Maximum Medical Improvement Colorado Workers Comp: What Happens After MMI?
Quick Answer: What MMI Means for Your Colorado Workers’ Comp Case
If you’ve been told you’ve reached maximum medical improvement in your Colorado workers’ compensation case, you’re probably wondering what happens next. Here’s the short version: MMI is the point when your authorized treating physician decides your work-related injury has improved as much as it’s going to with reasonable medical treatment—even if you’re still dealing with pain or limitations.
After you’ve reached MMI, several things happen quickly. Your temporary disability benefits (TTD or TPD) usually stop. Your doctor assigns an impairment rating that determines your permanent partial disability benefits. Settlement discussions often begin. And critically, strict deadlines start running that can affect your entire claim. An MMI determination can also trigger the payment of a permanent disability award, which is often the largest monetary benefit in a workers' compensation claim.
What you do in the 30 days after MMI—and after the insurance company files its Final Admission of Liability—can determine whether you keep or lose thousands of dollars in benefits. The Final Admission of Liability (FAL) outlines the benefits that have been paid and any future benefits that may be due. Many injured workers in Pueblo and across Southern Colorado don’t realize how much is at stake during this window. Workers must respond to a Final Admission of Liability within 30 days if they wish to contest the benefits awarded.
If you’ve recently been placed at MMI or received a Final Admission of Liability, don’t wait. Injured workers in Pueblo, Otero, Fremont, Custer, Huerfano, Las Animas, and Crowley Counties can call Johnston Law Firm, LLC at (719) 309-9484 or message us online for a free consultation about your workers’ comp case.
Remember to follow your doctor's advice to ensure proper recovery and avoid disputes with the insurance company.
What Maximum Medical Improvement (MMI) Is – And What It Is Not
Maximum medical improvement is a term that confuses a lot of injured workers. Under Colorado law, MMI simply means your medical condition has stabilized to the point where further medical treatment isn’t expected to produce significant additional improvement. Your treating physician determines you’ve hit a plateau.
This doesn’t mean you’re pain-free. It doesn’t mean you don’t need ongoing medical care like medications, injections, or physical therapy appointments. It just means your condition has improved as much as it reasonably can given current medical circumstances. Reaching MMI does not mean all additional treatment is finished—some workers may still require ongoing or maintenance care after MMI.
Here’s what MMI does NOT mean:
You’re “back to normal” or fully recovered
Your pain is gone
You can automatically return to your old job without restrictions
Your medical treatment is completely finished
While active curative treatment ends at MMI, the worker may still receive approved maintenance care to prevent worsening of the condition.
Only your authorized treating physician in the Colorado workers’ compensation system can officially place you at MMI. Not the insurance adjuster. Not your employer. Not your family doctor. The ATP is the one with the authority to make this determination.
Many Pueblo and Southern Colorado workers are placed at MMI with permanent work restrictions that affect their ability to do heavy labor, construction work, warehouse jobs, or oil and gas positions. Before declaring MMI, physicians should generally have tried reasonable treatment options—physical therapy, injections, surgery when appropriate—to ensure they’ve given your body the best chance to heal.
The Role of the Treating Physician in Reaching MMI
In a Colorado workers’ compensation case, your treating physician—also known as the authorized treating physician—plays a central role in determining when you have reached maximum medical improvement (MMI). This doctor is responsible for overseeing your medical treatment, monitoring your recovery, and making key decisions about your workers compensation claim.
Throughout your recovery, your treating physician will assess your medical condition at regular intervals, adjusting your treatment plan as needed. When your doctor determines that your injury has stabilized and further medical treatment is unlikely to result in significant improvement, they will declare that you have reached maximum medical improvement MMI. This is a pivotal moment in your workers compensation case, as it signals the end of active treatment and the beginning of the process for evaluating permanent impairment and benefits.
If you or the insurance company disagree with the treating physician’s decision about MMI, Colorado law allows for a Division Independent Medical Examination (DIME). This independent medical examination provides a second opinion on whether you have truly reached MMI and what your impairment rating should be. The DIME process is an important safeguard to ensure that the determination of maximum medical improvement is fair and based on accurate medical evidence.
Your treating physician’s expertise and documentation are critical throughout your workers compensation claim. Their records and opinions will influence not only when you are considered to have reached MMI, but also the benefits you may receive for any permanent impairment or ongoing medical care.
