Injured employees are usually eligible for workers’ compensation benefits. Workers’ comp offers medical coverage for all necessary treatment. Employees who require time away from work or light-duty job functions may also be eligible for disability benefits. They can supplement their reduced wages or replace their lost income with disability benefits.
The doctor overseeing a claim has a profound influence on the benefits that the worker receives. In some cases, a physician may determine that the worker has achieved maximum medical improvement (MMI) and that additional treatment is unlikely to yield significant improvements in their condition or a reduction of their symptoms. How does that determination affect their benefits?
MMI significantly changes the benefits available
Generally speaking, a physician’s determination that a worker has stopped responding to treatment makes future treatment coverage unlikely. However, some medical coverage may still be available. Workers can receive health coverage for symptom management. They may also be able to resume medical benefits if their symptoms worsen.
A physician’s designation of MMI can affect disability benefits as well. Employees may require permanent disability benefits. A physician’s determination that they have stopped responding to treatment may justify a claim that their symptoms are permanent and that they are therefore eligible for permanent partial or permanent total disability benefits.
In some cases, workers may need help officially questioning the physician’s determination and seeking a continuation of their treatment benefits. Other times, they may need assistance optimizing permanent partial disability benefits.
Reviewing the injury and the doctor’s determination with a workers’ compensation attorney can help people navigate a complicated process effectively. When an injury stops responding to treatment, employees may need insight into their rights and support in continuing their benefits.