Maximum Medical Improvement and Workers’ Compensation

MMI is a physical therapy term that usually means “as good as it gets.” Generally, after they complete medical treatment, job injury victims go through physical therapy. In some cases, there’s a (relatively) happy ending. The victim fully recovers and life goes back to normal. In most cases, however, victims plateau during physical therapy. If they make little or no progress for several weeks or months, insurance companies usually pressure doctors to make an MMI determination, so they can cut off benefits.
MMI disputes highlight the fact that the job of a Tampa workers’ compensation lawyer does not end once the parties reach a settlement or an Administrative Law Judge makes a final decision. Attorneys continue to give injured victims solid legal advice that makes a difference in their lives, now and in the future. The ultimate goal of a workers’ compensation claim is not obtaining benefits. Instead, the ultimate goal is enabling victims to live the rest of their lives free from excess worry about their livelihoods.
MMI Determinations
As mentioned, MMI usually means you’re all better or you’ll never get any better. These MMI determinations usually follow two pathways.
Usually, the insurance company approves a set number of physical therapy sessions. Some victims make steady progress during these sessions and regain 100 percent of the use of an injured shoulder or other injured body part. An MMI determination is a no-brainer in these situations.
In other cases, victims regain partial use during the set number of physical therapy sessions. At that point, if the case has settled, a Tampa workers’ compensation lawyer may be unable to extend physical therapy. That’s one reason victims should be wary of quick, easy settlements.
More often than not, the doctor says the victim is MMI and then performs a residual functional capacity examination. More on that below.
Occasionally, the benefit period expires, and the MMI designation applies as a matter of law. The benefits period in FLorida is usually 104 weeks (two years). The clock begins ticking down as soon as a victim receives any medical treatment.
RFC Evaluations
These evaluations determine what work, if any, an MMI job injury victim can perform. The RFC evaluation must account for not only the victim’s medical condition, but also other factors, such as the victim’s background and the job market.
Assume Lisa, an insurance adjuster, hurt her back at work. She hits MMI without fully recovering. Her doctor determines that she cannot stand for more than twenty minutes.
If Lisa becomes a telephone adjuster instead of a field adjuster, she can probably work while meeting the medical limitation. However, if no telephone adjuster position is available or Lisa doesn’t have the required skills, she probably cannot work.
MMI designations don’t automatically cut off benefits, especially if a Tampa workers’ compensation lawyer has anything to say about it.
In that latter instance, Lisa may be eligible for permanent disability benefits. If any permanent impairment whatsoever, however slight, is noted during the RFC examination, the doctor assesses the victim’s Impairment Rating of Whole Person Permanent Impairment. Based on that rating, the insurance company pays Impairment Income Benefits as compensation for future impairment and loss of function.
Connect With a Dedicated Hillsborough County Lawyer
Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We routinely handle matters throughout the Sunshine State.
Source:
flsenate.gov/laws/statutes/2021/440.02