What Happens Financially After You Reach MMI
MMI marks a major turning point in your workers’ compensation claim. It’s where temporary benefits end and the question becomes: what permanent benefits will you receive? The amount of benefits you receive after MMI can depend on the amount of missed work and whether you are eligible to receive benefits for lost wages.
When it comes to temporary benefits, to receive benefits for Temporary Total Disability, you must have medical approval for missed work and follow your doctor's instructions.
Throughout the claims process, workers compensation insurance is what provides coverage for work-related injuries and the associated benefits.
Temporary Benefits Stop
When you reach maximum medical improvement, your Temporary Total Disability (TTD) or Temporary Partial Disability (TPD) wage-loss benefits typically end. There is typically a waiting period of two weeks before wage-loss benefits begin, so the duration of missed work is important for eligibility. These are the checks that replaced your lost wages while you were recovering and couldn’t work your regular job.
Impairment Rating Assigned
After MMI, your doctor assigns a permanent impairment rating using the AMA Guides to the Evaluation of Permanent Impairment. This percentage—which can range from 0% to 100%—quantifies the lasting damage from your occupational injury and forms the basis for calculating your Permanent Partial Disability (PPD) benefits.
Permanent Disability Benefits Determined
If you cannot return to any gainful employment because of your work injury, you may qualify for Permanent Total Disability (PTD) benefits, which are paid for life. However, insurance carriers fight these claims aggressively, and proving PTD is notoriously difficult without experienced legal help.
Average Weekly Wage Matters
Your Average Weekly Wage (AWW) calculation affects every benefit you receive. Even small errors in how the insurance company calculated your AWW can cost injured workers in Pueblo and across Colorado thousands of dollars over the life of their claim.
Just received an MMI determination? Before making any decisions about settlement, call Johnston Law Firm, LLC at (719) 309-9484 or message us online. We offer a free consultation to review your situation.
Impairment Ratings and Permanent Disability Benefits in Colorado
The impairment rating your doctor assigns after MMI is one of the most important pieces of your entire workers’ compensation case. This single number largely dictates the size of your permanent partial disability award.
How Impairment Ratings Work
Doctors assign a percentage of whole person or scheduled impairment based on the body part injured. A back injury is rated differently than a finger injury or vision loss. Colorado requires that impairment ratings be determined using the AMA Guides by a Level II accredited provider.
Converting Ratings to Benefits
Colorado law takes your impairment percentage and converts it into a number of weeks of compensation. That number is then multiplied by your weekly benefit rate to produce the total value of your PPD benefits.
For example, an injured Pueblo worker with a 10% impairment rating for a back injury will receive significantly less than a worker with a 20% rating—potentially tens of thousands of dollars less over time. The difference between a “correct” rating and an undervalued one can be substantial.
Insurance Company Tactics
Insurance companies often try to minimize impairment ratings. They may:
Pressure treating physicians to assign lower ratings
Send you to independent medical examinations with doctors known to favor insurers
Challenge ratings they believe are “too high”
This is why having an experienced colorado workers comp attorney review your impairment rating is critical. Attorney Steve Johnston, with extensive Colorado workers’ compensation experience, can review your impairment rating, AWW, and benefit calculations to see if you’re being shortchanged. Call (719) 309-9484 or message us online to discuss your case.
What Is a Final Admission of Liability – And Why the 30-Day Deadline Matters
Shortly after you reach MMI, the insurance company files a document called a Final Admission of Liability (FAL) with the Colorado Division of Workers’ Compensation. This is one of the most important documents in your entire claim—and one of the most dangerous if you ignore it.
What the FAL Contains
The Final Admission of Liability sets out:
Your date of MMI
Your impairment rating
How much PPD or other permanent disability benefits the insurer believes you’re owed
Whether they think your medical care should remain open or close entirely
The 30-Day Deadline
Here’s the critical part: You generally have only 30 days from the date the FAL is mailed to object and request a hearing or a Division Independent Medical Examination (DIME). If you miss this deadline, your claim may close for good on those issues.
What Doing Nothing Means
If you don’t object within 30 days:
You accept the MMI date as correct
You accept the impairment rating as correct
You may not be able to reopen the claim later just because your medical condition worsens
This deadline is absolute. The Colorado Court of Appeals has made clear that missing it essentially locks in whatever benefit determination was made—whether it’s fair or not.
Do not sign or accept a Final Admission of Liability without first talking to a workers compensation attorney. This is especially important for workers in Pueblo, La Junta, Cañon City, Walsenburg, Trinidad, and surrounding communities.
