Reaching MMI: What's Next

Posted By Law Offices of Wax & Wax || 29-Dec-2017

According to the American Medical Association, Medical Maximum Improvement (MMI) is defined as “the point at which a condition has stabilized and is unlikely to change (i.e. improve or worsen) substantially in the next year, with or without treatment. Although signs and symptoms of the condition may way and wane over time, further overall recovery or deterioration is not anticipated.”

In other words, this means that a patient’s condition has improved as much as it is going to with treatment. However, a patient may continue to receive proper medical care such as continued doctor visits, medication, or psychiatric treatments. Additionally, a patient who has reached MMI can also receive future care.

I Reached MMI, So What Now?

In the context of workers’ compensation claims, if you are receiving benefits and reach MMI, your condition will be assessed, and the doctor will determine a disability rating. You must obtain a written statement from your physician when you have reached MMI, which should also contain your disability rating. Based on the rating, the doctor will advise your employer on what tasks you may or may not perform due to your condition—known as work restrictions.

Furthermore, the disability rating is a key factor in negotiating your settlement. Parties (your attorney and your employer’s insurance carrier) can conduct an adequate evaluation of your future injury-related care.

If the insurance company admits permanent disability, it will be done through a document called a “final admission of liability.” If this occurs, any temporary disability benefits you have been receiving will cease.

However, an injured worker also has the right to contest the insurer’s determination of benefits pursuant to the final admission of liability by requesting an administrative hearing to review the insurance carrier’s decision. You have 30 days from the date the final admission is mailed to object to the decision and request Division Independent Medical Examination (DIME), which is essentially a “second opinion” about your medical condition.

In conclusion, these matters a complex and require experienced legal representation from a qualified attorney. At the Law Offices of Wax & Wax, our Glendale workers’ comp lawyer understand the uncertainty and concern injured workers can have when it comes time to declare MMI and always act to protect their long-term interests and well-being. Whether you need to release your employer from your workers' compensation claim or fight your workers' comp provider for the appropriate, continuing benefits, our team can ensure that your goals are aggressively and competently pursued.

For more information, contact us and request a free consultation today.

Categories: Workers' Compensation
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