MMI, and Impairment, in Workers’ Compensation Cases: Why They Matter

The unfortunate reality is that when we are injured on the job (or in any kind of accident), we might heal…but we may never get back to our pre-accident self. Our injuries may get better and improve, and then stop healing and improving.

Maximum Medical Improvement

When that happens, an injured worker reaches a point that is called maximum medical improvement or MMI.

When MMI is reached, and the decision to say someone has reached MMI, can be more subjective than you might think. Different doctors may have different opinions on how much healing you can still anticipate, and you might feel you are improving and getting better with medical treatment, or conversely, that despite continuing to get medical care, you’ve improved as much as you can.

Why It’s Important

MMI is important in workers’ compensation cases, because your workers’ compensation doctor will, at some point, declare you to have reached MMI. Workers’ compensation doctors do this, because when you reach MMI, workers’ compensation will cut off your benefits–your ability to get free medical care to treat your work related injuries will end.

Sometimes, a doctor will declare you to be at MMI, to avoid having to provide you with a costly procedure. For example, a workers’ compensation doctor may declare you at MMI, knowing that if he or she does not, you will need surgery that your employer will have to pay for. So, by incorrectly declaring you to be at MMI, the employer/insurance company can avoid having to pay that cost.

When the workers’ compensation doctor says you are at MMI, but you feel that continuing medical care is still helping you and that you are still improving, you have the makings of a workers’ compensation case–a dispute with the workers’ compensation carrier over whether or not they should continue to provide you with medical care.

Your Impairment Rating

Not only that, but the workers’ compensation doctor will, once he or she declares you to be at MMI, also provide to you an impairment rating, which is the percentage that your overall body is affected by disabilities related to your accident and injuries.

Once again, the doctor, being paid by the workers’ compensation carrier, may have an incentive to give you a lower impairment rating, showing that you are healthier than you really are or able to do more than you really are.

This is because the higher the impairment rating, the longer or more workers’ compensation benefits (such as recoupment of lost wages) that you get.

The system provides workers with a certain amount of weeks’ wages, based on every percentage point of impairment that an injured worker has. So, it is in the company’s, employer’s, and insurance company’s (but not the worker’s) best interest to give an injured worker the lowest percentage impairment rating possible.

If you’re curious, the State has a calculator you can use that allows you to put in information about your injury to see how much in wages you will get from workers’ compensation based on information about your injuries.

If you go to the site, you will notice there is a place to put in the percentage of impairment rating–the lower the percentage, the less injured workers receive.

Are you being wrongfully denied workers’ compensation benefits? Schedule a consultation with our Tampa workers’ compensation lawyers at Barbas, Nunez, Sanders, Butler & Hovsepian today for help.

Sources:

ncci.com/SecureDocuments/Impairment_Interactive.html

ama-assn.org/practice-management/ama-guides/ama-guides-evaluation-permanent-impairment-overview