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Maximum Medical Improvement in Workers' Comp

Workers’ compensation laws in North Carolina provide benefits to employees who are injured on the job or contract occupational diseases. Inherent in any workers’ comp claim and timeline is the issue of Maximum Medical Improvement, or MMI. This is an important concept to understand because it is the point at which your benefits are calculated differently and the insurance adjuster will determine whether you are eligible for permanent disability benefits under workers’ comp.

When a worker is first injured in the course of their employment, they may have to take time off of work. Medical bills can quickly pile up, and lost wages can be significant. Fortunately, workers’ comp provides for almost immediate payment of medical expenses and lost wage benefits. It can be important to speak with an experienced workers’ comp attorney to help ensure that you are receiving the maximum amount of benefits you deserve or to appeal a workers’ comp application denial. The procedure for obtaining benefits can be complicated and insurance adjusters are too often focused on closing out files rather than ensuring that a worker receives the long-term benefits they deserve.

Disability payments under workers’ comp can be temporary or permanent, and depend on whether the disability to the limb and the person’s wage earning capacity is partial or total.

Timeline

When an employee is first injured to the point that they have to miss work, temporary disability payments under workers’ comp kick in after the employee has had to miss seven (7) days of work. If they are injured to the point where they have to miss at least 21 days of work, they will then receive the first week’s disability. The amount of these payments will depend on whether the injury is partial or total. Disability payments through workers’ comp are referred to and calculated as temporary benefits up through the person’s healing period.

Injury -> Healing Period (Temporary Disability after 7 days of work missed) -> MMI -> Permanent Disability

MMI is an important point along the workers’ comp timeline. Once the employee is deemed to have reached MMI, they are eligible to apply for a permanent disability award based on permanent bodily injury or loss of earnings.

What is Maximum Medical Improvement?

At a certain point, the employee’s medical doctor will determine that he or she has reached “Maximum Medical Improvement,” or MMI. This is, simply put, the doctor’s way of saying the injury is as “good as it’s going to get.” MMI means that the employee’s condition has reached the point in their healing where no other reasonable treatment can be done to help them improve, although all reasonable treatment options should be exhausted first.

MMI does not mean a person cannot still receive periodic treatment. Some injuries are such that they require medication, evaluation or other treatment for years to come. It is important for the doctor to be clear about what care the employee will require going forward once MMI is reached.

If the employee is receiving workers’ comp benefits and their doctor determines they have reached MMI, the doctor will assess their condition and assign them a disability rating. Depending on the rating, the doctor may also recommend work restrictions to the person’s employer. For example, if you injure your leg but are eventually able to return to work in some capacity, your doctor might medically advise you to perform sedentary tasks that allow you to be seated.

Issues With MMI

If you disagree with your doctor’s evaluation that you have reached MMI, you are entitled to a second opinion. Similarly, if you reach MMI but do not settle your workers’ comp case and your injury gets worse within the next two years, it is important to speak with your doctor and a workers’ comp attorney.

Navigating the workers’ comp process requires coordinating with your employer, the North Carolina Industrial Commission (the organization that handles workers’ comp claims here), and the insurance company. Each of these parties has largely their own interests at heart and can often encourage injured workers to take a settlement when that might not be in the injured parties best interest. For these reasons it can be important to have a knowledgeable workers’ comp attorney at your side fighting to ensure you receive the compensation you deserve. Arnold & Smith, PLLC is an aggressive civil and criminal litigation firm with offices in Charlotte, Mooresville and now Monroe North Carolina. Our offices handle workers’ comp and personal injury claims and would welcome the opportunity to help you with yours. Contact us today to schedule a consultation with one of our dedicated workers’ comp attorneys.

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