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What Does Maximum Medical Recovery Mean?

Maximum Medical Improvement | Medical Recovery | LaBovick Law Group of South Florida April 19, 2019 1:12 pm | Categorised in:

When you experience an injury at work, physical pain is only just the start. Hopefully, it is short-term and you will be back on the job in no time. But until then, you wrestle with a variety of issues. How will you pay for visitors to the doctor and specialists? How will you handle the cost of medications? How will you make ends meet when you are unable to work? How will you take care of your home, your family, and yourself? Workers compensation can help you make ends meet – but what happens when you reach “maximum medical improvement” and your checks stop?

What Is Maximum Medical Improvement?

Denied for Workers' Compensation | Why Don't I Qualify for Workers' Comp | LaBovick Law Group of FloridaFirst things first: what is maximum medical improvement (MMI), sometimes referred to as maximum medical recovery? It means that your injury has reached the point where it will not improve any further.

Now, this may mean that you are completely healed, so to speak, and are back up and running at full capacity. It could also mean that you are not fully recovered but further treatment will not be effective. Essentially, maximum medical recovery means that you’re as good as you’re going to get and your weekly benefits will stop. You do not quality for temporary disability or temporary partial disability any longer.

This leaves you with a major dilemma if you have reached maximum medical improvement but are not able to return to work at your previous functional level. 

Maximum Medical Improvement and Impairment Ratings

Fortunately, you may qualify for impairment benefits.

When your physician assesses that you are maximum medical improvement, they may say, “You’re at MMI and you have a five percent.” What does this mean? Five percent refers to your permanent impairment rating – a percentage assigned to account for your loss of function. But what does this mean in practical terms?

After you reach MMI, the insurance carrier has 14 days to pay your permanent impairment benefit, which equates to 75 percent of your temporary total disability rate. For example, if you were making $700 per week before you were injured, your temporary total disability rate would be about $470. Your impairment benefit is 75 percent of that, or $352.50. If you do go back to work, your impairment benefit can be reduced by half (in our example, this would be $176.25).

Free Workers' Comp Case Evaluation | LaBovick Law GroupThe impairment rating your physician assigns you also impacts the duration of your benefits:

  • 1 – 10 percent: two weeks lost wages for each percentage point
  • 11 – 15 percent: three weeks lost wages for each percentage point
  • 16 – 20 percent: four weeks lost wages for each percentage point
  • 21 percent or higher: six weeks of lost wages for each percentage point

In our example, you had a five percent impairment rating. You would receive two weeks of permanent impairment benefits for every percentage point, or ten weeks of benefits. After that, any additional benefits will stop.

One of the more unfair aspects of this system is that workers comp does not have to pay you for wage loss. That is, if you went from making $25 an hour to $10, you do not get benefits for wage losses perpetually because you still have earning capacity. The impairment benefits are meant to help make up for this loss in the short term – though, as you would guess, they do not cover the difference between $30 – $40 an hour, for example, and $10. That is a significant loss.

If you find yourself in this situation, it is worth sitting down with an experienced workers compensation attorney. Contact the workers compensation attorneys at the LaBovick Law Group today to explore your options and decide on the best course of action.