Workers’ Compensation: What Is Maximum Medical Improvement?

If you have been injured on the job, you’re in a difficult position, and you’ll look to workers’ compensation for the compensation you need to seek your fullest recovery. Your employer’s workers’ compensation insurance provider, which is covering your claim, is intent on keeping the amount you receive as low as possible. Doing so involves determining that you have reached your maximum medical improvement sooner rather than later. Better understanding what maximum medical improvement means and how it works can help you protect both your ongoing health and your workers’ compensation claim. If you’ve been injured on the job, seeking the professional legal counsel of an experienced South Carolina workers’ compensation attorney early in the process is well advised.

How Workers’ Compensation Works

Before you can fully understand what your maximum medical improvement refers to, it’s important to have a basic understanding of how workers’ compensation works. Workers’ compensation is designed to protect both you and your employer in the event that you are injured on the job. Workers’ compensation claims take negligence out of the equation, which means that you can seek compensation for your losses even if your employer isn’t to blame for the accident that caused you to be injured. Although the compensation is less robust than it would be in a personal injury claim, you don’t have to concern yourself with proving fault in the matter. Additionally, the company that employs you doesn’t have to be overly concerned with the prospect of defending itself from accident-related lawsuits. The idea is to balance the benefits experienced by each side (your coverage and your employer’s peace of mind regarding lawsuits) with the concessions made (the less complete coverage you receive and your employer’s need to cover your claim regardless of fault).

Maximum Medical Improvement 

Maximum medical improvement (MMI) is the legal term used to determine when an injured employee has recovered from their work-related injury to the degree possible. MMI means reaching the point where no further improvement is expected – according to a designated medical professional. Once your MMI is established, your workers’ compensation status of temporary total or temporary partial disability is likely to end, which means that the insurance company handling your claim can cease paying benefits. As such, the insurance company would prefer that you reach your MMI as swiftly as possible. Since your ability to reach your most complete recovery is likely to hinge on obtaining just compensation, however, your best interests are best served when this determination is not rushed.

MMI Doesn’t Necessarily Mean Fully Recovered 

While you may think that a determination of MMI means that you have fully recovered from the injuries you sustained on the job, such recovery isn’t necessarily the case. Some injuries lead to permanent physical or cognitive losses that can never be fully recovered from, which is not to mention the chronic pain that some claimants must continue to cope with – regardless of how much medical treatment or rehabilitation is received. MMI signifies that the claimant has arrived at a stable condition and that no additional improvement is expected.

What Happens Next? 

Once you’ve reached the classification of MMI, your treating physician may determine that you, nevertheless, require ongoing medical care. If you’ve suffered permanent injuries and have reached your MMI, your doctor will assign an Impairment Rating Evaluation (IRE), which is a percentage from 0 to 100 that designates the level of impairment you’ve suffered (the degree to which you’ve lost functioning or ability). This IRE number will help guide any future compensation you may receive. Factors that can affect your impairment rating include:

  • The medical procedures you’ve undergone, such as surgery, physical therapy, pain management, and more
  • Any work restrictions placed on you
  • Any decrease in range of motion identified
  • Any ongoing pain you experience

While this IRE is an important element when it comes to determining the percentage of your disability award, it is not the only consideration. The following can also play a role:

  • Your age
  • Your level of education
  • Your prior work history
  • Your need for future medical care

Your workers’ compensation should address your ability to move forward beyond your injuries and to continue supporting yourself.

Reaching Your MMI

It’s important to note that every workers’ compensation claim is unique in all of the following:

  • The person involved
  • The injuries they have sustained
  • How well they respond to treatment
  • How quickly they recover to the degree possible

Further, medical professionals sometimes disagree about when a claimant has reached their maximum medical improvement. In other words, it can be challenging from the outset to gauge how long it will take you to reach your MMI.

Workers’ Compensation and Disability

If you are determined to have a permanent impairment that involves more than one body part, or you are determined to have more than 50 percent disability in relation to your back, you may be deemed permanently and totally disabled. You will be entitled to permanent and total (P&T) disability benefits if you are unable to work at the job you had when you were injured or at any other job that is reasonably available to you within the context of the current economy. Permanent and total disability has a maximum duration of 500 weeks. Any temporary partial or temporary total benefits you received will be subtracted from your total disability amount, which is generally paid in a lump sum.

Turn to an Experienced South Carolina Workers’ Compensation Attorney for the Help You Need

If you’ve been injured on the job, the distinguished South Carolina workers’ compensation attorneys at McCravy Law recognize the gravity of your situation and are committed to skillfully advocating for your claim’s best possible resolution. Your recovery and your future are too important to leave to chance, so please reach out and contact or call us at 864-388-9100 for more information about how we can help you today.

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