How Maximum Medical Improvement Can Affect Workers’ Comp

by fihguide   ·  3 years ago  

When you’re hurt on the job, it can take months or years to recover. However, a full recovery isn’t always possible. Many people live with lasting damage from job-related injuries. If you get workers’ compensation benefits, the Social Security Administration (SSA) will keep tabs on your recovery. Once you reach Maximum Medical Improvement (MMI), your doctor will let the SSA know. MMI means you recovered as much as you’re going to from your injuries. This determination is important, because it means your benefits will likely change — or end.

Maximum Medical Improvement: Will You Stop Getting Benefits?

So, what happens after a Maximum Medical Improvement diagnosis? Will it affect your workers’ comp payments? It really depends on which benefits you’re getting now. There are four workers’ compensation benefit types available in every state:

  • Temporary Total (TT)
  • Temporary Partial (TP)
  • Permanent Partial (PP)
  • Permanent Total (PT)

If you receive PT or PP benefits for your workplace injury, Maximum Medical Improvement won’t affect you. However, TT or TP benefits will likely change.

A few different things can happen once you reach Maximum Medical Improvement. Even if you’re not fully functional, your doctor may medically clear you for work. Going back to work (even with limitations) usually terminates workers’ comp payments. But if your injury is bad enough, then you may qualify for a different benefit type.

What Benefits Can You Still Get After Maximum Medical Improvement?

If your temporary workers’ comp benefits stop, that doesn’t mean all assistance must end. You may now qualify for permanent total (PT) or permanent partial (PP) benefits instead. That usually applies to anyone with Maximum Medical Improvement who still cannot work.

You may also qualify for Social Security disability (SSD) benefits at this point. This is especially true if your state’s program has a time limit for PT or PP benefits. For example: In North Dakota, certain workplace injuries may qualify for Permanent Partial Disability (PPD) benefits paid up to 1,500 weeks. However, Massachusetts state law limits those same PPD benefits to 260 weeks.

In addition, some state workers’ compensation programs provide scheduled awards for specific losses (like amputated limbs). If have disfigurement and scarring, you may qualify for a scheduled award lump-sum payment in certain states.

Applying for Social Security Disability After Workers’ Comp Ends

If your workers’ comp runs out after you reach Maximum Medical Improvement, you should apply for SSD benefits. The disability claim process can take 3-5 months, on average, to complete. So, it’s better to file your application as soon as you learn when your workers’ compensation checks will end.

In addition, you may qualify for legal assistance filing your claim. Having a legal professional help you file doesn’t cost anything up front. However, it doubles your chances for approval the first time you apply for benefits. To see if you may qualify for legal assistance and get the process started, complete your free online evaluation now.

Related: State Guidelines for Workers Compensation Benefits