Maximum Medical Improvement

Workers Compensation Claim? What Happens When You Reach MMI?

Maximum Medical ImprovementEarlier this week, I saw a blog post titled “What Happens To Workers’ Compensation When You Reach MMI?” It’s a good question. It’s one we frequently answer for callers to our office. Unfortunately, that other blog post really failed to answer the question. Instead, it simply listed a number of different types of injury. It was short on answers but long on SEO keywords. So, I’ll try to discuss several actual events that are often triggered by Maximum Medical Improvement (MMI).

What is MMI? Maximum medical improvement is that point in time where the injured worker has reached their maximum healing. Does it mean you are totally healed? In some cases, yes. But, in many cases the worker is not totally healed. Instead, the worker is left with a permanent disability. Some people suffer permanent injuries and need continuing care to maintain their level of function. Under our work comp system, you are entitled to medical care for your injuries.

So, let’s discuss the two biggest events triggered by the MMI date in an Alabama workers’ compensation claim. And, I’ll add that the date of MMI is not always clear or agreed-upon.

The Insurance Company Is Likely To Cease Paying TTD (Temporary Total Disability) Benefits When You Reach MMI

The days and weeks after a serious work-related injury can be scary. Suddenly, you are thrust into a world of pain and worry. Will I get better? Will I be able to work?

Our work comp system provides temporary benefits for this period of time. These benefits are paid when you can’t work while recovering from your injuries. You can receive TTD (Temporary Total Disability) if you are physically unable to work while recovering. Alternatively, you might receive TPD (Temporary Partial Disability) if only able to do a portion of your work while recovering.

Your MMI date is important to these temporary benefits. MMI means you are no longer “recovering.” You may need continuing care but you have reached your maximum improvement. Because of that, the insurance company will stop paying temporary benefits.

When you reach MMI, temporary benefits will stop. And, the issue becomes whether or not you have a permanent disability. This can be a difficult time for many workers, especially those workers who continue to be totally disabled. If that is the case, talk to an experienced work comp attorney who can help you get the permanent benefits you deserve. Before hiring an attorney, make sure he or she has actually tried work comp claims to verdict in Alabama. Too many lawyers refuse to fight for their clients in court.

The Court Can Finally Determine Your Level Of Permanent Disability When You Reach MMI

As I mentioned in the prior section, once you reach MMI the issue is whether or not you have a permanent disability. Under Alabama law, the trial court cannot determine the extent of your final disability until you reach MMI. That means your case cannot be tried until then.

When you reach MMI, your lawyer can begin preparing your claim for trial. That means, your lawyer can gather the medical opinions as to disability. Your lawyer can have you evaluated by a vocational expert. Your lawyer can prepare and fight to get the permanent benefits you deserve.

The Date Of Maximum Medical Improvement May Be Disputed (The Court Determines The Correct Date)

In many cases, the date of maximum medical improvement is easy to determine. Maybe you had a back injury and saw the same orthopedist throughout your care. After treating you, that doctor determined you were at MMI. But, not all cases are that simple.

What if you were treated by more than one doctor and these doctors had different opinions on MMI? This happens all the time when a worker has an accident with multiple injuries.

What if your doctor initially assigned a MMI date but you later relapsed and required more care? This sometimes occurs. When it does, an injured worker may receive a new MMI date.

I could describe numerous issues which lead to differing MMI dates or confusing MMI dates. I’ve seen so many strange situations over the years. The MMI date is important because it factors into both your temporary and permanent disability payment times. In a disputed case, the trial court decides the proper MMI date. That means the court will likely look at all the medical evidence and determine the proper date for MMI.

Be Ready For Maximum Medical Improvement

The date of MMI is important. At MMI, you will likely lose temporary benefits. At MMI, the issue becomes one of permanent benefits. At MMI, the trial court can finally decide your claim. The date is an important trigger. Don’t be caught by surprise.

During your medical care, listen to your doctor. Many doctors discuss healing times. Some doctors begin mentioning MMI as the date approaches. If the doctor does not mention MMI specifically, the physician may start talking about other similar topics including:

  • Releasing you
  • Your need for easier or less physical work
  • Your ability to return to work (or not return to work)
  • Your need to learn to live with your limitations
  • Permanent restrictions
  • Testing for limitations (like a Functional Capacity Examination or FCE performed by physical or occupational therapists)
  • Your permanent Impairment Rating

These are all clues that your date of MMI is approaching. If you have legal counsel, you need to discuss these with your counsel so he or she will be ready to move the case forward. If you suffered a serious work-related accident, hire an experienced counsel who understands the hurdles that must be overcome to prepare your case fully. In Alabama, workers compensation benefits are limited. So, it is important you understand all the benefits to which you are entitled.