IME vs surgeon's recomendation

[Bummer Knees]

BB

Do you think a person is MMI at 4 months after a replacement?

I do realize the insurance company's goal is to place an IW at MMI soon an possible so they can terminate benefits, but looking at it from the medical view, dosen't make sense.

[Cycler]

Your are post stage 4 physical therapy after 4 months and most have returned to full activity including low impact sports. MMI may be considered anytime between 4 to 6 months and there is an inverse relationship between being out on sick leave at 5 months post-op and returning to work at all. *

Taken from the on-line edition of the Essentials of Physical Medicine and Rehabilitation p 403.

So I guess you can reasonably be deemed MMI at this point barring complications.

[Bummer Knees]

I am on SSD so if my TTD ends I will be okay. I do have other wc related injuries that will be addressed at a hearing next week.

My medical needs to stay open and I will fight in court to keep it open, if needed.

[Lilly]

Cycler....this may be true for young IW's who were active and fit to begin with....but this is not BK's case.

Lilly

[Bummer Knees]

The physical therapist working with me after surgery made the comment, "If you hadn't waited 30 months after your injury to have surgery you would be making a lot more progress in physical therapy"

As if the wait was my choice.

[Bad Boy Bad Boy]

Bummer, I waited 15 years to get my Total Knee Replacement done, that puts the therapist statement as a possible for some, and not for others. Do I think MMI at 4 to 5 months. That is a tough one. For I know it took me awhile also. But, if I was performing work duties as being say moderate, I think I could of handle it, as long as I kept up my routines for my knee.

Being MMI for your Knee is nothing to worry about. You have other issues that need to be addressed anyways. And each one of those will also have to be at MMI also, so saying Part 1 is MMI, where Parts 2, 3 and 4 are not MMI.

[Cycler]

The knee rehab literature does not suggest that age is an independent variable for recovery. What is stated as a factor is the pre-surgery activity level and is evidently a significant predictor of surgical outcome.

That's not to say THIS surgeon will not prevail in declaring THIS patient not MMI till 12 months if thats the case but the original question was :
"Do you think a person is MMI at 4 months after a replacement?"
and it seems that is often the case, seems pretty early to me too.

[Bummer Knees]

Cycler
In your post you write, “the pre-surgery activity level and is evidently a significant predictor of surgical outcome”

Previous to surgery the condition of my knee would keep me homebound for days because it would not support weight.

On my good days, which were few, if parking in the closest accessible parking place I would be able to make inside the door to where scooters would be kept., in the local store. This journey would be made with the assistance of a cane, one that I still use.

After surgery my surgeon apologized to my family saying he did not realize my knee was as bad as it was.

I go to court 4 days after the IME appointment to add my back to my claim. Due to the delay in treatment (30 months) after my injury I now have back problems of lumbar spine. I cope daily with nerve pain down my legs and in my feet.

I also have mobility problems with the use of my right foot.

As I posted before I really do not care if the TTD ends, my priority has always been to get my medical taken care of.

I wish you well.

Bummer Knees

[Cycler]

that's unfortunate.

[Bad Boy Bad Boy]

Meeting the Doctor
The doctor will ask questions to formulate opinions about your injuries. Be careful that you understand each question before you answer it. For example, if the doctor asks, "How do you feel now?" you should find out if he wants to know how you feel that minute or at this point after the injury. You may feel pretty well at that particular moment, but may have had pain associated with your injury earlier in the day, so it's important to be specific and accurate in your answers.

Take time to answer all questions carefully. If a question is unclear or confusing, don't be afraid to ask the doctor to explain or rephrase the question before you answer. If you make a mistake, correct it immediately.

Avoid unnecessary elaboration. Remember that the doctor is hired by the insurance company to help its case. So, while you should always answer a question politely, honestly, and completely, don't ramble on or elaborate unnecessarily.

Try to remember what goes on during the exam in as much detail as possible, but don't take notes in front of the doctor or bring a tape recorder into the exam - that could make it appear that you are more interested in getting money for your injuries than in improving your health.

Be honest and precise. During the exam, you'll be asked to describe your pain and discomfort. Since pain is subjective, it may be best to describe your pain by referring to what areas of your body hurt when you do certain movements or activities. Be as truthful and accurate as possible. No one likes complainers who exaggerate their injuries. On the other hand, don't understate your pain and the problems it causes you.

Behave consistently. The doctor will be observing you during the exam and looking for inconsistencies. For example: You tell the doctor that you can't turn your head to the right. Later, the doctor goes to your far right and asks a question. You turn your head all the way to the right to look at the doctor. Your physical action of turning your head is inconsistent with your prior response.

The Physical Exam
After taking a medical history, the doctor will make a physical exam. The exact procedures vary based on your injuries and the doctor.

Here are things to avoid:

Do not volunteer any information not requested.
Do not discuss who is at fault in your case.
Do not discuss settlement of your case.
Do not allow the doctor to take X-rays or conduct other diagnostic tests.
Do not take any written or psychological tests such as a MMPI.
Do not go to any other doctors or facilities without your attorney's approval.