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Maximum medical improvement, part 2: contesting a determination

Let’s continue the discussion we began last week of the concept of maximum medical improvement (MMI) in Colorado workers’ compensation cases.

As we noted in our April 17 post, MMI involves a formal determination that no additional medical treatment is reasonably likely to produce further improvement in someone’s medical condition after a work injury.

In this part of the post, we will elaborate further on this part of the work comp process.

A determination of “maximum medical improvement” does not mean someone has a crystal ball and knows with certainty how your condition will ultimately turn out. It means, rather, that the condition has become stable, with no reasonable expectation of further improvement.

As the Colorado Division of Workers’ Compensation explains, it is entirely possible that your condition could get better or worse. The MMI determination, then, is supposed to be based on reasonable expectation. After all, no one has any crystal balls.

This does not mean, however, that you have no choice other than to accept an MMI determination that you don’t agree with. It is possible to contest such a determination.

As an injured worker, you can do this by requesting another opinion about your condition from a different doctor. The procedure is known by the acronym DIME – for Division Independent Medical Examination.

An MMI determination can also be challenged by the workers’ compensation insurer. The occasion for such challenges is typically a disagreement about the permanent disability rating that has been given by the doctor who treated you.

To learn more about our practice, please see our more extended discussion on maximum medical improvement.

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