A Guide to Maximum
Medical Improvement
(MMI) in Workers’ Comp
Understand how maximum medical improvement (MMI) is determined and what it means for your workers’ comp claim in SC
If you’re healing from a work injury in South Carolina and receiving workers’ comp benefits, you may have heard the terms “maximum medical improvement” (MMI) and “permanent impairment rating” used by your treating physician or your employer’s workers’ compensation insurer. However, you may not fully understand what these terms mean or how they could impact your benefits.
This comprehensive guide aims to unravel the mystery surrounding MMI, clarify its distinction from a permanent impairment rating, and illustrate how both concepts directly impact your workers’ compensation benefits in South Carolina.
We’ll also delve into common questions and concerns, providing you with the knowledge you need to make informed decisions about your health and financial future. So let’s get started.
What does it mean to reach maximum medical improvement?
Reaching maximum medical improvement (MMI) means that your treating physician has determined that your medical condition has stabilized and is unlikely to significantly improve with further treatment.
This doesn’t mean that you’ve completely healed and are back to “normal.” It simply indicates that you have recovered as fully as possible, and any ongoing treatment is only expected to maintain your current condition rather than enhance your recovery.
Is MMI the same as impairment rating?
No, maximum medical improvement (MMI) and an impairment rating are not the same. The term maximum medical improvement (MMI) means your condition has stabilized and won’t improve further with treatment, while an impairment rating measures how much your injury has permanently affected your body.
Essentially, MMI marks the end of the healing phase, while the impairment rating helps determine the compensation for your permanent disability.
Does everyone who reaches MMI get assigned a permanent impairment rating?
No, not everyone who reaches maximum medical improvement (MMI) is assigned a permanent impairment rating. A permanent impairment rating is only given if there is a lasting impairment or permanent damage resulting from the injury.
If the worker has fully recovered without any lasting effects, a permanent impairment would not be necessary.
Does MMI mean the end of workers’ comp benefits?
No, reaching maximum medical improvement (MMI) does not necessarily mean the end of workers’ comp benefits. While it signifies that your condition has stabilized and is unlikely to improve further with additional treatment, you may still be entitled to ongoing benefits, depending on your situation.
After reaching MMI, you may receive the following:
- Medical benefits. You may continue to receive medical care and treatment necessary to maintain your condition or manage symptoms, even after reaching MMI.
- Vocational rehabilitation. If you cannot return to your previous job, you might be eligible for vocational rehabilitation services to help you find new employment suited to your abilities.
- Permanent disability benefits. If you have a lasting impairment, you may be eligible for permanent partial or permanent total disability benefits based on your impairment rating.
At this point, you may be wondering when workers’ comp might offer a settlement. Since this often happens once a worker reaches MMI, it’s crucial to fully understand the extent of your injury and how it impacts your future before accepting any settlement offer.
Consulting with an experienced workers’ comp attorney can help ensure you receive fair compensation for your long-term needs.
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What is considered to be a permanent disability?
In South Carolina workers’ compensation, a permanent disability is a lasting impairment that significantly affects an individual’s ability to work or perform daily activities. Permanent disabilities are categorized into 2 types: permanent partial disability (PPD) and permanent total disability (PTD).
Permanent partial disability (PPD)
PPD occurs when an injured worker sustains a permanent impairment that partially limits their ability to work. This means the worker can still perform some job duties but may be restricted from performing their previous job or any job at full capacity.
The impairment rating assigned by a physician helps determine the compensation amount for PPD.
Examples of PPD:
- Loss of range of motion in a joint (e.g., shoulder, knee)
- Chronic pain that limits certain activities
- Hearing loss
- Loss of vision in one eye
- Loss of a body part (finger, hand, foot, etc.)
Permanent total disability (PTD)
PTD occurs when an injured worker is completely unable to return to any form of gainful employment due to a severe and permanent impairment. PTD benefits are typically paid for up to 500 weeks, but in some cases, like severe brain damage or paralysis, they may extend for the remainder of the worker’s life, depending on the severity of the disability.
Examples of PTD:
- Spinal cord injuries resulting in paraplegia or quadriplegia
- Severe burns covering a large portion of the body
- Complete vision loss in both eyes
- Severe brain damage
- Loss of multiple limbs
Understanding the distinction between PPD and PTD and how they’re evaluated can help injured workers in South Carolina navigate the workers’ compensation process and secure the appropriate benefits for their situation.
How do you calculate an impairment rating?
Permanent impairment ratings are determined through a comprehensive medical evaluation conducted by a qualified health care professional, typically a physician specializing in the relevant field of medicine.
The evaluation process involves several key steps:
- Medical history review. The doctor will thoroughly review your medical records, including treatment notes, imaging studies (X-rays, MRIs, etc.), and any other relevant documents related to your work injury.
- Physical examination. The doctor will conduct a physical examination, focusing on the injured body part or system. They will assess your range of motion, strength, sensation, and any other relevant physical functions.
- Diagnostic testing. In some cases, additional diagnostic tests may be needed to further assess the extent of your impairment. These tests might include nerve conduction studies, functional capacity evaluations, or other specialized assessments.
- Impairment rating assignment. Based on the findings from the medical history review, physical examination, and any additional tests, the doctor will apply established medical guidelines to determine your impairment rating. In South Carolina, as in other states, the American Medical Association’s Guides to the Evaluation of Permanent Impairment are typically used. This rating represents the percentage of your total body function that has been lost due to your work injury.
As an example, if you suffered a shoulder injury that resulted in chronic pain and limited mobility, the doctor might assign a 10% impairment rating based on the AMA Guides. This would mean that your injury is considered to have caused a 10% decrease in your overall bodily function.
The impairment rating plays a crucial role in calculating your workers’ compensation benefits.
Get maximum compensation for your Columbia workers’ comp claim
If your doctor has recently determined that you’ve reached maximum medical improvement (MMI), it’s essential to understand your rights so you can secure the benefits you’re entitled to.
The experienced Columbia work injury attorneys at Smith, Born, Leventis, Taylor & Vega can provide invaluable assistance in this critical stage of your workers’ compensation claim. We can help you understand your impairment rating, negotiate with the insurance company, and, if necessary, take your case to trial to secure the full compensation you deserve.