COVID-19: Achieving Maximum Medical Improvement and Assessing Permanent Impairment

Abstract

Patients with coronavirus disease 2019 (COVID-19) may have persistent symptoms beyond the normally expected illness resolution. This disease was not diagnosed before late 2019, and therefore, we have more limited experience in understanding all of its outcomes. Thus, clinical, functional, and permanent impairment assessment is challenging. Symptoms including fatigue, dyspnea, and cognitive difficulties have been referred to as “post-acute COVID,” “long COVID,” or “long haulers.” Patients who present for assessment of causation, maximum medical improvement (MMI), and permanent impairment can be challenging. For some examinees, after 6 to 12 months without outgoing improvement and with appropriate investigation, treatment, and rehabilitation, the examinee can be considered at MMI. However, because this disorder is new and appropriate treatment may be unclear, the time to achieve MMI is less certain. Physicians may use approaches in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), to help define MMI. As science evolves, so will our understanding of how to evaluate chronic problems associated with COVID-19.