Reaching Maximum Medical Improvement in Spartanburg

There are different types of workers’ compensation benefits that an employee can receive based on their injuries and the stage of the claims process they have reached.  Workers are usually awarded temporary benefits when they first report an injury and file a workers’ compensation claim, and while a more extensive medical evaluation is pending.  These temporary benefits are later terminated in cases where a doctor determines that a person’s condition is at a stage where the impairment caused by his injury is no longer going to be improved through further medical treatment, and the person is deemed to have reached Maximum Medical Improvement (MMI).

 

It can sometimes take years for a person to reach MMI depending on the nature of his injuries.  Different doctors can also have different opinions as to when a person has reached MMI.  The insurance company’s doctors may give an opinion that an injured worker has reached MMI before his doctor does.  These disagreements as to whether a person has reached MMI can be settled through a hearing before the South Carolina Workers’ Compensation Commission which makes the final determination.

 

For some people, a determination that they have reached MMI means that they are permanently disabled in such a way that they cannot return to work in any capacity, with or without accommodations.  However, for others, work is still possible after MMI, although it may be different work than they performed before their injuries, or they may require some work place accommodations in order to continue working.  Doctors can also impose restrictions on the kind of work a person can do, or limiting a person’s ability to do certain tasks that could aggravate their injuries.  Just because a person has reached MMI and cannot get better medically does not mean that they cannot get worse if they overdo it.

 

MMI at Different Times

Temporary workers’ compensation benefits are usually stopped as of the date that a person is determined to have reached the MMI.  However, if a person has multiple injuries, the determination of MMI can be reached as to each of the person’s injuries at different times.  So if a person suffered injuries to his back and arm, and reached MMI as to the arm injuries months before the back injuries, it is possible for some of the temporary benefits to be stopped when the MMI is reached for the arm injuries, with the rest of the temporary benefits stopped at the date the MMI is reached for the back injuries.

 

Reaching MMI and having temporary benefits terminated does not mean that the injured worker is left without any form of compensation – in fact, a MMI determination usually leads to a settlement and marks the end of a workers’ compensation case.  When temporary benefits are terminated, the injured worker begins to receive either permanent total or partial disability benefits.  When a person has reached MMI, his doctor usually assesses his condition and issues an impairment rating, which is an indication of how much use a person still has of the injured part of his body.  For example, this could be a determination that a person only has twenty percent use of their leg following the work place injury and having reached MMI.  The South Carolina Workers’ Compensation Commission may rely on this impairment rating and other factors when determining how much of a permanent award the injured worker will receive.

 

Medical Treatment after Reaching MMI

Reaching MMI can also affect a person’s availability to employer paid medical treatment for work related injuries.  The law states that the employer is responsible for all reasonable medical costs aimed at reducing a person’s disability until such a time as the person is deemed to have reached MMI.  There are some exceptions in which the South Carolina Workers’ Compensation Commission may require the employer to continue covering some medical costs beyond the MMI date if the continued medical care allows a person to return to work.  When settling with an employer once a person has reached MMI, the employer may require the person to sign an agreement waiving all future claims based on the same injury.  This could mean that if complications later arise, the injured person will have to meet the associated costs.  It is important for a person to negotiate in order to account for certain unforeseen issues down the road.

 

Social Security Disability Benefits

Sometimes injured workers may qualify for Social Security Disability Insurance (SSDI) benefits for the same injuries that they are receiving workers’ compensation benefits, if they can show that they have a disabling condition that is expected to last more than 12 months.  While some wait until they have reached MMI to submit an application for SSDI benefits, there is no need to do so because MMI has no bearing on a SSDI application.  If an injured person otherwise meets the qualifications for SSDI benefits, they can apply and receive benefits while also receiving workers’ compensation benefits from their employer at the same time.  Potential applicants should note that there is a reduction of SSDI benefits to factor in the workers’ compensation benefits received.  A large lump sum workers’ compensation settlement may affect a person’s qualification for SSDI benefits, and therefore, you should discuss the structuring of settlements in such a way as not to disqualify yourself from federal benefits you are entitled to.  SSDI applications can sometimes take a long time to be approved and applying as soon as a person is eligible is always advisable.

 

Let Us Assist You

Workers’ compensation claims can also be complicated and take a long time to be resolved depending on the nature of the injury suffered.  Injured workers may not always be in a position to ensure that they are receiving all the benefits they are entitled to because they are focused on getting better.  Having a knowledgeable workers’ compensation attorney in Spartanburg, SC fight for you while you recover can make your recovery period less stressful.  Call Bryan Ramey & Associates for a FREE consultation if you have been injured on the job in Spartanburg, South Carolina and need guidance on how to seek workers’ compensation benefits from your employer.