire a Workers’ Compensation Attorney After Receiving an MMI Report?

An MMI report is one of the points in a claim where legal advice can be particularly valuable.

You should strongly consider speaking with an attorney if:

• you are still receiving TTD;
• your treating doctor disagrees with the MMI opinion;
• the MMI opinion came from an IME physician;
• you cannot return to your old job;
• you have permanent restrictions;
• surgery or other treatment is still being recommended;
• the insurer has issued an NOID;
• you may have permanent partial disability;
• you are considering retraining;
• you have been offered a settlement; or
• you are unsure what benefits may continue after MMI.

The consequences of MMI often involve much more than simply counting 90 days.

The employee’s work status, restrictions, medical treatment, rehabilitation, permanent disability, and future earning capacity all need to be considered.

Minnesota Workers’ Compensation Attorneys Representing Injured Workers

Lemmon & Tanasychuk, LLC represents injured employees throughout Minnesota.

We represent workers—not employers and insurance companies—in Minnesota workers’ compensation matters involving:

• maximum medical improvement;
• temporary total disability;
• temporary partial disability;
• independent medical examinations;
• stopped wage-loss benefits and NOIDs;
• permanent work restrictions;
• permanent partial disability;
• denied medical treatment;
• QRC and rehabilitation issues;
• retraining; and
• workers’ compensation settlements.

If you have received an MMI report or have questions about the 90-day rule, we can review your claim and explain how MMI may affect your benefits.

Contact Lemmon & Tanasychuk, LLC for a free consultation.

This article provides general information concerning Minnesota workers’ compensation law and is not legal advice. The rights and procedures that apply depend on the facts of each claim, and workers’ compensation statutes and rules can change.