Maximum Medical Improvement (MMI) is an important concept to know if you’re involved in a New Jersey workers’ compensation claim. To account for how heavily it can influence the status of a case, we’ve put together a guide on what the term means and how it influences your status in a workers’ compensation claim. Knowing is half the battle, so learn all you can about what goes into your case to have the best chance at a favorable outcome.
What is Maximum Medical Improvement (MMI)?
MMI is a term used in medical rehabilitation to denote the point at which a patient’s condition has stabilized and no further improvement is expected. In simpler terms, it is when an injured worker has recovered as much as they’re going to from their work-related injuries.
Determining exactly when an injured worker has reached MMI can be complex. It typically involves a comprehensive medical evaluation conducted by a healthcare professional experienced in managing workplace injuries. The medical professional will consider several factors, including the worker’s medical history, the severity and nature of the injury, the treatment provided, and the worker’s response to treatment.
This assessment is not a one-time process but an ongoing evaluation that occurs across multiple appointments, as the patient’s condition may change or improve over time. MMI is only declared when the medical professional is convinced beyond a reasonable doubt that the patient’s condition has stabilized and further treatment will not yield significant improvement in their state of health.
The Importance of MMI in Workers’ Compensation Claims
Reaching maximum medical improvement has a significant impact on the overall claims process and benefits for workers’ compensation. It often serves as the yardstick to determine when an injured worker’s temporary benefits cease and when they start receiving permanent benefits.
MMI plays a role in assessing permanent disability ratings, acting as the point at which a medical expert can evaluate the lasting effects of the work-related injury and determine to what extent it will impact the worker’s future earning capacity and their ability to carry out tasks. The disability rating assigned will directly influence the level of compensation the injured worker will receive.
MMI and Your Benefits
The declaration of maximum medical improvement triggers alterations in the level and type of benefits available to you as an injured worker. Upon reaching MMI, you may be eligible to receive permanent partial disability or permanent total disability benefits, depending on the evaluation outcome.
Transitioning from temporary to permanent benefits means the end of receiving compensation for lost wages due to the inability to work. Instead, the benefits will focus on the income lost because of the reduced working capacity caused by the permanent injury.
Challenges in Determining MMI
Determining someone’s point of MMI is not always straightforward and can become a major disagreement between insurance companies, employers, and medical providers. Each party may have conflicting interests, potentially leading to conflicts regarding when MMI has been reached.
Misjudging MMI can significantly impact a claim’s outcome, resulting in either an overpayment or underpayment of benefits. As such, everyone involved is trying to ensure the MMI determination is accurate and fair.
Legal Rights and Responsibilities Concerning MMI
As an injured worker approaching MMI, you have specific rights regarding medical treatment and evaluations. You are entitled to receive all necessary and reasonable medical care for your injury or condition until you reach MMI.
Employers and insurance companies also have responsibilities in this process. They must ensure that you receive adequate medical treatment, and they cannot arbitrarily decide when you have reached MMI without medical evidence. This prevents people from losing their compensation for the sake of profits, ensuring a patient-focused approach that actually prioritizes healing.
Steps to Take as You Approach MMI
Staying informed and proactive is the best way to help yourself as you approach MMI. Regularly communicate with your medical providers, understand your rights, and ask questions if something is unclear.
Gathering and preserving all relevant documentation and medical records that may influence MMI evaluations is equally important. This can include medical reports, bills, and any correspondence related to your treatment and recovery.
Get Help With Your Workers’ Compensation Claim Today
Understanding the role of MMI in New Jersey workers’ compensation claims is important to receive adequate care and compensation. It significantly influences your claim’s progression, benefits, and outcome. The more informed you are about MMI, the better positioned you will be to make informed decisions concerning your claim.
For personalized legal advice regarding workers’ compensation and maximum medical improvement, contact the Law Offices of Craig A. Altman today. We can provide tailored guidance based on your specific situation. Call us at (856) 327-8899 to schedule a free consultation.
