By Law Office of Aili Obandja
An opinion that a worker has reached End Medical Result or Medical End Result may affect temporary disability benefits, permanent impairment, and future medical care in a Vermont workers’ compensation claim. End Medical Result or Medical End Result is sometimes referred to as maximum medical improvement, or MMI.
Under Vermont Workers’ Compensation Rule 2.2000, a worker reaches End Medical Result when the recovery has substantially plateaued and significant further improvement is not expected, regardless of treatment.
Reaching End Medical Result does not necessarily mean that the worker has fully recovered or will never need medical care. It means the condition is sufficiently stable to evaluate the next stage of the claim. An End Medical Result opinion may be premature if further treatment is reasonably expected to produce significant improvement.
Who Decides Whether You Have Reached End Medical Result?
End Medical Result is a medical determination. A treating provider may give an opinion, or the employer or insurance carrier may arrange an independent medical examination and rely on that examiner’s opinion. If the parties dispute End Medical Result, the Vermont Department of Labor may ultimately determine, based on the medical evidence, whether and when the worker reached End Medical Result.
A medical opinion should address whether additional treatment is reasonably expected to produce significant improvement. The passage of time alone does not necessarily establish End Medical Result. If a recommended treatment still offers a meaningful prospect of improving the worker’s condition or function, an End Medical Result determination may be premature.
Disagreements may arise when the treating provider and an independent medical examiner give different opinions. The persuasiveness of each opinion may depend on the provider’s qualifications, familiarity with the worker’s history, review of the relevant records, examination findings, and explanation of whether further treatment is likely to improve the condition.
What Happens to Temporary Disability Benefits at End Medical Result?
An End Medical Result opinion may support a Form 27 seeking to discontinue temporary disability benefits, but the opinion does not itself terminate benefits. Unless the worker has successfully returned to work, the employer or carrier ordinarily must file the Form 27 with the Vermont Department of Labor and provide it to the worker.
The notice must identify the proposed discontinuance date and reasons and include the relevant supporting evidence. Under 21 V.S.A. § 643a and Vermont Workers’ Compensation Rule 12.1200, payments generally continue for seven days after the notice is received.
A worker who disputes the discontinuance may file a specific objection with supporting evidence and request an additional 14-day extension. Because these periods are short, review any discontinuance notice promptly.
End Medical Result is one possible basis for discontinuing temporary disability benefits, but it is not the only one. Return to work, restored work capacity, earnings, or other circumstances may also affect eligibility for temporary benefits under 21 V.S.A. § 642.
Important: End Medical Result and the ability to work are separate issues. A worker may reach End Medical Result and still have permanent restrictions or be unable to return to the former job.
If permanent restrictions prevent the worker from returning to work for which the worker has prior training or experience, vocational rehabilitation—including retraining or job-placement assistance—may be available under 21 V.S.A. § 641.
Does Reaching End Medical Result End Medical Treatment?
Not necessarily. Reaching End Medical Result does not automatically mean that all medical treatment must stop.
Under 21 V.S.A. §§ 601 and 640, compensable medical care may include treatment that helps restore or maintain health, prevents deterioration, or provides appropriate palliative care. Depending on the facts, treatment after End Medical Result may include follow-up visits, medication management, injections, assistive devices, or other care needed to maintain function or manage the work-related condition.
The employer or carrier may still dispute whether particular treatment is medically necessary or causally related to the work injury.
What Happens After End Medical Result?
After End Medical Result, the worker may be evaluated for permanent impairment. The resulting rating may affect permanent partial disability benefits, but it is separate from work capacity, permanent restrictions, and wage loss.
Over the next three weeks, this blog series will explain the evaluation and rating process and how it may affect Vermont workers’ compensation benefits.
What If You Disagree With the End Medical Result Determination?
If you believe the End Medical Result determination is premature:
Read the medical report carefully. Identify the conditions the doctor evaluated, the records reviewed, and the reasons given for concluding that further improvement is unlikely.
Ask your treating provider for a clear opinion. The provider should explain whether additional recommended treatment is likely to improve your condition or function and why.
Gather the supporting records. Preserve treatment recommendations, referrals, imaging, therapy notes, work restrictions, and scheduled procedures.
Review any discontinuance notice immediately. Objection and extension periods may be short.
Do not miss scheduled examinations. Failure to attend a properly requested examination may create additional issues in the claim.
Seek legal guidance promptly. An attorney can assess whether the End Medical Result opinion addresses every accepted condition and whether the carrier followed the required discontinuance procedure.
Can Your Condition Change After End Medical Result?
Yes. A worker’s condition may materially worsen after End Medical Result, or later medical evidence may support additional treatment. Whether that change supports further benefits depends on the medical evidence, its relationship to the work injury, and applicable procedural requirements.
Keep copies of important medical records and workers’ compensation documents even after an End Medical Result determination.
Speak With a Vermont Workers’ Compensation Attorney
The Law Office of Aili Obandja represents injured workers in Vermont workers’ compensation matters and can review the End Medical Result opinion, evaluate the medical evidence, review a Form 27, and assess how the determination may affect workers’ compensation benefits. Call 802-556-3582 to discuss your claim and the next steps that may be available.
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, and applicable deadlines. Consult an attorney about your particular situation.
