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What Is Maximum Medical Improvement?

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When a person is injured on the job, they are, with rare exceptions, entitled to workers’ compensation coverage under their employer’s policy. Workers’ compensation will give you appropriate benefits while you are injured, but it will not last forever – sometimes it will not last as long as you and your family might want it to. Once you reach what doctors call maximum medical improvement, your benefits will almost certainly cease, and it is important that you understand that that may not coincide with what you might consider “back to normal.”

The Workers’ Compensation Process

When you are injured on the job, your employer’s workers’ compensation coverage will pay you benefits to help cover wage losses, but will also send you to the doctor to be evaluated. These evaluations will be shared with your employer so that you both are on the same page regarding the extent of the injury and the method of treatment. The treating physician will make numerous judgment calls regarding just how badly you are injured, which will be factored into the benefits you are awarded by the state. For example, if your treating physician believes you capable of light duty work, such as a desk job, you will receive less in the way of benefits than you would if you were held to be incapable of any work at all.

Ultimately, one of two things will happen that will end your workers’ compensation benefits or at least significantly curtail them. Your injury may simply heal on its own and you will resume work as you did before, or either your treating physician or an independent medical examiner (IME) engaged by your employer’s insurance carrier will pronounce that your injury has reached maximum medical improvement (MMI). MMI is defined as the point during a person’s recovery when their condition is as stable as it will ever become – in other words, when no further medical improvement is possible. Either way, your benefits will cease unless it can be determined that your employer is responsible for continuing treatment.

MMI Matters

Maximum medical improvement is a critical measure of a person’s fitness for work, and affects almost everything about a workers’ compensation claim. Impairment rating stems from MMI, and impairment rating affects your overall amount of benefits and any future claims – for example, if you are ruled to be permanently partially disabled, you may be entitled to further payments. Rehabilitation or preventative treatment may still be covered regardless of impairment rating, depending on your doctor’s determination, but any other benefits will stop simply because no more improvement can be gained from remaining out on leave.

Only the treating physician or an independent medical examiner (or a judge from the Office of the Judges of Compensation Claims, which would have authority if your employer disputes your claim’s validity) may make the decision that MMI has been reached, but once it has been, it means all wage loss benefits cease. Be advised that once you agree to settle your case, you are not entitled to any further benefits, even if your injury worsens. If you have not settled and your injury worsens past what your treating physician has defined as MMI, you are entitled to seek a second opinion, but this is no guarantee that the determination will be overturned.

Contact An Orlando Workers’ Compensation Attorney

If you are determined to have reached maximum medical improvement too soon, it can lead to cessation of benefits before your injury has healed enough to permit a return to work. If you have questions or concerns about your own medical improvement, having an experienced attorney on your side can help ease the workers’ compensation process. The Orlando workers’ compensation lawyers at the Hornsby Law Group are ready and willing to try and help you clear up any concerns about your case. Call us today to set up an appointment.

Resource:

leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.02.html

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