In the Loop Vol. 26 — Why Maximum Medical Improvement is the Baseline for a Reliable IME

In medico-legal practice, the timing of an independent medical examination can matter as much as its findings. We regularly see requests for a permanent impairment assessment before the examinee has reached Maximum Medical Improvement (MMI) — the point at which the condition is stable and stationary and no further significant change is expected.

Why MMI Matters

Assessing an injury that is still healing produces a speculative, 'preliminary' report that cannot support a final WPI rating. That usually means a second assessment months later once MMI is reached — expert costs incurred twice over, added administrative burden, and limited value toward settlement in the meantime.

A Practical Rule of Thumb

As a rule of thumb, we suggest a minimum of nine months from injury for physical conditions and twelve months for psychiatric injuries, alongside evidence that symptoms and treatment have plateaued. Asking the specialist to address MMI status as well as WPI in the letter of instruction avoids the cost of a reassessment.

When an Early IME Is Justified

There are exceptions — an early IME can be worthwhile to resolve a disputed diagnosis, establish causation, or assess current work capacity before the clinical picture changes. The key is to undertake an early assessment only where it delivers a genuine benefit to the claim, not simply to move a matter along.