If you’ve received a Final Admission of Liability in the last few weeks, call Johnston Law Firm, LLC immediately at (719) 309-9484 or message us online to protect your rights before the 30-day deadline runs.
Challenging MMI and Impairment Ratings: The DIME Process
What if you believe your treating physician determined your MMI date too early? Or assigned an impairment rating that’s too low? Colorado law provides a way to challenge these decisions through the Division Independent Medical Examination (DIME) process.
What Is a DIME?
A DIME is performed by an independent physician approved by the Colorado Division of Workers’ Compensation. This DIME doctor reviews your medical records, examines you, and issues opinions about:
Whether you are truly at maximum medical improvement
What your correct impairment rating should be
Why DIME Opinions Carry Weight
In most cases, the DIME physician’s opinions are presumed correct and can only be overturned by clear and convincing evidence at a hearing before an administrative law judge. This is a high legal standard, which means DIME decisions are extremely difficult to challenge once rendered.
Who Can Request a DIME?
Both injured workers and insurance companies can request DIMEs. Insurers typically request them when they think your impairment rating is too high. You might request one if you believe you haven’t reached MMI yet or that your rating is too low.
DIME Selection Process
When parties can’t agree on a DIME doctor, they can petition for a DIME panel—a list of three certified physicians. The insurance company and injured worker each strike one name, and the remaining doctor performs the examination.
Strict Deadlines Apply
The DIME process involves strict procedural steps, fees, and deadlines. Missing a DIME deadline can permanently lock in an unfavorable MMI date or low impairment rating—costing you benefits you rightfully deserve.
Unsure whether to request a DIME? Received notice about a DIME requested by the insurer? Speak with Johnston Law Firm, LLC as soon as possible for guidance on protecting your interests.
What Happens to Future Medical Benefits After MMI
Reaching maximum medical improvement (MMI) does not necessarily mean the end of all medical benefits for an injured worker. After you have reached maximum medical improvement MMI, you may still require ongoing medical care to manage your condition, prevent further deterioration, or maintain your current level of function. This type of ongoing care is often referred to as maintenance care.
However, the insurance carrier may challenge the need for further medical treatment after MMI. If there is a dispute about whether additional medical care is necessary, you may be asked to provide medical evidence or undergo an independent medical examination (IME) to justify continued treatment. The insurance company may argue that your medical condition no longer requires active intervention, so it’s important to have clear documentation from your treating physician supporting your need for maintenance care.
In some cases, the insurance carrier may attempt to close out your medical benefits entirely after you reach MMI. If this happens, you have the right to contest the decision and seek legal advice from a Colorado workers comp attorney. An experienced attorney can help you gather the necessary medical evidence, navigate the claims process, and advocate for your right to receive the medical benefits you need for your work-related injury.
Understanding your rights and obligations regarding future medical benefits after MMI is essential. Don’t assume that your medical care will automatically continue—be proactive in communicating with your doctor and your attorney to ensure you receive the ongoing treatment and support you deserve.
Settlements After MMI in Colorado Workers’ Compensation Cases
Many Colorado workers’ comp claims settle after MMI, often after the Final Admission of Liability and impairment rating are issued. Understanding how settlements work—and the risks involved—is essential before agreeing to anything.
How Settlements Work
Settlements in workers’ compensation are usually structured as lump-sum or periodic payments that may close out some or all of your future rights. This can include:
Future medical care related to your work-related injury
The ability to reopen your claim if your condition worsens
Additional benefits you might have been entitled to
The Danger of Settling Too Soon
Settling too soon or for too little—especially right after MMI—can leave you paying out of pocket for surgeries, injections, medications, or lost wages down the road. Insurance companies often make quick offers hoping injured workers will accept before understanding the full value of their claim.
Factors Affecting Settlement Value
Settlement value depends on several factors:
Factor | Why It Matters |
|---|---|
Impairment rating and type of injury | Higher ratings and more severe injuries typically mean higher settlements |
Age, education, and work history | Affects your ability to find alternative employment |
Ongoing permanent restrictions | Limits what jobs you can perform |
Ability to return to prior job | Whether your Pueblo employer can accommodate you |
Risk of condition worsening | Future medical expenses and lost earning capacity |
Settlements Are Usually Final
Once you sign a full and final settlement approved by a judge, it is very difficult—and usually impossible—to reopen your case later just because your condition gets worse. The medical bills you thought wouldn’t come may arrive, but your settlement money will already be spent.
