Why You Should Understand Your MMI

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If you’ve been hurt at work and are seeking workers’ compensation payments, it’s crucial to consider the viewpoint of those who are paying the benefits.

Your Employer and Insurance Aim To Terminate Your Benefits

Employers and insurance providers (also known as insurance carriers) have a common goal: to make money. They want you to reach Maximum Medical Improvement (MMI) and then get your benefits terminated.

Learn more about your rights as a worker’s compensation claimant.

What Is Maximum Medical Improvement And How Does It Work?

It is the date that a treating medical doctor determines that you are no longer in a curative treatment stage. They decide that your recovery from your injury has effectively reached a halt.  If you are completely healed or not, you are the best you can be. When the MMI is identified by a physician, the claims adjuster at the insurance firm that pays the worker’s compensation claims receives a notification. 

An employee who manages correspondence and payments for the employer and insurance carrier is classified as a claims adjuster. After obtaining a physician’s opinion that the employee has achieved MMI, a claims adjuster may often suspend its benefits. If a surgeon decides that there is no longer any curative care available, he or she will discharge you from their practice. There is little more that can be said from the standpoint of the treating surgeon.

If Your Injury Prevents You From Working Again

If the condition is significant enough that you are unable to function, you could be eligible for lifetime benefits. For injuries suffered in the course and scope of work, a section of Workers Comp offers lifetime benefits and medical care. 

It should also be clear that work injury is still the leading cause of medical attention and treatment.

Impairment Ratings Come From Where?

A medical professional’s rating of your disability is required to assess how much an accident can affect your ability to function. 

When you hit MMI, you will be evaluated to determine your disability rating. If the treating physician’s determination of this disability level is greater than zero percent, it means the employee has suffered a permanent injury and is eligible for additional benefits.

Impairment Benefits?

These are forms of automatic compensation given to workers based on their percentage of impairment. For example, if an employee earns a six percent impairment rating, they are entitled to compensation of two weeks for each point of impairment or twelve weeks depending on their temporary total disability (TTD) rate.

If the employee’s IR is greater than ten percent, they are entitled to three weeks for each percentage point above ten percent.

How Do Ir And Ib Benefits Impact Compensation Rights?

An employee is entitled to the following Impairment Benefits:

  • For each percentage point of disability from one to ten percent, the employee is entitled to two weeks of benefits.
  • Three weeks of insurance are to be paid for each percentage point of disability from eleven percent to fifteen percent.
  • Four weeks of compensation are to be paid for each percentage point of disability from sixteen percent to and including twenty percent
  • Six weeks of compensation are payable for each percentage point of disability over twenty-one percent.

If the insurance provider fails to pay these benefits within seven days of receiving the IR from the prescribing physician, the employee will be subject to a twenty-percent plus interest penalty.

Furthermore, an employee can only obtain an IR for one portion of his or her body that has been damaged, and the other body parts may also need an IR from a physician. 

Unless the employee is appointed MMI for every part of their body damaged at work, they are also entitled to involuntary disability insurance (wages paid while the employee is unable to work due to a medical illness or injury).