Under Florida law, you are entitled to receive workers’ compensation benefits from your employer if you have been injured in the workplace. These benefits are comprised of medical care and income benefits. Benefits cease at the moment that you reach Orlando maximum medical improvement (MMI) unless you are totally or permanently disabled.
This can have devastating financial and health consequences for an injured employee who is suddenly left without an income or the means to pay for their own medical care. However, an MMI diagnosis is not necessarily final and there are ways to have the decision overturned or to continue to receive benefits.
Contact Work Injury Rights in Orlando if you have received an Orlando maximum medical improvement diagnosis but don’t agree with the decision for more information on what you can do next.
Table of Contents
What is Maximum Medical Improvement (MMI)?
Maximum medical improvement is when you have reached a state where further treatment will no longer have any benefit or improve your current condition. It does not mean that you are fully recovered or that you have regained your capacity to work – only that your injury has reached a stage of recovery where further improvement is not possible.
Once it has been determined that further medical treatment will have no benefit, then your workers’ compensation benefits will be terminated by your employer or their insurance carrier. This means that you will no longer receive income benefits and that your employer will no longer cover the cost of medical care.
In some cases, an MMI diagnosis may mean that you are fully or permanently disabled. In this case, you should continue to receive your workers’ comp benefits. However, your employer or their workers’ compensation insurance carrier may reduce your benefits at this time.
It is highly recommended to contact a lawyer as soon as possible after receiving an Orlando maximum medical improvement diagnosis.
Who Determines When an Injured Employee Has Achieved Orlando Maximum Medical Improvement?
In order to receive medical workers’ compensation benefits in Florida, you are required to receive treatment from an authorized doctor. This doctor is authorized by your employers’ insurance carrier. If you do not use an authorized doctor, then your medical care will not be paid by your employers’ insurance provider.
The authorized doctor is the one who decides when you have reached maximum medical improvement or MMI. As your treating doctor, it is assumed that they have the knowledge that allows them to make this decision. However, authorized workers’ compensation doctors are often placed under immense pressure to reach an Orlando maximum medical improvement diagnosis as soon as possible so that the insurance carrier can stop paying benefits.
The doctor may supply a yellow DWC-25 form at the beginning of treatment that may specify a date when MMI will be reached. This form will be completed at the end of each visit which will define your current status and when you have reached Orlando maximum medical improvement. It is important to keep this and other forms so that you can get a second opinion and appeal the decision to have your benefits terminated. This date may be adhered to even if you have not fully reached MMI.
Does Medical Treatment Continue After an MMI Diagnosis?
As mentioned above, an Orlando maximum medical improvement diagnosis does not mean that you have fully recovered from your injury and you may require ongoing medical treatment. However, you will no longer be eligible to receive temporary partial or total benefits. In rare cases, the insurance carrier may continue to cover medical care but income benefits will cease or be reduced.
If you receive a diagnosis of a full or permanent disability, your employer and their insurance carrier are still required to provide medical and income benefits. The payments will continue according to the impairment rating that you receive.
What if You Can’t Return to Work in the Same Capacity After Your MMI Diagnosis?
Your employer is required to offer you employment at a reduced capacity if you cannot return to work full-time or perform the same functions as you previously did. For example, if had a job that required physical labor, you can be moved to a desk job and you employer is required to provide the necessary skills training. You may continue to receive partial workers’ comp benefits if you are not receiving the same income as you previously did.
If your employer is unable to offer you employment at a reduced capacity that takes into consideration your medical needs, then they are required to provide occupational training to provide the skills that you will need to start a new job. The state of Florida also offers, at no cost to you, re-employment services.
If you are permanently disabled or fully disabled to the point that you will never work again, your employer and their insurance carrier should continue to pay benefits. However, in most cases, you will be offered a settlement by the insurance carrier so that they do not have to continue to pay for your future care.
If your employer is not willing to offer you employment in a reduced capacity or are unwilling to provide you with occupational training, contact Work Injury Rights. You should also speak to us before accepting any settlement from your employer or their insurance carrier. While a settlement may look immediately attractive, it may not be sufficient to cover your long-term medical and other needs related to your injury.
Receiving an Orlando maximum medical improvement diagnosis does not necessarily mean that your workers’ compensation benefits need to cease immediately. Few employers fail to inform their employees that they have a right to a second opinion. You can get a second opinion from a doctor of your own choosing or submit to an independent and impartial medical examination. An independent medical examination can be ordered by you, your employer or a judge of compensation claims. Your MMI status may even be changed at a later date as your injury changes or new treatments become available.
Keep in mind that your employer and their insurance carrier will do what they can to terminate or reduce your workers’ compensation benefits as much as possible and as soon as possible. This is to save them money. They may even put pressure on your authorized doctor to provide a diagnosis of MMI when you haven’t entirely reached an Orlando maximum medical improvement.
Contact a Workers’ Compensation Attorney to Discuss Your Orlando Maximum Medical Improvement Diagnosis
The workers’ compensation claims process can be tricky to navigate, and issues arise that can even throw-off seasoned attorneys. Reaching Orlando maximum medical improvement doesn’t have to be stressful by going it alone.
Our trusted workers’ compensation attorneys have the experience to deal with complications that have come along with a maximum medical improvement diagnosis. If you have received an Orlando maximum medical improvement diagnosis, contact Work Injury Rights immediately for a free consultation.