What a lot of injured workers don’t realize is that the months leading up to Maximum Medical Improvement (MMI) in Workers' Compensation are where your case is actually won or lost. Every doctor’s visit, every test, and every note in your medical record is building the foundation for your settlement. What you do before MMI can make a huge difference in how your case turns out, let's get into it!
Because by the time you hit MMI, your case is mostly already decided.
MMI is when your condition levels off and your case gets its value. From that point on, it’s about how hurt you are permanently, not right now, and that’s what your settlement is based on.
That number comes from your medical record. All the visits, complaints, and reports created before MMI. If something isn’t documented by then, it might as well not exist. At the same time, the insurance company is actively building their case to pay you less. If you’re not doing the same, you’re falling behind.
The time before MMI is your window to shape the record. Once it closes, that’s what your settlement is based on, whether it fully tells your story or not.
Start with this: if it is not in your medical record, it does not count.
Your doctor only writes what you say and what they observe. If you leave things out, your record will not reflect what you are actually dealing with.
Be specific and consistent. Talk about your worst days, not just how you feel at the appointment. If you are not sleeping or certain movements hurt, say it.
Mention every body part that hurts, even if it seems minor. Some injuries show up later or are connected.
Do not exaggerate and do not downplay. The goal is a clear, honest picture, because your settlement is built off that record.
Treat your case like it matters, because it does. Stay on top of your treatment by going to your appointments, following your doctor’s instructions, and rescheduling anything you miss. Gaps in care can hurt your case.
Keep track of your condition. A simple pain journal can help you note your pain levels, symptoms, and daily limitations, and it makes it easier to give your doctor an accurate picture of what you’re dealing with.
Save all your records. Hold onto test results, reports, and any medical paperwork. Things get lost, and this is your case.
Also, take the time to read your medical records. Check for mistakes or missing information and fix any issues before MMI, because it is much harder to correct later.
The insurance company is working your case from day one with one goal: pay you less.
They will send you to their doctors for IMEs, review your records for gaps or inconsistencies, and use your statements against you. They may also check social media or use surveillance to find anything that does not match your claims.
To fight back, be careful and consistent. Do not speak directly to them, give recorded statements, or send forms without your lawyer reviewing them.
At IMEs, show up on time, be polite, and be honest, but keep your answers short.
They are building a case to pay you less, so your protection is making sure your record stays accurate and consistent.
If there’s one thing I want you to take away from all of this, it’s that the time before MMI isn’t something to coast through. It’s where the real groundwork happens.
If you’re not sure where your case stands, or you just want a second set of eyes on it, feel free to reach out to me, Rex Zachofsky. No pressure, just a conversation.
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