Maximum Medical Improvement in Boston Workers’ Compensation Claims

Maximum medical improvement (MMI) is a term used by physicians when the patient has reached a plateau in their rehab and does not show any further change or improvement. MMI does not mean the person is cured or is back to his or her pre-accident condition. The injured worker may still require ongoing medical treatment to help maintain and manage the progress and prevent regression.

If you need help handling your workers’ compensation claim, reach out to a qualified attorney. They understand the role of maximum medical improvement in Boston workers’ compensation claims, and they could fight on your behalf for full benefits. Call today to discuss your case.

Loss of Function and Permanent Impairment

When someone is at MMI, they might still need treatment. For example, the most common reason is for pain management, and it is unlikely that the person will see any appreciable improvement. Depending on the person’s age, education, or work experience, the lawyer makes a decision about whether to have the person evaluated by a medical doctor for a loss of function evaluation and permanent impairment rating.

In a permanent impairment rating evaluation, the doctor gives a medical opinion as to the permanency of the person’s loss of function utilizing the American Medical Association’s guides to the evaluation of permanent impairment. The doctor will make an assessment about whether the injured worker remains disabled and whether the disability is total or partial. If the doctor determines that the injured worker is partially disabled, they may still be entitled to receive total benefits.

The reason for this is because the DIA Administrative Judge must make an independent assessment concerning disability within the parameters of the workers’ compensation statute and case law. In Scheffler’s Case, the Massachusetts Supreme Judicial Court held that a DIA Administrative Judge may consider the injured worker’s age, education, work history and physical limitations stemming from the work injury when making a determination whether the worker is disabled and whether the disability is total or partial.

DIA Assessment of Disability Hearings

It is important to note the difference between a medical opinion of partial disability and a DIA Administrative Judge’s legal assessment of disability. The judge is not simply a rubber stamp for the doctor. The medical opinion as to disability (total or partial) is just one factor, albeit an important factor, for the judge to consider when conducting a legal analysis to determine the nature and extent of disability.

In addition to the medical records, reports, and employee testimony at Hearing, a DIA Administrative Judge may also consider evidence submitted by vocational experts. This evidence can include reports and testimony concerning the injured worker’s employability or non-employability. Expert vocational witnesses testify on behalf of the employee and the insurer. The judge assesses the various testimony and makes a legal determination as to disability.

How a Boston Workers’ Compensation Attorney Could Help

Maximum medical improvement in Boston workers’ compensation claims can present a problem for injured workers. At this stage, there could be lingering problems that the insurance company is unwilling to help with.

If you need help negotiating with the insurance company in your case, contact a Boston workers’ compensation attorney today. If you are not eligible for permanent and total disability benefits and have reached MMI, the workers’ compensation lawyer could make a settlement demand on your behalf and negotiate the most favorable terms possible.