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Who Decides When I Have Reached Maximum Medical Improvement?

When an employee suffers an injury in the workplace, he or she will likely be entitled to workers’ compensation benefits. However, there are several factors that can potentially impact how long you are able to receive these important benefits, such as the length of time it takes for you to recover from your injuries. Of course, the recovery process is not an exact science and no two situations are exactly alike. Even if two people sustained identical injuries, how quickly they are able to return to work can still differ. Therefore, benefits can end at different times and is generally based on whether the worker reached maximum medical improvement. Who decides when or if an injured worker has reached maximum medical improvement?

Defining Maximum Medical Improvement

Maximum medical improvement does not mean that you have achieved a full recovery, but rather that you have reached the point in your condition where additional treatment will not improve your injury any further. For some, this means they are able to return to work and are in the same condition they were in prior to their injury. For others, this simply means that they cannot recover beyond a certain point and that treatment is no longer effective.

A maximum medical improvement diagnosis can potentially mean a few different things for a patient:

  • His or her injuries are completely healed and the employee is able to return to work.
  • His or her injuries are not completely healed, but a doctor has determined that the worker’s condition cannot get any better. It is possible that the worker will be able to resume his or her job if it can be performed, despite any new limitations incurred as a result of the injury.
  • His or her injuries are not healed and a doctor determined that the injuries will not improve. The worker will receive an impairment rating for the injury, which means he or she could be eligible for extended Impairment Income Benefits (IIBs).

Impairment Income Benefits

After a doctor determines that you have reached maximum medical improvement, he or she will assess if you are suffering from any permanent physical or functional damage and, if so, you will be given an impairment rating, which can potentially allow you to receive IIBs. These benefits will end after you have received a total of three weeks of payments for every percentage of your rating, up to 104 weeks. For example, if your rating was 10%, you will receive an additional 30 weeks of IIBs after you have reached maximum medical improvement.

Experienced Workers’ Compensation Attorneys in Sacramento

If you sustained an injury in the workplace, you are eligible for important workers’ compensation benefits that can help you during your period of recovery. To ensure you have the best chance of receiving these benefits, it is imperative that you obtain skilled legal counsel as soon as possible. At Smolich & Smolich in Sacramento, our team of attorneys have been representing injured and disabled workers for over 40 years.

Get started on your workers’ compensation case today and reach out to our team at (888) 452-0703 to request a free initial case evaluation. If we do not win your case, you will not owe us any legal fees!

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