Can I get my workers compensation if I can't return to work?

When drawing worker’s compensation, the goal is to get you back on your feet as quickly as possible. Unfortunately, that does not always happen, as many people reach the point of Maximum Medical Improvement or MMI without making a full recovery.

What exactly is MMI, and how can it affect your worker’s compensation claim?

Here is some important information you need to know.

Definition of MMI

MMI occurs whenever further improvement of your condition is unlikely regardless of how much medical treatment or rehabilitation you endure. In other words, things are as good as they are going to get. It doesn’t mean you are better, but rather that you have reached a plateau in your recovery and are not apt to go over it. Your treating physician is normally the one who determines an MMI date. However, an insurance provider may sometimes request an independent medical examination to come up with one as well.

Criteria Used to Evaluate

In determining MMI, a doctor may rely on one or more of the following:

• Results from medical testing
• Physician notes
• Examination from specialists

Benefits May Cease

Once MMI has been established, you will no longer be eligible for Temporary Total Disability (TTD) or Temporary Partial Disability (TPD) payments. Rather, your physician will provide you with an impairment rating, which will then be used to determine your disability benefits. The rating may be one of the following:

• Whole Person Impairment (WPI), which involves a permanent impairment of any body part
• Partial Impairment Rating (PIR), or a partial disability which is expressed as a percentage

Medical Treatment Following MMI

Medical treatment may also cease or be greatly reduced. Patients are sometimes afforded medical care only to help them manage their symptoms, but not to assist them with getting better. Co-pays are sometimes required for doctor’s visits, particularly for those who are earning the same or more than before they were injured.

If your case is not yet settled, you will need to see a doctor at least once during a 12-month period. Otherwise, the statute of limitations on your case will expire, and you could be left without recourse.

Returning to Work

Your provider may advise your employer to make certain accommodations on your behalf. This could involve allowing you to sit rather than stand, or transfer you to a different department. It isn’t always possible to make the necessary accommodations, in which case your inability to work will play a key role in negotiating your settlement.

You might also become eligible for Permanent Total Disability (PTD) benefits. In that case, Wisconsin law provides that weekly benefits be paid to you for life. PTD benefits are normally provided only in extreme situations as determined by the Worker’s Compensation Division of the state’s Department of Workforce Development.

Seeking a Second Opinion

If you have reached MMI, yet feel you have not yet reached maximum improvement, you are entitled to a second opinion. Likewise, if your condition worsens within the next two years, you should seek medical attention again. Your physician will then determine whether or not you have experienced a downturn in symptoms, and can then advise as to the necessity of further treatment.

Protecting Yourself After MMI

Upon reaching MMI, many people are faced with the loss of benefits or might find that the disability ratings they were given are inadequate. Insurance companies often pressure doctors to provide MMI ratings, even when further treatment could make a difference. As such, it is not uncommon to receive false MMI ratings either. If you have recently received an MMI rating and are struggling to maintain your benefits, do not try to fight the insurance company on your own. Instead, seek help from a highly experienced worker’s compensation attorney who will make sure your rights are protected.

Are you in need of Workers Compensation Help?

James J Moore of  J&L Risk Management is here to help!

Contact us today for a free workers Compensation consultants if you’ve been injured at work.