When a person gets injured on the job, they look to workers’ compensation to pay their medical expenses and lost pay. Those are the significant losses faced after being injured on the job.
During the filing process, there is usually a lot of insurance terminology that the typical layman may find difficult to understand. Even to receive the benefits can be mind-boggling. One of the things that confuse people injured on the job is the maximum medical improvement (MMI) requirement.
This is a very significant provision that can define many things regarding your request for workers’ compensation. Hence, you should evaluate its significance and how it influences you going forward.
What is the MMI?
The maximum medical improvement (MMI) is a topical issue in workers’ compensation. The term and its meaning have even baffled state regulators and attorneys, who’ve asked multiple questions about the constantly changing rules.
The MMI determines what adequate compensation for the injured employee is and whether a settlement should arrive.
The level of injury suffered is not yet placed on the table and only surfaces when the MMI has been ascertained. Additionally, the injured worker and their attending doctors will be mired with multiple medical tests and documents to meet the prerequisites.
Both the physician and the patient do not always fully comprehend the requirements of the MMI, and this could determine if the worker gets any settlement or maybe come out getting a meager amount.
The MMI is interpreted as the juncture where the injured worker’s medical circumstance has steadied, and further healing is doubtful. Despite therapy or rehabilitation, the worker’s situation will improve no further, despite not being fully healed.
Maximum level means the person is fully healed, partially disabled, or permanently disabled. A partially disabled person can only work temporarily for the rest of their life.
Who Determines the MMI?
The MMI boils down to a licensed Physician chosen from the worker’s compensation team, a situation which most injured workers and attorneys scoff at. This is even after treating physicians make their determination.
In other words, workers’ compensation does not take the name of a treating physician and always gets an Independent Medical Examination (IME) to deduce if the victim is entirely at MMI.
Once the medical report from the IME has been obtained, a copy of that summary is then given to the worker’s doctor to be reviewed.
The worker also gets a copy. If the injured worker’s doctor agrees with the IME results, that date marks the end of the provisional compensation to the Physician.
However, should the treating physician disagree with the outcomes, the claim is then sent to the council or a judge for a hearing and decision.
MMIs Importance To Your Benefits
The MMI is vital to the injured worker’s benefits as it will decide the benefits and reimbursement that they obtain from their workers’ compensation. The MMI is deemed as the dead-end street and assumes what impacts the worker will meet over the next few years as a result of their accident.
The medical improvement also specifies reasonable payment. Accordingly, if the IME deduces that the worker has an early MMI date, they may discover that their benefits are reduced considerably.
Furthermore, after a maximum medical improvement is established, a worker could be entirely or partly impaired but go back to their job based on what tasks are available. If the worker has severe injuries and is permanently unable to work, then they can proceed to receive benefits for a lifetime or to the state’s limit.