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Missouri Supreme Court Rejects MMI as Bright Line Test to Award TTD

December 10, 2015 (2 min read)

Cases that hold maximum medical improvement (MMI)  as a bright line test to end all TTD “should no longer be followed,” according to the Missouri Supreme Court in Greer v Sysco Food Services, SC  94724 (Mo. 2015) 2015 MO Lexis 248 (Lexis Advance), 2015 MO Lexis 248 (

The case involved a worker who crushed his foot in 2006; he treated and was found at MMI. Several years later he had additional surgery performed and he asserted that he was unable to work and was entitled to benefits during his recovery.  The employer objected to the commission’s award of about $19,000 in temporary benefits because it had already found the worker at maximum medical improvement before the surgery.

Missouri courts have previously used MMI as a benchmark which ends the employer’s obligation to pay TTD.  The ALJ  denied TTD. The Commission awarded it.  When the case went to the court of appeals they denied it.  Greer v Sysco Food Services, 2014 MO App. Lexis 1292 (Lexis Advance), 2014 MO App. Lexis 1292 ( The Supreme Court awarded it.

The Commission found that the worker established the disputed subsequent surgery was reasonably related to his treatment and undergoing surgery was a rehabilitative process to trigger a statutory right to TTD.  The employer offered expert opinion that such surgery was not reasonable, doomed to fail, and claimant reported that he still had daily foot pain, had to lie down frequently and believed he could never work again.   He was awarded partial disability benefits.   The court noted the TTD  statute under plain and ordinary interpretation did not use the word MMI and the proper test was the language of the statute and not the judicial construct of MMI that everyone follows.  The court noted it was not abolishing the concept of MMI, it just did not find the Commission’s finding of MMI inconsistent with an award.

MMI does not preclude a finding of entitlement to future medical care.  Poole v City of St. Louis, 328 S.W.3d 277 (Lexis Advance), 328 S.W.3d 277 ( (Mo. App. 2010).  Greer extends that concept further that MMI does not preclude liability for future periods of TTD.    This raises some question whether “maximum” in MMI really has meaning anymore.   Medical experts may now require further explanation of whether a worker is engaged in a rehabilitative process to define periods of disability for time both before and after any determination of MMI.

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug’s Mo. Workers’ Comp Alerts.

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