What Are Maximum Medical Improvement Benefits

What Are Maximum Medical Improvement Benefits

If you or a loved one has been injured at work it is important to get the medical care you need. This care should be paid for by your worker’s compensation claim, which should be filed as soon as possible after the injury takes place. Ideally, you will make a full recovery after you get treatment and you can get back to working and living life normally.

When a full recovery is not going to happen, your doctor’s will determine when you have reached your maximum medical improvement, or MMI. This is when you have reached a plateau in recovery that you are not likely to proceed beyond. Doctors may determine, for example, that while you are fully healed you will still have to endure a certain amount of pain due to the injury for the rest of your life. When you reach the MMI, the insurance company responsible for your worker’s compensation will be notified, which will impact the future of your claim.

Level of Impairment

After you have reached the MMI point your claims adjuster and medical professionals will have to determine your ongoing level of impairment (LOI). This will determine what, if any, impairment benefits you receive going forward. A medical professional will determine an impairment rating, which is a percentage that can range from 0 to 100% impaired. The higher the percentage, the more severe the impact of the injury is expected to be for the rest of your life. 

Future Claim Benefits

Florida law has specific information about what types of claim benefits you will be entitled to after you reach MMI. These benefits will be based off of your level of impairment. If your LOI is between 1 and 10%, you will be given two weeks of benefits for each percentage point. From 11 to 15% you will receive 3 weeks for each percentage point, from 16 to 20% you will get 4 weeks. If your LOI is 21% or higher, you get 6 weeks for each percentage point. 

Demanding Your Benefits

Not surprisingly, insurance companies often do everything they can to avoid paying out these benefits since they can be quite costly. Legally speaking, the insurance company must pay out the benefits associated with your impairment rating within 7 days of being notified by the doctors. If they don’t pay out your benefits, you may be entitled to additional compensation as a penalty. This penalty will be 20% of what is owed plus interest.

Request Your Assessment

If you have been injured at the workplace, it is important to make sure your rights are protected. This is especially true if it has been determined, or is likely to be determined, that you are not going to make a full recovery. Contact Feldman Legal Group to request an assessment of your case and get the legal representation you need to protect your rights.