No injured worker should sign a workers’ comp settlement without having an experienced Pueblo-based attorney review it. Call Johnston Law Firm, LLC at (719) 309-9484 or message us online for a free consultation before you sign anything.
Understanding the Settlement Agreement
A settlement agreement in a workers compensation case is a legally binding document that outlines the terms under which an injured worker will resolve their claim with the insurance company. This agreement specifies the amount of compensation you will receive, whether as a lump sum or structured payments, and details any conditions or restrictions that apply to your future benefits.
The settlement agreement may address permanent partial disability (PPD) or permanent total disability (PTD) benefits, depending on the extent of your injury and impairment. It will also clarify whether your medical benefits remain open for future treatment or if you are waiving your right to additional medical care related to your work injury.
It is crucial to review the settlement agreement carefully before signing. The terms you agree to can have a lasting impact on your financial security, your access to medical care, and your employment prospects. Some agreements may include provisions that limit your ability to seek further treatment or reopen your claim if your condition worsens.
A workers compensation attorney can help you understand the full implications of the settlement agreement, negotiate for fair compensation, and ensure that your rights are protected. Before finalizing any settlement, make sure you fully understand what benefits you are receiving and what rights you may be giving up.
Return-to-Work Issues, Restrictions, and Job Options After MMI
After you reach maximum medical improvement, your authorized treating physician usually sets permanent work restrictions based on what you can safely do going forward. These restrictions become a central issue in your workers’ compensation case and your career.
What Your Employer May Do
Once you have permanent restrictions, your employer may:
Offer you a modified work or light-duty job within those restrictions
Return you to your old job in Pueblo (if you can perform it safely)
Decide they cannot accommodate your restrictions and let you go
Benefits After Return to Work
If you can work within your restrictions, you may receive PPD benefits but no longer receive wage-loss checks—even though you may earn less than before. If you cannot work at all due to your original injury, permanent total disability benefits may be an issue, though these are harder to obtain.
Real-World Examples
For Southern Colorado workers, permanent restrictions often create serious problems:
A roofer who can no longer climb ladders
A construction laborer who can’t lift more than 20 pounds
A manufacturing worker who can’t stand for more than two hours
A truck driver who can’t sit for extended periods
A healthcare worker who can’t assist patients with transfers
These restrictions can effectively end careers in physically demanding fields common throughout Pueblo and the surrounding counties.
Additional Options
In some cases, vocational rehabilitation, retraining, or exploring Social Security Disability benefits may be appropriate. Because attorney Steve Johnston also handles social security law and related matters, Johnston Law Firm, LLC can advise on overlapping legal issues that affect injured workers.
You don’t have to navigate job offers, terminations, or pressure to return to unsafe modified work alone. Contact the firm for personalized advice about your situation.
What to Expect After Settlement
Once your workers compensation settlement is finalized, you can expect to receive your compensation according to the terms outlined in your settlement agreement. This may include a lump sum payment or ongoing benefits, depending on what was negotiated. After settlement, you may still be required to attend medical appointments or undergo further treatment if your agreement provides for continued care related to your original injury.
It’s important to understand your responsibilities after settlement. You may need to report any changes in your medical condition or employment status to the insurance company, especially if your benefits are ongoing. Failing to comply with these requirements could affect your eligibility for future benefits.
If you experience new or worsening symptoms related to your original injury after settlement, you should consult with a Colorado workers comp attorney as soon as possible. While many settlements are final, there may be options available if your medical condition changes significantly or if you encounter issues with your benefits.
Staying informed and proactive after your workers comp settlement will help you maximize your recovery and avoid unexpected problems. If you have questions or concerns about your obligations or your rights after settlement, don’t hesitate to seek legal guidance to ensure you are fully protected.
Common Mistakes Colorado Workers Make After MMI
What you do in the weeks and months after reaching maximum medical improvement can dramatically affect your long-term financial security. It is crucial to seek treatment promptly from an Authorized Treating Physician (ATP) to ensure proper documentation and coverage of your medical care and workers' compensation benefits. Here are the mistakes we see injured workers make most often:
Failing to seek treatment promptly or not following your doctor's advice, which can jeopardize your benefits and medical documentation.
Not keeping up with maintenance care or recommended follow-up appointments.
Missing deadlines for filing appeals or paperwork.
Not keeping thorough records of your symptoms, treatment, and work limitations.
Accepting a settlement offer without understanding your rights or the long-term impact.
