On behalf of Shardel Suber of The Bainbridge Firm, LLC posted in Workers’ Compensation Benefits on Friday, February 10, 2017.
The term “maximum medical improvement” is one that comes up in claims where an injured worker is receiving temporary total disability compensation. A finding of “MMI” is one way in which the BWC or a self-insured employer can attempt to terminate temporary total disability benefits.
The question of whether an individual is at MMI is a critical question that often requires a hearing before the Industrial Commission. At this hearing, the relevant issue will be whether the injured worker has reached a stable treatment plateau at which no further fundamental improvement in the allowed conditions is expected. This can be a source of confusion for claimants, especially where they have not returned to their level of pre-injury ability. Unfortunately, whether an injured worker has returned to his or her pre-injury status has no bearing on whether MMI has been reached.
While a finding of MMI will terminate temporary total disability compensation, it does not represent a termination of the claim. Instead, a finding of MMI can open the door to other forms of workers’ compensation benefits, including permanent partial awards and vocational rehabilitation options. Where the injury is severe enough that the injured worker will be precluded from returning to work in any capacity, the MMI finding can also serve as the start of moving toward permanent total disability compensation.
As indicated above, most MMI findings will require the BWC or self-insured employer to obtain medical evidence finding that an injured worker has reached MMI and then request a hearing on the issue. The earliest that temporary total disability can be terminated is the date of this hearing. However, there is one key exception. If the injured worker’s own physician of record finds that MMI has been reached, the BWC has the ability to terminate temporary total disability as of the date of the physician of record’s opinion, without having to wait for a hearing to be scheduled.