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What Happens When Your Medical Recovery Ends?

Thu Oct 7th, by Work Injury |

To begin negotiating for compensation following a work-related injury or illness, your attorney may want to wait until the point of maximum medical improvement (MMI). That being said, what does MMI actually entail in the context of a workers’ compensation claim? What can be done at this point in the process, legally speaking?

If you have received a work-related injury or occupational illness in North Carolina, be sure to contact M. Reid Acree, Jr., as soon as possible. Mr. Acree has over 30 years of legal experience, including extensive experience in workers’ comp—this includes working with occupational illness claims. You can reach out and begin scheduling a consultation through Mr. Acree’s website.

What Is Maximum Medical Improvement?

Simply put, MMI is the point at which you fully recover from your injury. However, if full recovery is unlikely, MMI is whichever point at which your injury or condition stabilizes. Essentially, regardless of the amount of additional treatment you receive, it won’t be possible for your recovery to progress any further.

Your medical care providers will determine when they believe you’ve reached MMI. This will be based on the current capabilities of medical science and its established ability to treat your particular condition or ailment. However, determining MMI isn’t always a straightforward process. This must be decided on a case-by-case basis, and there is no single metric to measure when an individual has reached this stage in their recovery.

Consequently, the amount of time it takes an individual to reach MMI can vary quite tremendously. For example, some accident victims will reach this stage within a few months, while others could take several years.

Before Signing a Settlement, Should You Wait Until MMI?

More often than not, your workers’ comp attorney will instruct you not to agree to a settlement before you’ve officially reached MMI. Before this point, it can be challenging to accurately gauge how much you’re owed in damages. In addition, if treatment is # ongoing, it isn’t always possible to predict the total cost of your future care, especially if you’re still early along in the process.

However, once you’ve reached MMI, the cost of continued care will be far easier to predict. In addition, at this point, your workers’ comp attorney will also have a much clearer idea of the full extent of your injuries.

Remember, once you have accepted a particular settlement, it can’t be undone—even if that settlement turns out to be unfair due to your condition being more severe than was initially anticipated. In any case, by accepting the settlement, you legally agree to drop the claim against your employer.

You often won’t be able to foresee complications with your recovery, so before you accept any claim, it’s best to wait until MMI.

What Is the Insurer’s Role, Before and After MMI?

Before you have reached MMI, the workers’ comp insurer will be required to pay for any medical treatments you receive that are believed to improve or heal your condition. However, this changes a bit after you’ve reached MMI. At that point, the insurer does remain obligated to pay for treatments relating to your injury or medical condition—nevertheless, the treatments they must pay for become more limited.

Typically, after you have reached MMI, workers’ comp insurer will only be required to pay for the secondary medical services you receive. More specifically, this refers to the ongoing treatment that allows you to continue performing your duties at work or those that make it possible for you to maintain MMI. Once you’ve reached MMI, the treatment options you can utilize will become far more limited. So, before this point, it is essential that your medical care provider exhausts all treatment options.

What Should I Expect to Happen, After I’ve Reached MMI?

Once you have reached MMI, you can expect to be assigned a permanent partial disability (PPD) rating by an authorized treating physician. Essentially, the purpose of this rating is to establish how severe the permanent impairment will be in the long term. After you have accepted the rating payment, you have two years to report any changes in your condition, which could have an unforeseen impact on your PPD. This change in condition claim must be placed with the North Carolina Industrial Commission (NCIC).

Generally, the treating physician will determine any permanent work restrictions once PPD has been formally established. The purpose of these restrictions is to outline what kinds of work the injured individual will be able to perform following their work-related injury or illness. In addition, understanding your permanent restrictions can allow a worker to gauge their employment status and opportunities more accurately, moving into the future.

If necessary, the aforementioned worker will be able to find suitable employment for themselves at this stage. Still, what is “suitable employment,” and how is it impacted by reaching MMI? Before they reach MMI, the injured employee will be required to accept any work offered to them by their current employer, as long as those duties fall within the established medical restrictions. That being said, once MMI has been reached and permanent work restrictions have been established, the individual can broaden their search and find a position based on their new limitations.

Finally, just because someone has reached MMI doesn’t mean this is the end of the wage replacement disability benefits they were receiving. Are you unsure when a workers’ comp insurance provider can cut off your access to workers’ disability benefits? You can always reach out to an experienced workers’ compensation attorney for guidance and advice.

M. Reid Acree, Jr., Is There for Injured Workers, Every Step of the Way

If you or a loved one was injured in a work-related accident in North Carolina, then it is essential to have an attorney guide you through the claims process every step of the way. Unfortunately, dealing with workers’ compensation insurance providers can quickly grow difficult before and after an individual reaches maximum medical improvement. To contact Mr. Acree today, simply fill out the form on his website or call for a consultation.