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What happens when a worker reaches maximum medical improvement?

A worker hurt on the job at your company will require workers’ compensation benefits, which New York law requires you to provide. Your insurance policy will cover their medical treatments as they work toward recovery. You may also need to help support them through disability benefits paid until they can return to their job.

For employers, especially those who self-insure for workers’ compensation, claims by injured employees can be very expensive. When a worker achieves maximum medical improvement (MMI) for their condition, that will mean a likely change in the benefits the worker can claim. 

What is maximum medical improvement?

The term maximum medical improvement applies when a worker’s condition reaches a point where it has improved as much as it is likely to with the current treatments available. If the worker will likely have the same symptoms and limitations even with another 12 months of treatment, then the physician overseeing their care will likely determine that they have achieved MMI.

If there are still limitations on what the employee can do because of their injury, they may need to undergo a medical evaluation to determine what limitations they still have and what percentage of impairment persists after treatment. If there is noteworthy impairment that affects someone’s earning potential, then they may qualify for ongoing disability benefits. They will transition from temporary to permanent disability benefits.

Although there may still be medical coverage obligations for persistent symptoms requiring management or future flare-ups, the intensive treatment portion of the claim will end when the patient achieves MMI.

How your company can help workers achieve MMI

There are a few ways that employers can support all of their workers during a workers’ compensation claim. Agreeing to provide certain accommodations on the job, like remote work or a change in job functions, can help a worker reduce the strain on the affected body parts and get back to employment more quickly. Cooperating with leave requests so that workers can get the treatment they need is also important.

Knowing how a worker’s improving health will alter their workers’ compensation claim can help your business minimize the claim costs it must cover.

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