Georgia’s workers’ compensation laws can be confusing at times. Injured workers often find themselves worried about whether certain injuries will be covered, what types of benefits are available, and whether they should accept any form of settlement. With multiple benefit options and settlement types available, we understand how these questions can seem overwhelming.
If your case seems too complex to handle alone, then we are here to help. Our firm has provided highly qualified workers’ compensation lawyers and case managers to Clarkston residents for years. We pride ourselves on our client-focused approach and unique legal experience.
One of the most common questions we are asked by our clients is “What does Maximum Medical Improvement mean?” This is a term that can seem problematic at first, but it often signals the next step forward in your claims process. Let’s look at what reaching Maximum Medical Improvement in Clarkston, GA really means and how it can affect your benefits.
Call our office at 770-796-0919 to discuss your workers’ comp case in further detail.
What Is Maximum Medical Improvement (MMI)?
MMI, or maximum medical improvement, is a term used in conjunction with workers’ compensation law to indicate that the injured patient can improve no further with standard medical treatments. It does not necessarily mean the patient is fully healed. They may have a disability and could still suffer from pain caused by the injury. But once MMI is reached you can assume that ongoing medical treatment will yield no further improvement.
MMI is important for various reasons. From a medical perspective, it means any future treatments will likely have a different focus. Many patients still receive ongoing treatment for pain long after they have reached the MMI milestone. The overall scope of the treatment is going to be more limited.
From an insurance perspective, it means they are no longer obligated to pay for ongoing treatment for the condition because treatment would serve no benefit. This doesn’t mean that all of your related medical bills are now coming out of your own pocket. The insurance provider is still required to pay for specific secondary medical services that are related to the injury.
These secondary services are generally required to help the patient return to work. They are more limited compared to treatment options prior to MMI and there is often a smaller time frame available for treatment. Exactly which new treatments are covered is a tricky subject because there is no definitive list.
It’s not uncommon for insurance providers to fight back and attempt to avoid paying for secondary treatments following MMI. Having an experienced workers’ compensation attorney on your side will make the fight easier for you.
Reaching MMI indicates that it is a good time to consider settling your claim. You may even hear from the insurance provider on the subject. Settling can be a smart move, but you should always speak with an attorney before committing.
Who Determines Maximum Medical Improvement in Clarkston, GA?
Maximum Medical Improvement is a medical determination and as such, it can only be given by an authorized treating physician. There is no other party with the legal right to declare when an injured worker has reached MMI. Your employer may try to tell you that you’ve reached that point or you may even feel as though you’ve returned to normal. Neither of those declarations has any legal bearing on a workers’ compensation claim.
Do not let an employer or insurance provider pressure you into ending your treatments prematurely. It is their responsibility to provide medical benefits and you should take full advantage of those benefits. Do not end treatment until your appointed physician declares that you have reached MMI. Only they have the necessary medical experience and understanding. Employers are often more interested in protecting their funds than ensuring you have a full recovery.
Does Medical Treatment Continue After an MMI Diagnosis?
That depends on the injury and any lasting effects it might have. You may reach MMI and still be partially disabled. In that case, your physician will provide you with a Permanent Partial Disability (PPD) rating. Your PPD will impact future benefits, the type of work you are able to perform, and the types of medical treatment you will require going forward. You may also require ongoing medical treatment for pain management.
Patients who suffered severe disabilities may require ongoing physical therapy treatments for years. The treatments will help them acclimate to life with a permanent disability and learn to function as normally as possible.
Your physician will inform you of any necessary ongoing treatments after you receive your MMI declaration. The insurance provider may try to avoid paying for some of these treatments. Taking a settlement can make it easier to cover a wider range of necessary treatments without ongoing legal battles. We can discuss these options when reviewing your claim.
What If You Can’t Return to Work at the Same Level After MMI?
Georgia workers’ compensation laws are more generous than many nearby states. They take into account the fact that a serious injury, even when fully treated, can prevent a patient from ever returning to work. Reaching MMI will likely impact your medical benefits, but it does not necessarily mean an end to your indemnity benefits.
Disability/indemnity benefits are intended to compensate employees for wages lost because of their inability to work. Some states end these benefits when the patient receives an MMI diagnosis. From that point forward, they are only able to receive their PPD benefits. Georgia does not work like that. Our residents are still able to receive ongoing disability benefits after reaching MMI if they are unable to return to work.
Get Help With Your Clarkston Workers’ Compensation Claim
If you’ve reached maximum medical improvement in Clarkston, then it’s time to consider your next step forward. But you don’t need to do it alone. Our expert workers’ compensation attorneys understand how workers’ comp laws function in Georgia and can fully represent your needs. We will fight to ensure you get the benefits you deserve and the compensation you are owed.