Workers’ Compensation: Navigating the Gray Area of Maximum Medical Improvement

Understanding the intricacies and fine print of North Carolina Workers’ Compensation Law isn’t easy (that’s why people hire Attorneys like us). Workers’ Comp Law is filled with legal jargon, gray area, and a whole lot of “what-if’s”. One of the thorniest issues in NC Workers’ Comp Law is the concept of Maximum Medical Improvement (MMI).

Maximum Medical Improvement is used to define the point that an injured employee reaches in their treatment when their injury can no longer be improved. Essentially, when an injured employee’s treatment plateaus.

I’m sure you can already see how MMI is a bone of contention.

So, how do you navigate the gray in addition to everything else you’re dealing with from your injury? The purpose of this article is to shed some light on your rights as an injured employee and answer a few frequently asked questions about Maximum Medical Improvement. 

Who determines when an employee has reached MMI?

The answer is [mostly] simple: a physician determines MMI. Typically it is the treating physician of the injured employee. However, an employer or insurer may request an Independent Medical Examination to be carried out. This independent examination must then be approved by the physician, or it is forwarded to the Industrial Commission or a judge.

Will medical treatment continue after MMI is reached?

Not always. Sometimes, if an injured employee’s condition will worsen if treatment ends, they will continue to receive treatment for their injury.

If an employee continues to receive treatment after establishing MMI, who pays for it?

If the discontinuation of treatment will result in regression of the employee’s medical condition, the employer may be responsible for paying medical expenses related to an injury throughout an employee’s lifetime.

In other cases, an employer may offer a specific amount for a “release”. A release restricts an injured worker for bringing any future claims against the employer or workers’ compensation carrier.

What happens if MMI is established but the employee cannot return to the same level of work?

If the employee begins working again but receives a lower wage or works fewer hours, they may be entitled to compensation for lost wages. If the employee cannot work due to their injuries, they may be compensated with non-working wage loss for what they would have been making.

It’s okay to have a lot of questions about your Workers’ Compensation case, but we hope this cleared a few things up. Still feeling a little (or very) confused? That’s understandable. However, you don’t have to go through this alone. Miller Law Group has a team of Attorneys with over 25 years of experience serving clients with Workers’ Compensation cases. If you have questions or would like to consider legal representation for your case, please give us a call at (919) 348-4361 or contact us online.

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