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Maximal Medical Improvement (MMI)

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Newsletter Articles
Guides Newsletter (2007) 12 (2): 1–3, 9-11.
Published: 01 March 2007
... figures were revised in the Errata to the Fifth Edition of the AMA Guides . Evaluators should note three key points from the AMA Guides: permanent impairment is based on findings at maximal medical improvement (MMI); motion in the spite must be abnormal to qualify for permanent impairment; and imaging...
Newsletter Articles
Guides Newsletter (2001) 6 (2): 1–3.
Published: 01 March 2001
... of medication needed to maintain maximal medical improvement (MMI). The ATS Guidelines contained a scoring system that was used to place the individual into one of six impairment classes. The Fifth Edition uses the same method of scoring the three clinical parameters and using the point score to...
Newsletter Articles
Guides Newsletter (2021) 26 (2): 3–12.
Published: 01 March 2021
....” Patients who present for assessment of causation, maximum medical improvement (MMI), and permanent impairment can be challenging. For some examinees, after 6 to 12 months without outgoing improvement and with appropriate investigation, treatment, and rehabilitation, the examinee can be considered at MMI...
Newsletter Articles
Guides Newsletter (1999) 4 (1): 5.
Published: 01 January 1999
..., introduced a new approach, the Injury Model or Diagnosis-related estimates (DRE) Model. The Injury Model is different from other approaches in the AMA Guides because when the individual reaches Maximal Medical Improvement (MMI), the degree of persisting anatomic or physiologic loss is rated. In contrast, the...
Newsletter Articles
Guides Newsletter (2018) 23 (3): 7–9.
Published: 01 May 2018
...Charles N. Brooks, MD; Christopher R. Brigham, MD Maximum medical improvement (MMI) and its multiple synonyms are important terms to understand because one cannot determine permanent impairment until a condition has resolved or reached a stable plateau with respect to improvement. Further, in many...
Newsletter Articles
Guides Newsletter (2011) 16 (2): 1–7.
Published: 01 March 2011
... scientific knowledge base regarding prescription narcotics for chronic benign pain, evaluators may question how any patient could credibly be considered to have reached maximum medical improvement (MMI) if that patient has a prescription for a narcotic. Hyperalgesia associated with narcotics does not appear...
Newsletter Articles
Guides Newsletter (2003) 8 (4): 4–5.
Published: 01 July 2003
...Christopher R. Brigham, MD; James B. Talmage, MD Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides...
Newsletter Articles
Guides Newsletter (2020) 25 (6): 3–6.
Published: 01 November 2020
... prior industrial disabilities. © 2020 American Medical Association. All Rights Reserved. 2020 American Medical Association California Permanent Disability System Labor-disabling Pre-existing Disability Maximal Medical Improvement (MMI) Permanent Disability (PD) Retroactive Prophylactic Work...
Newsletter Articles
Guides Newsletter (2020) 25 (5): 12–15.
Published: 01 September 2020
... disability once the injured worker is at maximal medical improvement (MMI) or permanent and stationary (P&S). Causation of an injury refers to the reasons why the injury occurred. Did the injury arise out of employment (AOE) and did it occur in the course of employment (COE)? The issue of COE is...
Newsletter Articles
Guides Newsletter (2020) 25 (4): 3–7.
Published: 01 July 2020
... polymerase chain reaction (PCR), and individuals who state they were ill and were not permitted to be tested, will likely have to have the causation question formally adjudicated before physicians are asked to assess for maximal medical improvement (MMI) and permanent physical impairment (PPI). For those...
Newsletter Articles
Guides Newsletter (2021) 26 (1): 9–17.
Published: 01 January 2021
...% indeed were warranted by the severity of the ocular discomfort, such excruciating eye pain might even represent an ocular emergency, and in any event could not be reasonably associated with maximum medical improvement (MMI). Insofar as these four potential adjustments all are within Chapter 12, a simple...
Newsletter Articles
Guides Newsletter (2020) 25 (5): 3–11.
Published: 01 September 2020
...). She has not desired to have sexual intercourse or stimulation since her injury. Accordingly, no impairment rating for sexual dysfunction on a neurological basis was recommended. At maximal medical improvemen (MMI), the examinee has complete incontinence of bowel function. She is managed with...
Newsletter Articles
Guides Newsletter (2019) 24 (3): 10–13.
Published: 01 May 2019
... requires the use of flexion and extension X rays performed at or after maximal medical improvement (MMI) has been established. To qualify for loss of motion segment integrity, measured translation or relative translation on radiographs must be greater than the normal maximal translation documented in the...
Newsletter Articles
Guides Newsletter (2015) 20 (4): 9–16.
Published: 01 July 2015
... to ½ flight and a daily, dry cough. His HP was unresponsive to steroids and he is now at maximal medical improvement (MMI). He smoked 1–2 packs of cigarettes per day since he was 21 but quit 2½ years ago when he began having exertional fatigue. His pulmonary function tests (PFTs) show a forced vital...
Newsletter Articles
Guides Newsletter (2013) 18 (2): 6–10.
Published: 01 March 2013
... bronchoconstriction, mucus production, and cough. Bronchoconstriction causes shortness of breath and wheezing. In between exacerbations, and when at maximum medical improvement (MMI), most asthmatics have normal airflow rates when measured either with a peak flow meter or during spirometry. In 1956, the Board...
Newsletter Articles
Guides Newsletter (2017) 22 (1): 11–16.
Published: 01 January 2017
..., including surgery, was covered by the workers' compensation carrier. However, at maximum medical improvement (MMI), any residual impairment or disability will be apportioned to nonindustrial factors. A June 2014 magnetic resonance imaging (MRI) scan of her right shoulder revealed probable full-thickness...
Newsletter Articles
Guides Newsletter (2015) 20 (5): 3–11.
Published: 01 September 2015
.... He is now at maximal medical improvement (MMI). You are asked to rate his current condition and apportion his current rating between the new and the old injury. How is apportionment determined for musculoskeletal injuries? Each of the 3 most recent editions of the AMA Guides uses a variety of...
Newsletter Articles
Guides Newsletter (2016) 21 (4): 3–8.
Published: 01 July 2016
... in organ system anatomy and function at maximal medical improvement (MMI) and to identify the impact of the impairment on the individual's function, based on the ability to perform activities of daily living (ADLs). The impact on ADLs can provide direct and indirect examples of work ability; however...
Newsletter Articles
Guides Newsletter (2017) 22 (1): 3–10.
Published: 01 January 2017
... comply with Sixth Edition methodology in terms of the establishment of a specific diagnosis (or even a nonspecific diagnosis). 3: The evaluator's documentation indicated that the examinee had not reached a state of maximum medical improvement (MMI) when the evaluation was conducted. The 2014...
Newsletter Articles
Guides Newsletter (2005) 10 (6): 1–9.
Published: 01 November 2005
... utilizes protocol for impairment rating Directed toward diagnosis; rarely utilizes protocol for impairment rating Diagnosis Always Always Always Always Causation Often Often Rarely Rarely Prognosis Often Often Often Often MMI (Maximum Medical Improvement) Usually Often...