By Aili Obandja, Esq.
Yes. End Medical Result means that your recovery has plateaued and significant further improvement is not expected, regardless of treatment. It does not mean your condition cannot worsen or that you will never need additional treatment.
Medical Care May Continue After End Medical Result
Under 21 V.S.A. § 640, your employer or its workers’ compensation insurance carrier remains responsible for reasonable and necessary medical care related to your compensable work injury, subject to any applicable settlement or order. Depending on your condition, that care may include follow-up visits, medication, injections, assistive devices, or treatment to relieve symptoms or maintain function.
Your employer or its insurance carrier may dispute whether the treatment is medically necessary or related to your work injury.
Does More Treatment Mean You Are No Longer at End Medical Result?
Not automatically. Palliative treatment—care that relieves symptoms or maintains function—can be appropriate even when significant further improvement is not expected. Needing palliative treatment does not automatically change your End Medical Result status.
If your physician recommends treatment intended to improve your underlying condition, ask whether significant improvement is expected and whether you remain at End Medical Result. More treatment alone does not change your End Medical Result status; its purpose and expected effect matter.
Your condition may change after you reach End Medical Result. That is different from arguing that you had not reached End Medical Result in the first place. For that issue, see Get Help With a Vermont End Medical Result Dispute.
How Could a Change Affect Your Benefits?
A worsening condition does not automatically reinstate wage-replacement benefits or increase a permanent impairment award. Each benefit involves a different question:
Medical treatment: Do you need additional reasonable and necessary treatment related to your work injury?
Temporary disability benefits: Has your work-related condition changed your ability to work and caused lost wages? Your medical evidence should explain whether your restrictions prevent you from working or reduce what you can earn, and whether you remain at End Medical Result.
Permanent partial disability benefits: Has the change caused additional permanent impairment? A new medical assessment may be needed once your condition has again stabilized. Any additional payment must account for applicable credits for previously paid impairment and the effect of prior agreements or orders. See How Does a Permanent Impairment Rating Affect Vermont Workers’ Compensation Benefits?.
Prior Awards and Time Limits Matter
Under 21 V.S.A. § 668, the Vermont Commissioner of Labor may review an award based on a change in conditions, either on the Commissioner’s own motion or at the request of an interested party. The statute permits review within six years of the date of the award, with at least six days’ notice to the parties or their attorneys. On review, the Commissioner may end, reduce, or increase the compensation previously awarded, subject to the statutory maximum and minimum. The review does not affect money already paid.
This six-year provision concerns review of an award; it does not itself set an end date for all medical care. Review prior agreements, settlements, and orders, and seek advice about the deadline and procedure that apply to the benefits you are requesting.
What Should You Do If Your Condition Changes?
Seek appropriate medical attention. Describe your new or worsening symptoms, when they began, and how they affect your daily activities and ability to work.
Ask your physician to document the change. The medical report should identify what changed and when, its connection to your work injury, recommended treatment and expected benefit, current work restrictions, and whether you remain at End Medical Result. Tell your physician about any injury or new work activity since the original injury so the physician can address its role.
Notify the employer or insurance adjuster handling your claim in writing. Describe the change and identify the treatment or additional benefits you are requesting. Provide supporting medical records and restrictions, and keep a copy of your request. If you have an attorney, coordinate the request through your attorney.
Request approval for additional treatment. You or your treating provider may request written preauthorization from the employer or carrier. The request should include medical records explaining why the treatment is needed and how it relates to your work injury. It should also describe what treatment is proposed, how long it will last, and how often you will receive it.
Preserve your records. Keep treatment notes, imaging, referrals, bills, work restrictions, records of missed work or reduced earnings, and prior workers’ compensation agreements and orders.
Seek help promptly if benefits are denied or have not resumed. Ask for the reason in writing and consult an attorney about presenting new medical evidence to the Vermont Department of Labor and requesting review. Do not assume notifying the adjuster alone satisfies a filing deadline.
Get Help After a Change in Your Work-Related Condition
I represent injured workers in Vermont workers’ compensation matters. I can review your new medical evidence, prior agreements or orders, and whether you may qualify for additional treatment or benefits. Call 802-556-3582 to discuss your claim.
This blog is for general informational purposes only and is not legal advice. Reading it does not create an attorney-client relationship. Workers’ compensation rights depend on the specific facts, medical evidence, prior agreements or orders, and applicable deadlines. Consult an attorney about your particular situation.
