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What is maximum medical improvement for an injured worker?

On Behalf of | Feb 2, 2024 | Workers' Compensation

Most employees working for New Jersey companies benefit from workers’ compensation coverage. If they get hurt on the job or develop a medical condition directly related to their employment, they may qualify for workers’ compensation benefits.

Those benefits can be very valuable for someone in need of medical care. The health coverage available through workers’ compensation can fully pay for someone’s treatment. If a medical professional recommends a leave of absence from work or if someone cannot work due to the limitations created by their condition, workers’ compensation can also provide disability benefits.

Workers may receive a portion of their average weekly wages until they can return to work. But, in some cases, a worker’s benefits may change or end abruptly if they achieve maximum medical improvement (MMI).

Who establishes MMI for a worker?

Many aspects of a workers’ compensation claim rely on the perception of the doctor providing someone’s treatment. A physician can determine what the underlying cause of someone’s symptoms is and how to reduce those symptoms. They can propose a treatment plan and can also estimate how much impact that treatment might have on someone’s functional abilities.

When a doctor believes that a patient has improved as much as they likely can with treatment, the doctor may declare that the patient has achieved MMI. Those who reach MMI through treatment may still have lingering symptoms. However, they are unlikely to experience any major improvements in their condition even with ongoing treatment.

What MMI means for a claim

Once a doctor has determined that a patient has achieved MMI for their condition, their benefits may change. Instead of receiving full coverage for treatment, their health benefits may end or may only apply toward care intended to manage their symptoms. If the worker can go back to their employment, their disability benefits may and as well. Other times, they may need to pursue permanent disability benefits because they cannot return to work or can only take a lower-paid position because of their functional limitations.

Understanding the terminology and rules for workers’ compensation claims may help injured workers get the support they require and better understand what to expect from their circumstances.