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Maximum Medical Improvement (MMI) in Workers Compensation

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If you have been injured on the job, you may be wondering what happens next. You may be eligible for workers’ compensation benefits, which can help cover your medical expenses and lost wages while you are recovering. Let’s take a closer look at MMI and what it means for your workers’ compensation claim.

Contact a workers’ compensation attorney at Collier Law for assistance with your workers’ comp claim or to learn more about workers’ compensation benefits and your rights.

Workers’ Compensation Law in North Carolina

In North Carolina, workers’ compensation is a no-fault system. This means that it does not matter who was at fault for your accident or injury. As long as you were injured while working, you should be eligible for benefits. Workers’ compensation can help cover your medical treatment related to your injury, lost wages, and more.

What is Maximum Medical Improvement?

Maximum medical improvement (MMI) is the point at which your condition has stabilized and is not expected to improve any further. This does not mean that you have fully recovered from your injury. It just means that you have reached a point where further medical treatment is not likely to improve your condition.

Who Determines When I Reach Maximum Medical Improvement?

The determination of when you have reached MMI is made by your treating physician. They will review your medical records and determine whether or not you have stabilized. In some cases, they may order additional tests or evaluations to reach a determination. In some cases, an employer may also request an Independent medical examination (IME) by a qualified physician to make this determination.

It is important to note that just because your doctor says you have reached MMI does not mean that your workers’ comp case will be closed or that your payments will cease.

What Happens After Reaching MMI?

Once you have reached MMI, your treating physician will prepare a report for the insurance company. This report will detail your injury, your treatment to date, and whether or not you have reached MMI.

The insurance company will then use this information to determine whether or not they will approve any further benefits. If you have already been receiving weekly benefits, these will continue until you either return to work or settle your case.

Will I Stop Receiving Benefits When I Reach Maximum Medical Improvement?

If you are receiving a weekly check and are released at maximum medical improvement, your benefits do not cease. Your weekly check will continue, and you will still have the right to medical treatment. Your benefits cannot be stopped unless you (a) return to work, (b) settle your case, or (c) a judge orders the carrier to stop your payments. The insurance carrier may assign a vocational counselor to assist in return to work. 

What If My Injury Worsens After Reaching MMI?

MMI plays a vital role in determining how much compensation and benefits an injured employee receives. This assessment determines that an injury won’t get better going forward but that doesn’t mean a person can’t get worse. If an individual does experience a deterioration of their condition, their doctor will need to evaluate their condition to determine if the injury is the cause of the symptoms and if they require further treatment.

An injured employee has the right to question or disagree with the doctor’s evaluation. If you believe that you have not reached MMI or that your condition has worsened, you should speak with an experienced workers’ compensation attorney. They can help you understand your rights and options under the law.

What If I Have Not Reached MMI?

If you have not yet reached MMI, you will still be eligible for workers’ compensation benefits. Your case will remain open until you reach MMI or until your doctor releases you from care. If your injury is severe, you may be eligible for long-term disability benefits.

Workers’ Compensation Benefits

Medical Benefits

Workers’ compensation will pay for all necessary and reasonable past and future medical treatment related to your work injury. This includes, but is not limited to, hospitalization, surgery, doctor’s visits, prescriptions, physical therapy, and other types of treatment. You should not have to pay any out-of-pocket expenses for these medical benefits.

Temporary Disability Benefits

If you are injured at work and your doctor says that you cannot return to work, you may be eligible for temporary disability benefits. These benefits will replace a portion of your lost wages while you are out of work.

Temporary partial disability (TPD) is a type of benefit that you may receive from workers’ compensation if you return to work but earn less because of your injury.  The amount of the TPD payment is 2/3rds of the difference between wages earned after the injury and the employee’s Average Weekly Wage. TPD benefits can continue for up to 500 weeks.

Temporary Total Disability

Temporary total disability “TTD” benefits are payments that you receive while you are unable to work at all due to your injury. These benefits last up to 500 weeks maximum with some limited situations that allow extension of that. If your claim is accepted, then an insurance carrier will pay you TTD until you return to work, settle your case, or a judge allows them to stop your check.

Permanent Partial Disability

Permanent partial disability is a condition that results from an injury or illness at work, often referred to as the loss of use of a certain body part Once you reach maximum medical improvement, your doctor will usually assign a permanent partial disability rating to your injured body part. There is a calculation contained in N.C. Gen. Stat. 97-31 to determine the injured body part’s worth.

Contact Collier Law to go through these calculations and discuss getting a second opinion on your rating. You should know that if you are unsatisfied with the rating you receive from your treating physician you are entitled to a second opinion with a doctor of your choosing.

Vocational Rehabilitation Services

If you are unable to return to your previous job due to your injury, you may be eligible for vocational rehabilitation services. These services can help you learn new skills or find a new job that is suitable for your current condition. The cost of these services is covered by workers’ compensation.

Death Benefits

If a worker dies as a result of a work-related injury, the worker’s spouse and dependent children may be eligible for death benefits, which includes pay for lost wages and funeral expenses. These benefits are paid in addition to any medical and funeral expenses that are incurred. The amount of the benefit is based on the worker’s pre-injury earnings and the number of dependents.

To learn more about what these benefits entail and which ones you may be eligible for, contact a workers’ compensation attorney at Collier Law.

Contact an Experienced Workers’ Compensation Attorney at Collier Law

 As an injured worker under North Carolina law, you have a right to fair compensation, and your employer has an obligation to provide it.

Workers’ compensation companies try to rush injured workers through the claims process, which leads to smaller payouts. When you hire a skilled workers’ compensation attorney, you’ll have someone fight for your case. When you’re a client at Collier Law, you are so much more than a number to us: we value our attorney-client relationship and getting the justice you deserve above all else. 

Contact us today for a free evaluation. We will honestly evaluate the details of your case and offer personalized, compassionate legal counsel at no obligation to you. We work hard to earn our clients’ trust and business, and we only get paid when you do.