When a person is injured on the job, they’re entitled to workers’ compensation benefits to cover the cost of medical expenses. However, when reaching maximum medical improvement (MMI), this assistance can be lost, resulting in out-of-pocket costs if further medical care is sought. For that reason, it’s essential to understand the label and how it can impact a case.
What Is Maximum Medical Improvement?
MMI is a categorical term utilized when a doctor thinks an injured person’s healing possibility has leveled out. They may experience some physical improvements over time, but continued treatments are unlikely to assist with the process. Additionally, their pain level should be under control or subsided.
A doctor is in charge of providing an MMI based on the medical evidence available. Typically, it’s the treating physician, but the insurance provider may request a review from their doctor of choice. Once they’ve decided that MMI has been reached, they also determine a disability rating and outline any work restrictions. The information is provided to the injured party, their employer, and the workers’ comp insurer.
How Does MMI Impact Workers’ Comp Claims?
As soon as an MMI label is obtained, the insurer can stop providing temporary workers’ compensation. Often, the change is accompanied by a settlement offer.
However, once agreeing to it, the injured worker gives up their rights to seek further damages. If the injury worsens in the future, they can’t reestablish coverage for new expenses.
What Are the Options?
To prevent an MMI from being prematurely assigned, it’s important to utilize open communication with the treating doctor. Make sure they know about any improvements or changes that happen with specific treatments. It’s also important to let them know about any new or worsening symptoms.
If the MMI is filed by the insurer’s doctor, but the employee’s physician disagrees, the injured party can appeal and request a special hearing. If the worker's primary doctor agrees or is the one who assigns the MMI, they also have the right to request a second opinion.
Additionally, an MMI doesn’t end eligibility to file claims for other types of damages related to the injury. As long as a settlement and release haven’t been accepted, the injured employee can request compensation for lost wages, permanent total or partial disability, and vocational rehabilitation costs. They can also request or negotiate a lump sum to cover the expenses as a whole.
Whether you’ve reached MMI or simply faced resistance with the provider, reach out to Carey & Hamner for guidance. The local attorneys provide dependable assistance to injured parties across Dothan, Ozark, and Enterprise, AL. The law firm offers personalized case reviews and aggressive legal representation to help their clients achieve the compensation they deserve. Find out how they can assist you online or by calling (855) 435-4797 for a consultation.