In the Loop – Vol. 26 | January 2026
QA Insights
Timing is Everything:
Why Maximum Medical Improvement is the Baseline of a Reliable IME
Are you aware that in the Australian medico-legal landscape, the timing of an Independent Medico-Legal Examination (IME) is just as important as its findings? In VERIFY’s experience, we have observed situations where legal practitioners request a permanent impairment assessment, despite the examinee not having yet reached Maximum Medical Improvement (MMI).
So, what effect does the timing of the examination truly have, and how can you refine your referral timing to maximise the outcome and quality of your report?
Author
Evie Le
Defining the plateau: MMI & Stability
For legal practitioners, the standard for requesting a permanent impairment assessment is when an examinee has reached Maximum Medical Improvement (MMI) or is ‘stable and stationary’, as detailed in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition (‘the Guides’) (p. 19):
An impairment should not be considered permanent until clinical findings indicate that the medical condition is static and well-stabili[s]ed. …
Maximum medical improvement refers to a date from which further recovery or deterioration is not anticipated, although over time there may be some expected change. Once an impairment has reached MMI, a permanent impairment rating may be performed.
Essentially, ‘stable and stationary’ means the condition has reached a plateau. No further significant improvement is expected, regardless of further treatment. Assessing an examinee while they are still healing leads to speculative reports that struggle to stand up under cross-examination. This is why the Guides specify that a permanent impairment rating can only be performed once MMI is reached.
The practical cost of ‘jumping the gun’
In my role as Quality Assurance Manager at VERIFY, our team has flagged numerous cases where an examinee was referred for an IME while they are still undergoing active treatment or awaiting further surgery. This represents a highly problematic (yet easily avoidable!) circumstance.
When an expert assesses an injury that is still healing, they cannot provide a final Whole Person Impairment (WPI) rating, as their condition has not yet stabilised. This usually results in a ‘preliminary’ report, which inevitably leads to the examinee requiring reassessment several months later, upon reaching MMI, at additional cost to the referring solicitor. Not only are you saddled with expert report costs twice over, but the additional administrative burden imposed is significant. A ‘placeholder’ preliminary report is of limited benefit in settling the case.
While there are instances where obtaining an ‘early’ IME and preliminary report are beneficial – which I will discuss shortly – most matters are best served in the interests of all parties by waiting until MMI is reached.
How to identify when an examinee is ready
Determining the moment an examinee reaches MMI requires looking at both the clinical evidence and the time elapsed since the injury. It is also useful to look at whether physical movements have stopped improving and/or medication dosages have remained steady for months.
For matters involving physical injuries, we generally recommend nine months as the minimum ‘safe timeframe’ between injury and IME, to allow for acute healing and stabilisation in the anticipated recovery/deterioration of the condition.
For psychiatric injuries, a minimum of twelve months from the time of injury, plus as much consistent treatment as possible, is recommended. This allows enough time to see how the condition stabilises under consistent treatment.
When an ‘early’ IME is strategically useful
There are rare instances when you might need an IME before an examinee is stable. If you do not require a WPI rating, an early IME and preliminary report may be useful to:
● resolve disputes regarding a diagnosis; or
● establish causation,
before the clinical picture changes. Early assessments are also frequently used to check a person’s current work capacity or to see if a specific treatment is ‘reasonable and necessary’.
Only undertake an ‘early’ IME when you are sure it is of practical benefit to the claims proceedings, as opposed to a misguided endeavour to ‘move the claim along’.
A tailored approach for your case
To avoid the unnecessary cost of a reassessment or a supplementary report, it is advantageous to specifically ask the specialist to address both the MMI status and the WPI within your Letter of Instruction.
Every injury has its own set of complications, meaning standard timelines do not always apply. If a case is time-sensitive or involves complex, multi-system injuries and you need an assessment quickly, we can help.
If you’re ever unsure whether an examinee has reached the medical improvement necessary for permanent impairment to be assessed, please contact our dedicated Quality Assurance Team. We can assist in reviewing the medical status and recommend an optimal timeframe to schedule the assessment.
We’d much rather assist you beforehand, than be the bearer of bad news and potentially delay your claim if a non-MMI examination has been performed!
