While maximum medical improvement (MMI) sounds like a status that most injury victims would hope to reach, in actuality, it is often a significant concern. This is because MMI could mean the end of workers’ compensation benefits.
MMI means that an injured worker has reached a point in their recovery at which their medical condition is not expected to improve, even with continued treatment. At this point, the employer and the insurance company may begin attempting to resolve the claim and try to close the books.
Depending on the severity of a work injury in South Carolina, the doctor will determine if an injured worker is permanently impaired, and if so, to what extent. A physician’s impairment rating is only one factor considered by the South Carolina Workers’ Compensation Commission. Some providers may be motivated to classify individuals as having reached MMI when such decisions will benefit employers. The MMI classification does not necessarily mean that your workers’ compensation case is over, or your benefits have come to a halt.
If you are dealing with concerns about MMI under the workers’ compensation system in South Carolina, legal representation can be crucial, especially if you need continuing medical care or treatment despite the MMI determination. For 50 years, Jebaily Law Firm, P.A., has made a difference in the lives of injury victims and their families throughout South Carolina.
Our workers’ compensation attorneys can put our skills and resources into action before and after an MMI designation and fight to make sure that you are able to recover the entire range of benefits that should be available to you. We can discuss your legal options in a free consultation. Call us or contact us online to set up an appointment. Our offices are located in Florence and North Myrtle Beach.
MMI means that an injured worker has recovered from his or her injury as much as possible and will not likely improve with any additional medical treatment. When a physician determines someone has reached the MMI plateau, he will issue an impairment rating, any future work restrictions, and recommendations for future medical treatment that will help maintain the injured worker’s level of functioning.
Smith v. South Carolina Department of Mental Health The maximum medical improvement impairment rating becomes more complicated in the case of a worker dealing with a permanent injury that is likely to provide an entire lifetime of challenges.
An impairment rating is usually denoted as a percentage of injury to a certain part of the body. The impairment rating is based on factors described in The American Medical Associations Guide to Impairment, such as whether a person undergoing surgery, how much strength was lost, whether there is a decreased range of motion, and the pain levels involved.
When a worker has reached MMI, the South Carolina Workers’ Compensation Commission will assign a percentage of disability, or it will be assigned pursuant to a settlement. The percentage of disability is not the same as an impairment rating.
A worker could reach MMI for one injury, but still, be eligible for ongoing treatment for another injury arising from the same workplace accident.
Certain types of workers’ comp MMI rating issues are more complicated than others, such as workplace injuries to the back. When a back injury encompasses more than 50 percent of that part of the body, the worker will be presumed to be permanently and totally disabled. Back awards based on 49 percent or fewer injuries have a 300-week maximum.
Wage loss issues can affect workers whose income has decreased because of their injuries. Workers can be entitled to compensation based on the difference between their pre-injury average weekly wage and their post-injury average weekly wage. Wage loss benefits can be paid out for up to 340 weeks and consist of two-thirds of the difference between a pre-injury average weekly wage and post-injury average weekly wage.
Permanent and total disability (P&T) is awarded by the Commission if workers have suffered injuries that will prevent them from returning to work in any capacity. P&T awards are customarily 500 weeks in length minus any temporary total disability already paid.
Lifetime weekly benefits are available to workers’ comp-eligible claimants who the Commission finds qualify for P&T benefits and who have suffered either permanent and severe brain damage, paraplegia, or quadriplegia. The claimant will receive their compensation rate every week for life, with the individual’s life expectancy included in the evaluation.
A study in the Journal of Risk and Insurance found that South Carolina had a mean impairment rating of 19.0 and a final disability rating of 23.4. The same study indicated that 89.7 percent of claims had an impairment rating, while 92.2 percent of claims had a disability rating, and there was a 0.454 correlation between the two ratings.
Simply put, your recuperation is one of the driving factors in an MMI rating. You are more likely to be classified at MMI as you continue to heal, and your condition improves.
Always note any discomfort that you are still feeling or any continued limited range of motion for a body part when you are undergoing any evaluations by a medical professional. This helps healthcare providers understand when an injury continues to cause you problems.
Are you worried about how reaching MMI could impact your South Carolina workers’ compensation benefits? You do not have to deal with these complicated and technical issues by yourself. Instead, let an experienced workers’ compensation attorney take charge.
With offices in Florence and North Myrtle Beach, Jebaily Law Firm, P.A., has a respected record of success in workers’ compensation cases. For example, we’ve recovered $288,981.50 for a client who was originally denied a workers’ compensation claim for a head injury that lead to quadriplegia, and $308,469 in an occupational exposure case.