If you’re receiving workers’ compensation for a work-related injury, you will eventually reach maximum medical improvement (MMI).

MMI is the point at which the symptoms of your illness or injury are unlikely to improve any further, according to a doctor. This has important implications in terms of your compensation entitlements, which we’ll detail in this blog post.

How Do I Know When I’ve Reached MMI?

You should file a claim with the Georgia Workers’ Compensation Board after sustaining a work injury; the rules state that you should begin receiving benefits within 21 days of the first day you miss work.

The longest time that you can receive benefits before reaching MMI is 400 days, but most claimants reach the point of maximum improvement much earlier than that. After your physician has been treating you for a certain length of time, they should determine that you have reached MMI.

It’s important to note that only an authorized treating physician can determine when you have reached MMI. Your employer cannot make this determination, nor can a physical therapist or nurse practitioner.

Your own opinion on your recovery is also irrelevant for the purposes of MMI evaluation. Even if you feel as though your condition has reached a plateau and won’t improve further, an authorized physician might refuse to sign off on MMI because they believe your injuries could get worse in the future. They might also want to try additional treatments to attempt to improve your condition further.

What Is a Disability Rating?

Once a doctor has determined that you have reached MMI under Georgia law, and that you cannot return to work in the same capacity as before, you will be assigned a disability rating.

This does not mean that your workers’ comp benefits will be stopped. It means that you will be assigned a disability rating by a doctor, which will determine how much you will receive after reaching MMI. There are four categories of workers’ compensation benefits that a doctor can assign to you after you have reached MMI.

  • Temporary Partial Disability Benefits (TPD) – TPD benefits apply if you can return to work in your previous role, but only on light duty. TPD benefits should make up some of the difference in pay due to your reduced hours.
  • Temporary Total Disability Benefits (TTD) – TTD benefits apply if you cannot work for seven days or more. The benefits will provide two-thirds of the salary that you earned before your accident.
  • Permanent Partial Disability Benefits (PPD) – If your injury has caused permanent damage but you’re still able to work, these are the benefits that will apply. PPD benefits can be either scheduled or unscheduled, depending on the nature of your injury (we discuss the difference between scheduled and unscheduled benefits in more detail below).
  • Permanent Total Disability Benefits (PTD) – PTD benefits apply if your doctor states that your medical treatment has brought about all possible improvements in your condition and you still cannot return to work in any capacity.

If you disagree with a doctor’s decision that you have reached MMI, you don’t have to accept it. You can always see another doctor to get a second opinion. If both doctors reach the same conclusion, but you still want to challenge it, you should contact a workers’ compensation attorney to discuss your options.

Does Reaching MMI Mean That My Case Is Settled?

One thing that you need to keep in mind is that insurance companies are in the business of making money. This means that your insurer will want to pay out the smallest possible amount for your workers’ compensation claim.

Most workers’ comp insurers will offer you a settlement right after you make a claim. It may be tempting to take the offer right away because it could seem like a lot of money at the time. The insurance company knows you’re in a vulnerable position and wants to use this to persuade you to make a rash decision.

Many injuries that happen on the job do not fully develop right away. Some symptoms take weeks or months to appear. If you’ve already settled with the insurance company and your condition worsens, you will be responsible for any medical bills that arise after the settlement. This is where MMI comes in.

You should not consider settling with the insurance company until you have reached MMI under Georgia law. If a doctor (or more than one doctor) has determined that you’ve reached maximum medical improvement, then it’s unlikely you’ll develop any further symptoms. If you choose to discuss a settlement with the insurance company at this time, make sure you consider all of your options with a knowledgeable workers’ compensation attorney.

To summarize, you will reach MMI when an authorized physician has determined that you have made the best possible recovery. You will then be told whether you can return to work completely, partially, or not at all. If the doctor determines that you cannot return to work in the same capacity as before, you will receive a disability rating, and your benefits will continue for a certain period of time.

Scheduled vs. Unscheduled Benefits

A scheduled work injury is one that causes permanent impairment to a limb or organ, such as the loss of an eye. An unscheduled injury is one that causes general impairment, such as an occupational disease. The key difference between the two is related to the way in which they’re paid for under workers’ compensation.

If you develop a scheduled injury, your insurance company policy will dictate your entitlements based on the state’s injury schedule. Workers’ comp policies set out detailed guidance on the amount of compensation available for specific scheduled injuries. So, for example, if you lose the use of your dominant arm, you’ll be entitled to a certain maximum amount of compensation for that injury.

With unscheduled injuries, compensation is based on the reduction in your earning capacity related to your condition. Your physician will carry out an assessment and recommend a disability rating based on your capabilities post-injury. This system creates a much greater variance between award amounts than you generally see in cases involving scheduled injuries.

If you’re not sure how these rules will affect your case, you should discuss the situation with your attorney.

What Should I Do If I Am Confused About MMI?

Workers’ compensation claims can be complicated; you may still be asking “What happens after I reach MMI in Georgia?” The MMI workers’ comp attorneys at Mann Law Firm will help you understand all the important details so that you can pursue the benefits you deserve.

Attorney David Mann worked for many years as in-house counsel for a large insurance company, so he knows the tactics insurers use to get away with paying out as little as possible in workers’ compensation benefits. He can use this experience to build as strong a case as possible on your behalf.

If you have been injured at work, call Mann Law Firm today at 478-742-3381 or fill out our online contact form to start the process of pursuing the benefits you deserve.

Attorney David Mann

Attorney David MannBefore leading his own firm, Mann served for several years as in-house defense counsel for a large insurance company, which gives him unique insight into how insurance companies work. He uses this critical knowledge as an advantage for his clients. He is a tough negotiator and litigator, and he is exceptionally strategic in building cases on behalf of personal injury victims.[ Attorney Bio ]

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