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Maximum Medical Improvement (MMI)

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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 (2020) 25 (6): 13.
Published: 01 November 2020
...James B. Talmage, MD This is a brief introduction to maximum medical improvement (MMI), which is pertinent to permanent impairment assessment. The definition and explanation of MMI according to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) , Sixth Edition, is discussed...
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 (2014) 19 (1): 8–10.
Published: 01 January 2014
...Charles N. Brooks, MD; Christopher R. Brigham, MD Most acute injuries and illnesses resolve, ie, reach maximum medical improvement (MMI), within days or weeks and without permanent impairment. Fractures, more severe soft tissue injuries and illness, and conditions that require surgery take longer...
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 (2000) 5 (5): 1–3.
Published: 01 September 2000
...Charles N Brooks, MD The term maximum medical improvement (MMI) is important to understand because an evaluator cannot determine permanent impairment until a condition is permanent and stationary. In addition, in many jurisdictions MMI represents the date beyond which at least some benefits cease...
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 (1): 3–11.
Published: 01 January 2020
... Edition, should be used in conjunction with the AMA Guides to the Evaluation of Permanent Impairment, ( AMA Guides ), Sixth Edition. A person who is prescribed opioids is not yet at maximum medical improvement (MMI) and cannot be rated. Referral for substantiation of the diagnosis and for initiation of...
Newsletter Articles
Guides Newsletter (2018) 23 (3): 10–13.
Published: 01 May 2018
... comparison with her previous size, shape, contour, and comparison with her right breast. Ten years previously, she had received double lumen prostheses (saline on the outside and silicone gel on the inside). One year later she was found to be at maximum medical improvement (MMI) and described no signs or...
Newsletter Articles
Guides Newsletter (2014) 19 (6): 8–12.
Published: 01 November 2014
... presented below describe how different providers can inconsistently provide ratings, yet the AMA Guides methodology should produce a specific and reliable rating. Chapter 17, The Spine and Pelvis, is frequently used when determining a permanent impairment rating at maximum medical improvement (MMI...
Newsletter Articles
Guides Newsletter (2013) 18 (3): 3–6.
Published: 01 May 2013
... rated using the rating systems for the affected organ system when the individual is at maximum medical improvement (MMI). In addition, the risk of future impairment should be assessed when the individual is at MMI, and that rating should be combined with the rating for organ system vascular compromise...
Newsletter Articles
Guides Newsletter (2011) 16 (1): 12–13.
Published: 01 January 2011
... lateral part of his left elbow. At maximum medical improvement (MMI), the individual complained of moderate pain at rest and severe pain with repetitive forceful gripping and grasping. Radiographs taken at MMI showed a healed distal radius fracture in anatomic position with no posttraumatic arthritis and...
Newsletter Articles
Guides Newsletter (2011) 16 (2): 8–9.
Published: 01 March 2011
... not alter the rating for a cervical or lumbar fusion at the time the patient's condition is determined to be at maximum medical improvement (MMI). The term adjacent segment degeneration refers to the presence of radiographic findings of degenerative disc disease, including disc space narrowing...
Newsletter Articles
Guides Newsletter (2003) 8 (1): 1–10.
Published: 01 January 2003
... remain idiopathic. The patient must be at maximum medical improvement (MMI) before permanent impairment is rated, but determining MMI is challenging, particularly if neuropathy is secondary to an underlying medical condition such as hypothyroid or diabetic neuropathy or toxic exposure. A table in this...
Newsletter Articles
Guides Newsletter (2002) 7 (4): 6–7.
Published: 01 July 2002
... the Evaluation of Permanent Impairment ( AMA Guides ) specifically addresses IDET. Evaluators who use the AMA Guides, Fifth Edition, apply the Diagnosis-related estimates (DRE) method to assess impairment when the patient is at maximum medical improvement (MMI). Because the long-term effects of IDET...
Newsletter Articles
Guides Newsletter (2019) 24 (5): 14–15.
Published: 01 September 2019
... excluded. Also notice in Table 17-6 (page 575, 6th ed), Functional History Adjustment: Spine, that a GMFH value of “0” means the patient is asymptomatic. If the patient is indeed asymptomatic at maximum medical improvement (MMI), then impairment Class 0 should be chosen, not Class 1. Because a GMFH value...
Newsletter Articles
Guides Newsletter (2021) 26 (1): 3–6.
Published: 01 January 2021
... improvement (MMI). The appropriate rating would be a diagnosis-based estimate of 2% LEI or 1% WPI. While the medical literature contains insufficient data to formulate any firm conclusions, assuming adequate information is available regarding the tear and amount of meniscus resected in a partial...
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 (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 (2013) 18 (6): 1–9.
Published: 01 November 2013
... techniques; they were called methods rather than models. The DRE Method remained the principal means to evaluate an individual having an injury, but there are changes in when and how it is used. Impairment is rated only when an individual has reached maximum medical improvement (MMI); and the choice of a...