Let’s break down what MMI is, what happens next, and how to make sure you come out ahead.
MMI just means your doctor believes you’ve healed as much as you can from your injury. You might still have pain or limits, but more treatment won’t make a big difference.
Before MMI, it’s all about getting better—surgery, therapy, recovery. After MMI, the focus switches to what’s permanent: your lasting medical issues and how they affect your ability to work.
This point in your case decides everything—your benefit rate, disability rating, and possible payout. If things aren’t handled right here, you could lose out on serious money.
It starts with your treating doctor. They’ve been following your recovery, so they’ll know when your progress has leveled off. Once they believe you’ve healed as much as possible, they’ll fill out an official form—like the C-4.3 in New York—stating that you’ve reached MMI. That report also includes their opinion on your permanent disability, work limits, and whether you still need any long-term care.
Next, the insurance company’s doctor, called an IME (Independent Medical Examiner), does their own exam. They’ll file a separate report, and—no surprise—it usually says you’re less disabled than your doctor thinks. Sometimes the IME comes first, sometimes second, but both reports end up in front of a judge for review.
If your case has been sitting for a while with no big medical updates, the judge might order both sides to submit their MMI and permanency reports to move things forward.
And when the two doctors don’t agree (which happens all the time), they’re usually questioned under oath in depositions. Each lawyer gets to ask questions, and the judge decides which doctor’s opinion makes more sense.
So, the process looks like this:
When you reach Maximum Medical Improvement (MMI), your benefits don’t just stop—but they do switch gears. Up until now, you’ve been getting temporary disability payments while you heal. After MMI, your case moves into the permanent disability phase, where everything is based on how much lasting damage your injury left behind.
Here’s how it works: once you’re officially at MMI, your temporary checks end and the judge classifies your condition. If you’re partially disabled, you’ll get weekly payments for a set number of weeks based on your percentage of disability. If you’re totally disabled, you keep getting paid—sometimes for life.
There’s also the work search issue. If your doctor says you can still do some kind of job, you might have to show that you’re looking for work within your limits to keep your benefits going. Skip that step, and the insurance company can try to pause your payments.
The upside? Once you’re classified and can show you made a real effort to find work, you usually don’t have to keep proving it.
Once you reach Maximum Medical Improvement (MMI), your case finally has a clear price tag—and that’s when settlement talks usually kick off. Before MMI, nobody can really say what your case is worth because you’re still healing. But once your doctor gives you a disability rating, everyone knows what they’re working with.
If you want to talk through your situation or just get some honest advice, give me, Rex Zachofsky, a call. No pressure, no sales pitch—just straight answers about your options and how to protect yourself.
