What is Maximum Medical Improvement (MMI)?
In workers’ compensation claims, maximum medical improvement (MMI) refers to the point at which your recovery from a work-related injury has reached a ceiling and a doctor determines that your condition will no longer improve.
You can reach MMI with a permanent disability or after a full recovery – it all depends on the unique circumstances of each worker’s injury.
Once you reach MMI, your treating physician will assign a Permanent Impairment Rating (PIR) to your condition. The PIR is a number that quantifies your diminished capacity in comparison to your baseline pre-injury condition.
Under Florida law, MMI and PIR determinations directly influence your right to continue collecting workers’ compensation benefits as well as the total amount of benefits you are eligible to receive.
If you disagree with your physician’s determination or believe that your employer’s workers comp insurance carrier is withholding benefits that you deserve, Berlin Law Firm is here to assist you in any way we can.
Our attorneys can review your medical records, listen to your story, and help you challenge any determinations about your health on the part of doctors or insurers that are adversely affecting your benefits or jeopardizing your right to collect the compensation you deserve.
Who determines MMI in a Florida Workers’ Comp Case?
Your authorized treating physician is the only person who has the authority to determine that you have reached your MMI in your Florida workers’ comp case. Your employer and its insurance carrier have no right or authority to make that determination. Likewise, physical or occupational therapists, nurse practitioners, and consulting medical specialists cannot conclude that you are at your MMI.
Florida allows your employer’s workers comp insurance company to select the doctor that provides authorized treatments, but it also allows an injured worker a one-time right to request a change in who is the authorized treating physician. The worker must request that change in writing, after which the insurer has five days to notify the worker of an alternate authorized treating physician.
If the insurer does not designate a new doctor within five days, the worker can select a new authorized treating physician.
If the injured worker and the insurer have a dispute over a Florida maximum medical improvement determination or other matters involving workers’ comp benefits, each party can appoint an independent medical evaluator (IME), or a judge may appoint an expert medical advisor (EMA) to address the dispute.
Our Florida workers’ compensation lawyers at Berlin Law Firm provide staunch representation to our clients at every stage of the process to make sure they receive the full benefits they are entitled to after being hurt on the job.
What workers’ comp benefits can an injured employee recover after a Florida MMI determination?
Your Florida employer and its insurance company will likely terminate your temporary lost wage benefits and require you to return to work after your authorized treating physician has determined that you have reached your MMI. As long as you are consulting with a physician for treatment of your injuries at least once every twelve months, however, you can still recover reimbursements for those medical services.
If your Permanent Impairment Rating shows that you are partially or fully disabled, you can recover Impairment Income Benefits (IIBs) that will replace a portion of the wages you cannot earn due to your disability.
You can use the IIB calculator that is published by the Florida Department of Financial Services to estimate the amount of those benefits.
I Have Reached MMI, Now What?
As your legal representative, the Berlin Law Firm will explore every possible option on your behalf to secure full and fair workers’ comp benefits.
We can:
- Seek a second opinion from an IME
- Challenge the conclusions of a workers’ comp insurance carrier before an administrative panel
- Negotiate a settlement for ongoing workers’ comp benefits that includes a lump-sum amount or structured payments
- Appeal Permanent Impairment Ratings to justify more generous IIB payments
- Verify reimbursements for continued medical treatments for work-related injuries after an MMI determination
- Reopen workers’ compensation cases when an injured worker’s condition deteriorates after a return to work
Florida workers are inevitably at a disadvantage when they go up against insurance companies that have teams of claims adjusters and lawyers who routinely review and deny legitimate claims. Berlin Law Firm levels the playing field and fights to represent the best interests of injured workers at every stage of the process.
Call for a free consultation today. We will review your case and establish a plan for how we can best help you with your workers’ comp case. We invite you to reach out anytime to our offices in Sarasota and Tampa.
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