The system in place for workers’ compensation in the state of Georgia is intended to take care of the worker’s medical and financial needs until they are fully recovered. Financial benefits are often paid on a weekly basis while medical benefits are provided as needed for treatment. It’s entirely possible for the worker to reach a settlement agreement with the workers’ comp insurance provider, which will then provide them with a lump sum amount instead of weekly benefits.
The negotiations for a settlement often start after the worker has reached a state of Maximum Medical Improvement (MMI). At this stage, medical treatment will no longer continue to improve the worker’s condition. They will be assigned a disability rating that determines the duration of their weekly benefits. In the case of very severe injuries that leave serious, permanent disabilities, the insurance provider may be more interested in settling rather than paying ongoing weekly benefits.
You can increase the likelihood of receiving a settlement by bringing a Villa Rica workers’ compensation lawyer to your negotiations. We have the industry experience and knowledge to help reach a positive resolution. You should consider contacting the Workers’ Compensation Lawyers Coalition if you have recently reached a state of MMI. Contact our staff at 770-796-0919 for a free review of your Villa Rica Maximum Medical Improvement.
What Is Maximum Medical Improvement (MMI)?
The designation of MMI is given to injured workers who have reached a point where medical treatment would have no further benefit. The designation does not indicate that they have completely healed or are no longer injured. In fact, many people who reach MMI will have to deal with a lifelong disability. This can also include ongoing treatment for pain management.
You will receive a partial disability rating if you are still disabled after reaching MMI. This rating relates to the overall severity of your disability. Different body parts and levels of functionality will result in different maximums when it comes to receiving Permanent Partial Disability (PPD) benefits. Some body parts, such as arms and legs, are weighted more heavily than others. The more severe the disability is considered the longer you will be eligible to receive PPD benefits.
After receiving your MMI designation and disability rating you can begin negotiations for a claim settlement. You are not required to settle your claim and insurance providers are not required to offer a settlement. However, there are some advantages (and disadvantages) to settling a claim at this point. If you cannot reach a settlement agreement with the insurance provider, then the case remains open and you will continue to receive benefits until their duration expires.
We advise contacting a workers’ compensation lawyer to discuss your available options after reaching MMI. A lawyer can act as a negotiator between you and the insurance company. They will immediately decline typical low-ball options and fight to ensure you receive adequate compensation for your injury.
Who Determines When You Have Reached MMI in Villa Rica, Georgia?
Your attending physician is the only party with the power to determine that MMI has been reached. Some insurance providers find this problematic because they want your treatment and medical benefits to end as soon as possible. However, according to Georgia law, they are required to continue paying these benefits until the physician declares MMI. Do not be intimidated by an employer or insurance provider who wants you to end your medical treatment ahead of schedule.
Your goal is to follow through with all available medical treatments recommended by the physician until you have reached MMI. According to Georgia Workers’ Compensation Law, you are required to accept any standard medical treatment that your physician recommends. If you do not, then the insurance provider may dispute your claim and you could lose future benefits.
Does Medical Treatment Continue After an MMI Diagnosis?
Yes, but the treatment may be different than before. The MMI diagnosis generally marks the end of standard treatment for your injury. However, you may require ongoing treatment for pain management or rehabilitation. The insurance provider is required to continue paying for these treatments even after you have reached MMI. This is another reason why the insurance carrier may decide to enter settlement negotiations. It can protect them from paying for pain management treatments for the 400-week duration of benefits.
What If You Can’t Return to Work and Perform the Same After MMI?
You may not be able to work at the same performance level after reaching MMI. This is where your PPD benefits will come into play. The PPD benefits are made available for a duration determined by the disability rating, but not more than 400 weeks. The compensation amount is equal to 2/3rds of your weekly income prior to the date of the injury.
Unlike TPD benefits, your PPD benefits cover more than just the difference between your past and current wages. They provide a substantial bonus to your income as compensation for the injury occurring.
You may also be able to receive ongoing benefits for the remainder of your life if you suffered from a catastrophic injury. This includes disability benefits as well as medical benefits. A catastrophic injury includes total blindness or the functional loss of two major limbs. It also includes severe and permanent paralysis, which is often the result of a neck or spinal injury. It’s highly likely that the insurance provider will want to negotiate a settlement if you have suffered a catastrophic injury.
Call Us to Understand Your Villa Rica Maximum Medical Improvement
Reaching MMI signals a time of change in your treatment and your benefits. You may start hearing more from the insurance provider if they are interested in a settlement. Likewise, you may decide to reach out to the provider yourself to ask for a settlement.
In either case, you will have a better chance of success if you work with a professional workers’ compensation lawyer. Take a moment to call the Workers’ Compensation Lawyers Coalition at 770-796-0919 to discuss your Villa Rica maximum medical improvement diagnosis and whether a settlement is right for your case.