- October 22, 2019
- Attorney David Mann
- Workers' Compensation
If you’ve been injured on the job, workers’ compensation should pay your medical and rehabilitation costs and provide you with income benefits. These benefits are meant to help you recover from your injuries and get back to work. That sounds simple, but the reality is much more complex. What happens after you reach maximum medical improvement (MMI) under Georgia law is your ability to work, return to your job and what benefits you receive should become more clear.
What is workers’ compensation?
Workers’ compensation is insurance provided by employers for medical, rehabilitation and income benefits to those injured or who become ill on the job. If you’re unable to work for more than seven days, you’re entitled to income benefits based on your earnings. Any business with three or more workers must have workers’ compensation insurance. Who was at fault for the injury or illness is normally not an issue when you seek benefits.
To qualify for workers’ compensation benefits…
- You must be the organization’s employee, not an independent contractor or freelancer unless you can show your employment status is misclassified.
- Your employer must have workers’ comp insurance. Any business with 3 or more workers, including regular part-time workers, must carry it. If not, your employer would be guilty of a misdemeanor under Georgia law
- You must have an injury or illness related to your job. You performed work that benefitted your employer and were injured or became ill because of the work.
- You must meet the applicable deadlines: inform your supervisor about your injury as soon as possible but no longer than 30 days after your accident, and formally file your claim within one year of your accident.
What is MMI?
MMI is the term that healthcare professionals, insurance companies, employers, and lawyers use to indicate that your work-related injury has healed as much as can be expected, your ability to work has progressed as far as it’s likely to go, and you’re not likely to improve with additional treatment or rehabilitation. Your physician should try all reasonable treatments before deciding you’ve reached MMI. You want an MMI designation that shows a full recovery, but for many it’s a sign they will need to cope to some degree with some of the negative effects of their injuries.
After your accident or diagnosis of a work-related disease, it’s impossible to accurately estimate the value of your workers’ compensation claim until the full extent of your injuries and limitations are known.
How is my claim for benefits impacted after reaching MMI in Georgia?
Insurers like workers’ comp claims to be settled as soon as possible for many reasons, including the fact that you may be stuck with a settlement that doesn’t fully compensate you for the true extent of your injuries, saving them money but costing you and your family. If your condition deteriorates or lasts longer than expected, you — and not the insurance company — could be paying for your medical expenses.
his doesn’t mean you shouldn’t make any decisions or take any actions before your MMI is declared. You may fall into a situation where settling early may make more sense because it could maximize the value of your case. If it appears your treating physician will state that you’re ready for unrestricted work in the near future, settlement before your next appointment may make sense.
What happens after you reach MMI under Georgia law, if you’re collecting benefits?
- Your physician will normally examine you.
- He will determine the status of your condition.
- The doctor will assign a disability rating, possibly a permanent work restriction.
If you’re healthy enough, your physician will release you to unrestricted work and the insurer may suspend your income benefits after you reach maximum medical improvement in Georgia. But that’s an exception to state law. Generally, medical treatment and income benefits can continue after you reach maximum medical improvement if you’re not approved for work without restrictions or you come back to your job with restrictions but earn as much, or more, income than at the time of your accident.
If your physician determines you’re at your MMI, but you don’t think that’s true, you aren’t forced to agree. You could get a second opinion from another doctor. If that physician decides there are other treatments that could help you, workers’ comp may pay for additional care.
What happens after I reach MMI under Georgia law and I don’t fully recover?
If further recovery isn’t possible through reasonable treatment after reaching MMI in Georgia, your doctor will state that you’ve reached MMI and give you a disability rating. It plays a role in determining whether you can go back to your job and, if so, what restrictions are needed. Based on those restrictions and your job duties, you may need to be assigned to another position or need another job you can perform within your restrictions.
If you are deemed partially disabled, you can receive workers’ comp benefits, but the amount will be cut by the percentage of disability you are given. If your knee injury results in a finding that you’re 30 percent disabled, what benefits you’ll receive is based on the appropriate schedule for knee injuries, reduced by the 70 percent function that you are not disabled.
If you’re declared totally disabled, the doctor is of the opinion that you are unable to have any “substantially gainful” employment without pain or significant restrictions. You should receive benefits based on your type of injury and its severity for a designated time period.
What should I do if I have questions or need help?
The Mann Law Firm helps Macon, Georgia, residents who have been injured in a workplace accident obtain the workers’ compensation benefits they deserve. If you have been injured on the job, or a member of your family has been killed in a workplace accident, contact a work injury attorney at the Mann Law Firm today. Call us at (478) 742-3381 or through our online form for a free initial consultation with a Macon Workers’ Compensation Lawyer.