If you haven’t heard the acronym “MMI,” before, it stands for Maximum Medical Improvement. It is expressed in the form of a specific date and will usually be accompanied by an impairment rating. The specific date is a point in time determined by a doctor the injured worker has been authorized to treat with. In terms of a Florida Workers Compensation case, MMI is a significant point in any claim. The significance is the change that occurs in relation to the person’s entitlement to wage loss benefits, eligibility for impairment benefits, and obligation to pay $10.00 co-payments.
To better understand what MMI means, it would be best to first explain a few things that MMI does NOT mean. Reaching maximum medical improvement does not mean the following:
- That you are 100% better.
- That you no longer experience any functional limitations resulting from your work injury.
- That you will not require further treatment for your work injury or injuries.
- That your workers compensation is closed.
- That you are not entitled to further treatment.
Florida Law defines maximum medical improvement as the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability; Fla. Statute 440.02(10). Defined another way, it simply means you have reached a plateau in your recovery. There are no other invasive or curative type treatments that would improve your condition resulting from the work injury.
What are some of the significant implications of being determined MMI? Your eligibility for wage loss benefits ends. Meaning, if you were receiving a check every two weeks from the workers compensation carrier as payment for your lost wages, receipt of that check will end. If you are permanently and totally disabled, then you would receive permanent total disability benefits from this date forward.
Very few people are permanently and totally disabled after a work accident. If the resulting condition you are in upon reaching MMI is one that qualifies for an impairment rating, then you will be eligible for what is called impairment benefits. These are abbreviated as “IB,” benefits. You are entitled to two weeks of IB’s for each percentage point of impairment. The rate at which you are paid is 75% of your temporary total disability benefit rate.
So, if you were determined to have a 4% impairment rating, you would be eligible for 8 weeks of impairment benefits. As an example, the following is provided: If your average weekly wage (AWW) (the gross amount earned on average during the 13 weeks before your work accident) was $500.00, your temporary total disability benefit rate would be $333.35. When considered to be on a no work status, your eligibility for wage loss benefits is classified as being entitled to temporary total disability benefits. These are abbreviated as TTD benefits. The amount payable through TTD benefits calculated by determining what amount is equivalent to 66 and 2/3 of your average weekly wage. 66 and 2/3 of your AWW is determined by multiplying your AWW by .6667.
So, using the $500.00 AWW example above, 75% of $333.35 is $250.01. 8 (weeks) multiplied by $250.01 equals a total of $2,000.08. Sometimes a workers’ compensation carrier will pay the full amount of impairment benefits in one check sent directly to you. Sometimes they will send the checks every two weeks. The amount of your impairment benefits is reduced if at the time you are determined to have an impairment rating, you are working and earning at least 80% of your AWW. If you are receiving income of at least 80% of your AWW, then the amount of your impairment benefits is 50% of your of your TTD rate, rather than 75% in the example above.
Your impairment rating is determined by the 1996 Florida Uniform Permanent Impairment Rating Schedule. There are times when we have reviewed a client’s worker’s compensation claim and determined that they were not assigned an appropriate impairment rating. We work to have the doctor correct the error in hopes of generating entitlement to the full amount of impairment benefits our client should receive. We will also review the amount paid to determine if our client is being paid correctly. This determination is also done when we undertake representation in terms of how much the person is receiving in lost wages. Because workers compensation carriers so often miscalculate the monetary benefits you are entitled to, our review helps ensure that any unpaid or underpaid amounts are corrected.
A consultation with us regarding your work related injury is free. Dolman Law Group can be reached by calling (727) 853-6275.
Dolman Law Group
5435 Main Street
New Port Richey, FL 34652