Maximum Medical Improvement (MMI) is a legal term used in workers’ compensation claims in Jacksonville, NC. It’s important to understand MMI and how it may impact your claim.
Our experienced Jacksonville workers’ compensation lawyers at Horton & Mendez, Injury & Car Accident Attorneys explain maximum medical improvement in Jacksonville, NC, workers’ compensation claims.
What Does Maximum Medical Improvement (MMI) Mean?
Maximum Medical Improvement in workers’ compensation indicates that the injured person has recovered as much as they can expect to recover from their workplace injury. It means that the medical condition has plateaued and most of the healing has already occurred.
While MMI is based on what’s reasonable and expected, the worker may still improve slightly after reaching MMI.
Examples of MMI in Workers’ Compensation
Here are a few examples of how MMI works in workers’ compensation.
Example #1: The injured worker suffers a strained back. They undergo physical therapy and rest for eight weeks. At that point, they’re able to return to work with light restrictions. They still see some minor improvement in the weeks that follow.
Note: A determination of maximum medical improvement doesn’t necessarily coincide with returning to work.
Example #2: A person suffers from hearing loss. The person receives the appropriate evaluation, including hearing aids. Some of their hearing loss is irreversible. The person has reached maximum medical improvement when no additional treatment is reasonably likely to improve their hearing.
Example #3: The worker suffers several injuries in a car accident. Over the next three months, they improve significantly with surgery, medication, rest, physical therapy, and other measures. Despite this care, the person has scars and nerve damage. Additional medical care is unlikely to help.
Reaching maximum medical improvement is an individual determination for each case. Even when two people have similar injuries, no single time period for medical recovery applies to every person.
What is MMI in Jacksonville, NC, workers’ compensation?
Maximum medical improvement means an individual’s medical condition has stabilized and is unlikely to improve further. At this point, their health status is considered stationary.
The North Carolina Industrial Commission (NCIC) defines permanent impairment based on guidelines from the American Medical Association. According to these guidelines, a permanent physical impairment is an abnormality or loss that remains after the individual has reached maximum medical rehabilitation. Permanent physical impairment may be anatomical or functional.
North Carolina workers’ compensation rules apply in Jacksonville and the surrounding areas.
How MMI Impacts Your Jacksonville Workers’ Compensation Benefits
MMI is often a shifting point in a Jacksonville workers’ compensation claim. MMI may shift the case from weekly partial disability compensation and medical care to one of permanent disability and settlement of the worker’s compensation claim.
A premature determination of maximum medical benefits can cut off your access to needed medical care and result in missing the benefits that you deserve. After reaching MMI, your payments may end or change. In addition, MMI may impact what vocational rehabilitation benefits are appropriate.
MMI doesn’t necessarily mean that all medical care is done, as a person may still need maintenance care. But when the person’s health condition plateaus, the extent of their medical condition should be fully known. Those involved should be able to assess ongoing medical needs and functional ability. This information can help the parties reach an appropriate resolution to the case.
Who Determines When You Reach MMI in North Carolina?
The treating physician determines when the worker has reached maximum medical improvement. In Jacksonville, NC, the employer has the right to choose the treating physician.
Although it’s the treating physician who determines maximum medical improvement, the permanent disability rating isn’t a medical responsibility. It’s an administrative function of the workers’ compensation case.
MMI and Permanent Partial Disability (PPD) Ratings
Permanent Partial Disability (PPD) is evaluated and awarded based on the person’s permanent disability, even after reaching MMI. PPD is based on the severity of impairment. Compensation for PPD is for a specific impairment that persists despite the person achieving the highest level of expected medical improvement.
An MMI declaration is not the PPD rating itself. The PPD rating is a separate evaluation that occurs after reaching MMI.
Can You Still Receive Compensation After Reaching MMI?
Yes. Reaching MMI doesn’t automatically end workers’ compensation. You may be entitled to additional medical care if necessary. For example, you may need periodic evaluation of medical supplies or a prosthetic device.
If you cannot return to work, temporary disability benefits may continue for up to 500 weeks. However, the ability to work may be calculated as part of a lump sum settlement.
What If You Disagree with the MMI Determination?
If you disagree with the maximum medical improvement determination, you can contest it by asking the North Carolina Industrial Commission to review the case. To make your appeal successful, you must provide medical evidence. You may also request a second medical opinion. If the employer does not agree to it, you may ask the Industrial Commission to order it at the employer’s expense.
Generally, when you file a motion for an administrative ruling regarding a medical dispute, the Commission must decide the issue within 30 days of filing. They may grant an extension for the employer to respond, and you may ask for an expedited formal hearing. There are also procedures for emergency medical motions.
How a Jacksonville Workers’ Compensation Lawyer Can Help After MMI
When it comes to contesting an MMI workers’ compensation determination, there may be multiple options. It’s important to know what you can do, what steps to take, and the timeline for each step.
A Jacksonville workers’ compensation lawyer can help with these steps, evaluate the permanent impairment rating, and negotiate your workers’ compensation settlement.
Talk to a Jacksonville, NC Workers’ Compensation Lawyer About Maximum Medical Improvement
Maximum Medical Improvement can be an important factor in a Jacksonville, NC, workers’ compensation claim. Horton & Mendez, Injury & Car Accident Attorneys, represent injured workers. Our team understands how MMI works and how it matters to your claim. We can pursue your maximum benefits.
Call or message us to talk to a lawyer and get help today.
