# Maximum Medical Improvement (MMI) Explained — State by State > MMI defined, why the MMI date matters, how states define it differently, and what happens when examiners disagree. Verified 2026-08-15. Canonical page: https://medrecords.ai/content-hub/guides/mmi-explained/ --- [Content Hub](https://medrecords.ai/content-hub/) › Guides ## Maximum Medical Improvement (MMI) Explained — State by State Maximum medical improvement is the point where a condition has stabilized and is unlikely to change substantially in the next year — and the MMI date anchors the impairment rating and benefit calculations in most workers' compensation systems. 5 sections·4 sources·Verified 2026-08-15 ✓ 01 ### The definition The AMA Guides Newsletter's jurisdictional review describes MMI as a well-stabilized state unlikely to change substantially in the next year, with or without treatment. New York (12 NYCRR 324.1), Texas (28 TAC 130.1), and Washington's handbook each restate this core with local refinements. 02 ### Why the date matters In Texas, an impairment rating is invalid if it is based on a date that is not the MMI date — the rating and the date must both appear on the Report of Medical Evaluation. In New York, SLU is evaluated at MMI. In California, permanent disability is rated at MMI under the PDRS. 03 ### State differences Rating basis by jurisdiction — 10 states profiled [California — QME — Labor Code § 4660(b)(1) — **AMA Guides 5th** ](https://medrecords.ai/content-hub/states/ca/) [Pennsylvania — IRE — 34 Pa. Code § 123.105; Act 142 — **AMA Guides 6th** ](https://medrecords.ai/content-hub/states/pa/) [Tennessee — IR training — State-approved training list — **AMA Guides 6th** ](https://medrecords.ai/content-hub/states/tn/) [Colorado — DIME — Rule 11 — **Edition set by agency** ](https://medrecords.ai/content-hub/states/co/) [Ohio — IME / DME — BWC policy — **Edition set by agency** ](https://medrecords.ai/content-hub/states/oh/) [Texas — Designated Doctor — 28 TAC 130.1 — **Edition set by agency** ](https://medrecords.ai/content-hub/states/tx/) [Washington — IME — L&I Medical Examiners' Handbook — **Edition set by agency** ](https://medrecords.ai/content-hub/states/wa/) [Florida — IRE / Schedule — 1996 Florida Impairment Rating Schedule — **State schedule, not AMA** ](https://medrecords.ai/content-hub/states/fl/) [New York — IME / SLU — 2018 SLU guidelines — **State schedule, not AMA** ](https://medrecords.ai/content-hub/states/ny/) [Arizona — DME — No canonical state source verified — **Not confirmed** ](https://medrecords.ai/content-hub/states/az/) The MMI date anchors the rating, and the dispute path that settles it is jurisdictional: a DIME in Colorado, a designated doctor in Texas, a panel QME in California. The rating basis each of the 10 jurisdictions profiled here works to is below. - **New York:** no MMI before 6 months in non-surgery/non-fracture cases (12 NYCRR 324.1) - **Texas:** designated doctor certifies MMI and rating; presumptive weight - **Colorado:** DIME resolves MMI disputes within 30 days of the dispute - **Washington:** handbook defines MMI and report content (WAC 296-23-382) 04 ### When examiners disagree The dispute-resolution path is jurisdictional: DIME in Colorado, designated doctor in Texas, panel QME in California. The disagreement usually comes down to whether further treatment could substantially change the condition — the exact question the MMI definition answers. 05 ### Practice points Document the basis for the MMI date (findings, imaging, treatment plateau). Distinguish 'no lasting improvement' from 'no further reasonable treatment.' Keep the date consistent across the report, forms, and rating. ### Sources - [AMA Guides Newsletter: MMI jurisdictional perspectives](https://ama-guides.ama-assn.org/view/journals/ama-guides-newsl/23/3/article-p7.xml) - [12 NYCRR 324.1](https://regulations.justia.com/states/new-york/title-12/chapter-v/subchapter-c/part-324/section-324-1/) - [28 TAC 130.1](https://regulations.justia.com/states/texas/title-28/part-2/chapter-130/subchapter-a/section-130-1/) - [Colorado DWC Rule 11](https://cdle.colorado.gov/dwc/workers-compensation-rules-of-procedure) Medrecords AI Every line cited back to its page. Send one real record set. We return a cited chronology you can check line by line, and a human decides what it means. [Test on a file](https://medrecords.ai/test-a-file/?src=content-hub-mmi-explained) [Book a demo](https://medrecords.ai/demo/?src=content-hub-mmi-explained) ### How Medrecords AI does this work Medrecords AI does this category of work as software. The record is sorted, deduplicated and read in minutes, every statement cited back to its page, and a qualified human signs off on what it means. [Solution — **IME & medical-legal** — Referral packets prepped and cited before the physician opens them. Read more →](https://medrecords.ai/solutions/ime/?src=content-hub-mmi-explained) [Product — **IME report drafting** — Dictation and record turned into a template-complete draft for the examiner. Read more →](https://medrecords.ai/product/ime-report-drafting/?src=content-hub-mmi-explained) [Product — **Medical chronology** — A dated, deduplicated timeline with a citation on every entry. Read more →](https://medrecords.ai/product/chronology/?src=content-hub-mmi-explained) Test it on a file you already have. Send one real record set. You get back a cited chronology and decide for yourself whether the read holds up — no obligation either way. [Test a file](https://medrecords.ai/test-a-file/?src=content-hub-mmi-explained) [Book a demo](https://medrecords.ai/demo/?src=content-hub-mmi-explained) ### Explore the Content Hub [ #### Software & platforms AI and case-management platforms across medical-record review. ](https://medrecords.ai/content-hub/software/) [ #### Service providers & BPOs IME, peer review, retrieval, and BPO providers. ](https://medrecords.ai/content-hub/services/) [ #### State programs Rules, AMA Guides edition, and MMI standards by state. ](https://medrecords.ai/content-hub/states/) [ #### Comparisons Head-to-head vendor and program comparisons. ](https://medrecords.ai/content-hub/compare/) [ #### Guides Editorial reference on report writing, MMI, and validity testing. ](https://medrecords.ai/content-hub/guides/) [ #### Conferences & events Workers' comp, claims, and IME conferences with editorial takes. ](https://medrecords.ai/content-hub/events/) [ #### Directories Link-out rosters of examiners, LNCs, and expert witnesses. ](https://medrecords.ai/content-hub/directory/) [ #### State matrix report All 10 verified state programs, side by side. ](https://medrecords.ai/content-hub/reports/ime-state-matrix-2026/) [ #### Content Hub home The full index of everything in the hub. ](https://medrecords.ai/content-hub/) Medrecords AI ### Minutes per file. Every line cited. 10¢ a page. Bring the hardest file from this page. Get a cited chronology and a report draft in minutes — every line traced to its source page, ready for your review and signature. - Minutes per file, not days - Every line cited to its source page - Flat 10¢/page, duplicates free — no license, no minimums - HIPAA-eligible · SOC 2 audit-ready [Test on a file](https://medrecords.ai/test-a-file/?src=content-hub-mmi-explained) [Book a demo](https://medrecords.ai/demo/) See how Medrecords AI compares with anything on this page — over a 30-minute call, side by side. Last verified: 2026-08-15