What is Maximum Medical Recovery and Why Does it Matter in a Personal Injury Case?

by Gina Corena

posted in Las Vegas Personal Injury Attorneys on December 21, 2022

What is Maximum Medical Recovery and Why Does it Matter in a Personal Injury Case?

Nevada rates high in car crashes that result in injury, with over 236,000 accidents between 2016 and 2020. There are frequent drowning incidents in lakes or pools, and many individuals suffer harm from a variety of accidents. All these injuries can end in limited recovery for their victims, and this becomes important during their personal injury lawsuits against those responsible.

Ideally, victims will heal and be able to return to their previous activities, but this is not always the case. Maximum Medical Recovery (MMR) or Maximum Medical Improvement (MMI) are terms used to rate how well someone has recovered from their injuries. In personal injury claims, it can mean the difference between having barely enough to pay the bills and living comfortably with a disability or other permanent medical condition.

What Maximum Medical Recovery Means

MMR means one of two things. In an ideal situation, the victim fully recovers and is able to return to work and other parts of their life. Usually, these cases involve more minor injuries. However, when the patient has been severely injured, they may not be able to return to their former state of health, no matter how much treatment they receive.

Victims who suffer paralysis, amputations, major burns, brain injury, or other catastrophic damage will likely face restrictions for the rest of their lives. They may be unable to continue in their careers, or they may be so severely hurt that they require lifelong nursing care. Regardless of the circumstances, it is critical to note what percentage they have healed and determine compensation for the percentage they lack.

For example, if the doctor determines that someone will only recover 80% of the abilities they had before their accident, the remaining 20% must be accounted for in the settlement or jury award. Many lawyers won’t finalize a client’s damages calculation until the individual has received a statement of their expected MMR. This action prevents the client from facing a future without sufficient financial relief for their suffering.

MMR Is Determined by a Doctor

The determination of what constitutes MMR for a particular client comes from their treating physician, often in consultation with doctors who advised or treated the client for specific injuries. Surgeons, therapists, and other specialists forward their final reports to the primary care doctor, who then assesses and provides the final MMR rating.

The insurance company may disagree with this rating and ask the client to submit to an Independent Medical Exam (IME) from another practitioner. This is to ensure the injuries are properly assessed as permanent or not. 

Maximum Medical Recovery Doesn’t Mean “Fully Healed”

When a victim has reached their maximum recovery level, it doesn’t mean they do not still need treatment. Determining what ongoing care is needed for the remainder of their life is critical to creating a fair and appropriate list of damages. All the past, present, and future expenses must be included, so the client does not end up in financial distress after a few years. 

As with any personal injury case, the damages are calculated for both economic and non-economic losses. Each expense with a specific price is considered economic, so a victim’s surgeries, ongoing doctor visits, and continuing physical or mental therapy can be estimated for however long they expect to need it. However, the less tangible non-economic losses must also be considered in the compensation total when the MMR is less than 100%.

In some instances, a victim may develop a mood disorder such as anxiety, depression, or PTSD as a result of their injury. They may have enjoyed a very active lifestyle that is now curtailed because of someone else’s negligence. Being unable to pursue their personal goals and suffering new conditions as a consequence must be factored in when their lawyer presents the claim for these losses.

Maximum Medical Recovery and Elective Treatments

Medical Recovery Law

In some situations, a victim may try elective surgery or other treatment to recover more fully. They may even ask to be included in medical trials to heal their conditions. On the other hand, a doctor may recommend a treatment such as spinal fusion surgery to repair damage to the victim’s back but the patient declines because of the risk.

The use or avoidance of elective treatments is between a victim and their physician and varies in each personal injury case. If the patient decides to use pain management techniques instead of having surgery, the doctor will factor this into their assessment for the MMR rating. Victims should have careful discussions with both their physician and lawyer to determine how their decisions will affect the claim for compensation as a result.

How MMR Affects When to Ask for Compensation

During a personal injury trial, one of the actions the attorney will take is to issue a demand letter to the person at fault. This letter outlines the damages and other demands that the victim is requesting. Sometimes, the lawyer will wait until their client reaches their MMR, but in other situations, they will send the letter sooner.

If a victim has suffered extreme injuries that will likely exhaust the insurance policy coverage amounts, the attorney will often send a letter as soon as the client is diagnosed. Let us suppose a person suffered a car accident that caused a Traumatic Brain Injury (TBI), but the at-fault driver’s insurance only covers up to $100,000 of medical treatment per person. The victim’s expenses will easily be higher than the policy limit, so it makes sense to send the letter right away.

Regardless of whether the victim pursues an insurance claim settlement or moves to a personal injury lawsuit in court, it is vital that they allow their attorney to guide them. Asking for a settlement before the full extent of injuries is known can leave them with too little compensation. Each situation is unique, and the circumstances will dictate how the MMR rating factors into the claim.

If you are dealing with a personal injury case, please call 702-680-1111 or contact us online so we can start discussing your case.

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