Numerous considerations influence the medical benefits available through workers’ compensation. For example, employers might question whether a medical condition actually began with someone’s job. In such cases, the worker may have to undergo a specialized evaluation to establish that their job is the likely underlying cause of their condition.
In some cases, workers may disagree with a physician who declares that they have fully recovered and can return to work without pain or functional limitations. Sometimes, there are disputes about how long a worker should continue receiving medical benefits. In some scenarios, a physician may recommend the end of active treatment because they believe the worker has achieved maximum medical improvement (MMI).
MMI relates to the permanence of symptoms
Many work-related medical challenges improve with the right treatment. Workers with broken bones, for example, typically expect to make full recoveries and return to work without any lasting implications for their job performance.
In theory, workers’ compensation can continue paying for treatment until a worker makes a full recovery. However, some conditions do not typically result in full recoveries. For example, repetitive strain injuries caused by performing the same job functions may never fully heal. Instead, the worker may always have lingering symptoms.
When a physician determines that additional treatment is unlikely to improve a worker’s condition, they may submit paperwork indicating that the worker has achieved MMI. At that point, the remaining impairments resulting from the worker’s condition become permanent disabilities.
The worker may qualify for ongoing medical coverage for symptom management. However, workers’ compensation may no longer pay for treatment intended to cure their condition because it is unlikely to respond to additional treatment.
MMI designation can also influence disability benefits. Workers who still have significant limitations because of their conditions may qualify for permanent partial disability benefits in many cases. In more severe cases, they may qualify for total permanent disability benefits.
Learning more about the rules that apply to California workers’ compensation cases can help employees understand what they are eligible for and when other parties involved may have reached the wrong determination. Those with lingering symptoms may eventually need help negotiating for permanent disability benefits and addressing changes to available medical coverage.
