Workers' Comp Claims MMI

An In-depth Look at the Meaning of MMI

To understand the workers’ comp claims process, you must first understand a few things about MMI or Maximum Medical Improvement. Unfortunately, employees become injured every day while on the job. Injuries are mostly due in part to the negligence of another person. When you become injured on the job, you have a certain period to file a compensation claim. This compensation helps to cover part or all of your costs related to your injuries.

With your attorneys’ help, you must calculate the amount of money it will take to pay for anything and everything related to your injuries. When you are seriously injured, and the damages caused you a lifetime disability, you must claim a settlement large enough to pay future costs like medical treatment and bills and take care of you for the rest of your life. Should you be able to return to work due to your injuries? The settlement covers your living expenses and much more for the rest of your life.

  • Most serious injuries require you to undergo rehabilitation from any number of therapy services your doctor orders.
  • Rehabilitation therapists meet with you to set milestone goals for recovery.
  • The therapists and doctors monitor your progress, hoping that they reach their functional level before their accident. But, this highest level may be far from what you enjoyed before your accident.

MMI or Maximum Medical Improvement is a term used by workers’ comp describing the point after which you are not likely to improve anymore. You reached a pinnacle, and you will not get any better. You are declared to have made a full recovery at the best level possible for you. MMI is also a definition used by workers to explain an employee’s treatment and benefits for a work-related injury or illness.

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Why You Need an Attorney to Fight for Your Rights

Never should you navigate the judicial system alone and without an experienced and trusted attorney by your side. There are many negotiations between the employee’s attorney, insurance companies, the employer, and anyone having to do with the employee’s injuries. Insurance companies never want to pay you any more money than they absolutely must. Insurance companies will persistently call you or attempt to visit with you to get you to agree to a less than satisfactory settlement. These companies want you to agree to an out-of-court settlement.

These settlements are far fewer amounts than what you are entitled to receiving. If you settle without your lawyer by your side and the amount of money does not take care of their needs, the injured person cannot file another claim. If the injured person accepts a less than adequate settlement, this will likely ruin their life further.

When phone calls and visits by the other side start, you must tell them they can speak to your lawyer and that you have nothing to say to them. Attorneys must take a hard look at your case and decide what amount the final settlement needs to be to cover you for the rest of your life. Calculations are in place regarding how much the injury costs your past, present, and future. There is an endless list of unexpected costs associated with employee injuries.

Much of this information is based on an MMI report by the primary doctor. This doctor provides treatment to the employee during the workers’ compensations claim. MMI means that your condition is stable, and you reached your rehabilitation plateau and will likely get no better or make any significant positive changes. This statement does not mean that you need no further medical treatment.

The MMI Process

You have several legal options after you reach your MMI, which is why we cannot stress enough to hire a seasoned and skilled attorney whose expertise is accidents, injuries, wrongful death, and worker’s compensation claims. These claims are long, tedious, complicated, and complex. If you do not have the right attorney by your side fighting for your rights, you will not get the settlement you deserve or possibly any settlement.

  • When you reach your MMI and you have your Workers Compensations Award Letter, this provides to you an open award of the following, Wage loss benefits
  • Temporary total or temporary partial disability
  • Continued cash benefits as long as your injuries prevent you from working at your pre-injury job
  • Insurance companies and employers may try to stop your income replacement benefits when you reach your MMI, which is why you need the continued support of your attorney.
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If your primary physician deems you capable of full duty when you reach MMI, you should expect an Employer’s Application for Hearing to suspend or terminate benefits. You will want to defend yourself against this letter and keep your wage loss benefits. Your attorney helps you do this. But depending on other factors, your employer and its insurer may try to stop your income replacement benefits at this time. Your lawyer tells you that your MMI process is just beginning, not ending. The following steps may happen in your MMI process.

  • The primary doctor refers you to an orthopedic doctor.
  • The orthopedic doctor refers you to a physiatrist or pain management doctor if the orthopedic doctor can do nothing else to help you.
  • May recommend undergoing a Functional Capacity Evaluation. This test helps to determine your permanent restrictions after you reach your MMI.
  • There may be other future referrals to specialist doctors.
  • Doctors may refer you for counseling, medication, work restrictions.
  • Your doctor may say you can never return to work as you once knew because you will always be under restrictions and limitations.

It would be best if you worked closely with your attorney after you reach your MMI. You must know the differences between MMI and permanent partial disability. It would be best if you told your attorney that you met your MMI. Some states say that you cannot file for endless partial disability benefits if you are injured on the job until you reach your MMI. Your attorney will inform your doctor how permanent partial disability is evaluated. The attorney may request an evaluation and disability report from the doctor. The letter from your doctor includes,

  •  MMI date
  • The doctor calculated a percentage rating regarding the percentage loss of use and function due to work-related injury. You have an impairment if your normal body function is less than 100 percent. These ratings must comply with American Medical Association guides.
  • Your attorney compares permanent restriction to pre-injury job duties.
  • Your attorney determines if you can no longer perform your job duties.
  • It must be determined if you can return to work with work restrictions such as weight limitations.
  • Over the next ten to 20-years, the lawyer must calculate your treatment cost, future medical needs, and future living expenses. These amounts include amounts billed to insurance companies and payments collected.
  • Your attorney may have to find you a doctor who will evaluate your permanent impairment in addition to a life care planner to calculate the cost of all medical needs in the future.
  •  Once your work status is determined, your attorney may file a worker’s comp claim for additional benefits, which is your right to receive.
  • Your attorney stands ready for additional litigations and negotiations.
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A Call to Action When You are Injured On the Job

We are a seasoned and experienced team of lawyers in the state of Texas. Our specialty is an accident, injuries, and wrongful death cases. We handle many workers’ compensation cases and are experienced in getting our clients a fair and just settlement when they are injured on the job. We promise to work with you to get you fair compensation and detail your legal options after you reach MMI. We are ready to hear your story. Give us a call today at 713-973-8888 and access our website for more information. Never navigate the judicial system alone. Your future depends on a just settlement.


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