Understanding Maximum Medical Improvement in Your Workplace Accident Case

Understanding Maximum Medical Improvement in Your Workplace Accident Case

The purpose of the workers’ compensation system in Florida is to ensure that employees who are injured on the job can access quality and effective medical treatment. Along with medical treatment, employees can also receive replacement wages when they are out of work. The benefits will be ended when one of two things happens:

  1. You exhaust the 104 weeks of benefits allocated by Florida law.
  2. Your workers’ compensation doctor determines you have reached maximum medical improvement.

Here, you can learn more about maximum medical improvement, what it means, and how it is determined that you have reached it.

It is important to remember that if you believe you are being asked (or forced) to go back to work before you are well enough to do so, then you should talk to our Boca Raton workplace accident attorney at Sternberg | Forsythe, PA.

Receiving Treatment for Your Workplace Injury

When your employer or their insurance provider approves your workers’ compensation claim, you will begin receiving treatment from a state-approved doctor.

The state of Florida has several physicians who are qualified to provide treatment for employees who are receiving workers’ comp benefits. When it comes to receiving medical treatment, you don’t have a choice in what doctor you go to.

If you don’t receive treatment from a state-approved doctor, then your claim will be denied, and your benefits will be terminated. While this is the usual course of events, it does not mean that your Boca Raton workplace accident attorney can’t request another opinion.

During your treatment, if you believe that you aren’t receiving quality or proper care, your lawyer can have you go to a different doctor. If this doctor doesn’t agree with the set treatment plan, or if they don’t believe you are ready to go back to work, they can provide documentation for this in your case. This is particularly true if the state-approved workers’ compensation doctor believes you have reached the point of “maximum medical improvement.”

Workers’ Compensation Benefits Are Only Available for a Limited Time

As mentioned above, you can only receive workers’ compensation benefits in the state of Florida for 104 weeks, which is two years. When two years have passed, your attorney can negotiate a settlement for a permanent disability you have sustained, or you will have to return to work.

At this point, if you don’t believe you are ready to go back to work, you have some options.

One is to have your Boca Raton workplace accident attorney file a lawsuit on your behalf. Your attorney can also negotiate a settlement for a permanent disability you have sustained because of the workplace accident.

Workers’ Compensation Benefits Can End in Two Ways

Above, we explained the two ways that your workers’ compensation benefits can end. One, when they reach the 104-week maximum, and two, if your doctor states that you have reached maximum medical improvement (MMI).

MMI means that you have come to a point where additional medical treatment won’t be beneficial. An example will be if you have injured your back while carrying something heavy at work. The initial treatment recommended by your state-approved workers’ compensation doctor is surgery to repair the three herniated discs you have experienced.

You go through with the surgery and complete four months of rehabilitation and physical therapy. At this point, your doctor may state that you have reached maximum improvement and can return to work.

However, you may not agree with this assessment. You may believe you still need chiropractic care or physical therapy and that you can’t return to your job.

If you find yourself in this situation, your Boca Raton workplace accident attorney can request a second opinion by having you make an appointment with an independent doctor. This doctor will examine you to determine if you have reached MMI. If they agree with the first doctor’s assessment, then your only option is to return to work.

Sometimes, the injuries will be so severe that you sustain a permanent disability. At this point, your attorney can demand a lump sum settlement or permanent benefits.

How Is Maximum Medical Improvement Determined?

Determining if you have reached the point of maximum medical improvement is challenging. It isn’t the job of your state-approved workers’ compensation doctor to try all the different treatments and therapies that exist for your injury. Instead, their job is to administer the reasonable treatment they believe would benefit your recovery. After this is done, the doctor must decide if additional treatment would benefit your injury or condition or if there is no reason to continue care.

This is when the doctor could state that you have experienced a permanent disability. However, they may also state that you can return to work but need a different, less demanding position. No matter the findings, your employer will accept this as fact and then respond based on the information they are given.

Your Options When MMI Is Declared

Just because your doctor states you have reached MMI, it doesn’t mean you can’t receive treatment for aggravations of the injury. Going back to the state-approved workers’ compensation doctor once a year after you reach MMI is important. If you don’t, you will lose your right to receive benefits.

After your doctor states you have reached MMI; there are a few options available. Discussing these with your Boca Raton workplace accident attorney is smart to determine which one best suits your situation.

A Settlement from Workers’ Compensation

Sometimes, insurance companies want to settle your claim after you reach MMI. Your settlement amount depends on how much medical care and the wage benefits the company may have to pay you in the future.

Request a Second Opinion

While Florid Legislature does not allow you to get a second opinion, it’s possible to use the one-time doctor change to do this. When you request this change, the second doctor can determine if the first doctor’s assessment of your injuries was correct.

Enroll in Vocational Retraining

If you can’t return to work in your former position due to your on-the-job injury, it’s possible to seek vacation retraining. This is available through a vocational school, college, or the State of Florida. If you opt for retraining, the insurance company will have to pay you benefits for another six months, even if you have reached MMI.

Keep Your Claim Open

If you can’t receive medical care for the injury you experienced on the job through another avenue besides your workers’ compensation assigned doctor, it’s possible to leave your claim open. If you choose to do this, you can continue to receive treatment from them. In fact, you can keep the claim open indefinitely if you attend annual appointments with them.

Challenging a Declaration of Maximum Medical Improvement

If you don’t believe you can return to work, you should let your Boca Raton workplace accident attorney know. You should never refuse to go back to work without telling your attorney about your decision. This can blindside them; they will have to clean up the mess when your benefits are ended, and they know nothing about it. By letting your lawyer know your decision, you can appeal the doctor’s findings or file a lawsuit against your employer.

Don’t Wait to Contact a Boca Raton Workplace Accident Attorney for Help with Your Claim

Workers’ compensation claims in Florida can be complicated. If you don’t have the right legal representation, navigating this process may be difficult.

Our Boca Raton workplace accident attorney at Sternberg | Forsythe, PA, is ready to help you with your claim and ensure you get the treatment you need and the benefits you deserve.

It’s important to remember that maximum medical improvement is just one aspect of your claim. You need to understand all the different factors that go into this to understand how long you can receive benefits and what requirements you must meet to continue getting these benefits.

If you have questions or need help with your workers’ compensation case, be sure to contact us. We offer new clients a free initial consultation to ensure they get the best possible outcome for their situation.

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