Hiring a workers' compensation attorney can help injured workers navigate the complexities of the MMI process and ensure they receive the benefits they deserve. An attorney can also assist in fully documenting your workplace injury to challenge medical assessments effectively.
Ignoring the 30-Day Deadline
Many injured workers receive the Final Admission of Liability and set it aside, not realizing they only have 30 days to object. By the time they understand what’s happened, their claim is closed on unfavorable terms.
Accepting the First Impairment Rating
Just because your doctor assigned an impairment rating doesn’t mean it’s correct. Many workers assume the rating can’t be challenged—but the DIME process exists precisely for this purpose. A second opinion through a DIME can result in a higher rating and significantly more benefits.
Returning to Heavy Work Against Restrictions
Employer pressure and fear of losing time at work lead some injured workers to return to duties that exceed their permanent restrictions. This can worsen your medical condition and give the insurance company an excuse to argue that your problems aren’t related to the original injury.
Accepting a Quick Settlement Offer
Insurance companies know that injured workers often need money immediately after their temporary disability benefits stop. They may offer a quick settlement that sounds good but is far below what the claim is actually worth.
Failing to Keep Up with Maintenance Care
If your doctor recommends ongoing medical care like physical therapy appointments, medications, or injections, missing medical appointments gives the insurer ammunition to argue that your continuing problems aren’t related to your work injury.
These mistakes frequently occur in real Pueblo and Southern Colorado cases handled by Johnston Law Firm, LLC—and they can cost injured workers significant money and needed future care.
Treat the MMI stage as a time to slow down, ask questions, and get legal advice before signing or agreeing to anything.
Why Work with Johnston Law Firm, LLC After MMI?
Johnston Law Firm, LLC is a Pueblo-based law firm focused on helping injured workers and accident victims throughout Colorado, including Otero, Fremont, Custer, Huerfano, Las Animas, and Crowley Counties.
Broad Experience for Complex Situations
Attorney Steve Johnston’s six key practice areas—workers’ compensation, personal injury, automobile accidents, estate planning, criminal law, and social security law—mean the firm can help with overlapping legal issues that often arise. If your work injury also involves a car accident in Pueblo, or if you need to apply for Social Security Disability benefits, Johnston Law Firm can assist with those connected matters.
How We Help After MMI
The firm helps workers after MMI in several specific ways:
Reviewing and challenging MMI determinations and impairment ratings that seem too low or premature
Evaluating whether to pursue a DIME and handling the procedural requirements
Checking the accuracy of the Final Admission of Liability and wage calculations
Negotiating fair settlements that account for future medical expenses and wage loss
Representing clients at workers’ compensation hearings across Colorado
Local Knowledge Matters
When you’re dealing with scheduling conflicts, administrative law judges, and claims process issues, working with an attorney who knows the local courts and understands the unique challenges facing workers in Southern Colorado makes a real difference.
To discuss what MMI means in your case and what to do next, call Johnston Law Firm, LLC today at (719) 309-9484 or message us online through our website. Consultations about Colorado workers’ compensation cases are free.
Next Steps: Protecting Your Rights After MMI
Maximum medical improvement is not the end of your Colorado workers’ comp case—it’s the point where permanent benefits, settlements, and long-term planning really begin. The decisions you make now affect your financial security for years to come.
Your Action Checklist After MMI
Step | Action |
|---|---|
1 | Read any MMI paperwork and Final Admission of Liability carefully |
2 | Do not sign or accept anything until you understand its long-term consequences |
3 | Track continuing symptoms, restrictions, and work difficulties |
4 | Follow your doctor’s advice and keep up with recommended treatment |
5 | Consider getting a legal review if you have any doubts about your rating or benefits |
Deadlines Are Unforgiving
The claims process moves quickly after MMI. Missing the 30-day deadline to object to a Final Admission of Liability can close your claim and leave you without recourse if your condition worsens. Don’t let a waiting period or scheduling conflicts cause you to miss critical deadlines.
Get Help From Workers Compensation Attorneys Who Understand Your Case
Whether you’re in Pueblo, Colorado Springs, or anywhere in Southern Colorado, you deserve accurate information about your rights and options after reaching MMI. Johnston Law Firm, LLC offers a free consultation to review your case and help you understand what comes next.
Ready to protect your benefits?
Call Johnston Law Firm, LLC at (719) 309-9484 for a free consultation
Message us online to schedule a time to talk about your Colorado workers’ compensation case and MMI questions
Don’t let the insurance carrier dictate the outcome of your claim. Get the guidance you need to make informed decisions about your future.