Maximum medical improvement is the point where a treating physician determines your condition will no longer be improved by further medical treatment.
One term you are likely to hear during your course of treatment for a work-related injury is maximum medical improvement (MMI). This is the point where your treating physician determines that your condition has reached the point where it will no longer be improved upon by further medical treatments. Many employer’s mistakenly take this to mean that there will be no future treatments or physician visits in relation to the injury and may deny claims for medical bills after MMI has been declared.
Workers’ Compensation Benefits Denied
In the event that your claim involving care for a medical condition after MMI is being denied, our Missouri workers’ compensation attorney can help you file an appeal with the labor board. If the treatment you are receiving is medically necessary and related to the workplace accident or injury, then your employer may be obligated to pay for it through their workers’ compensation insurance.
Case Study – Ongoing Treatment for Pain
An injured Missouri worker damaged her lower back in the course of her day-to-day activities in an in-patient care facility. As is common with back injuries, the pain persisted long after MMI had been determined. She sought various treatments to help alleviate the pain and submitted those to the employer for compensation.
To further complicate matters, a condition of her MMI put her on restrictive duty at her job, which resulted in the employer terminating her position. Despite this, and the insistence of the employer that they were not responsible for the ongoing pain treatments, the labor board decided in favor of the employee and obligated the employer to pay for the treatment as well as psychiatric treatment she was undergoing as a result of losing her job.
Medical testimony is essential in these types of cases and providing the right kind of compelling evidence is critical in persuading the board to rule in your favor. These types of hearings mirror civil trials, where evidence is presented and refuted by both sides. In order to be prepared, you will need assistance from an attorney who has experience with these types of proceedings.
Preparing for an Appeal
Maximum medical improvement does not necessarily mean that no more treatment is necessary. Although the underlying condition may not improve, it may still be causing you pain, which you are entitled to seek treatment for. Some physicians may even find other means of improving your condition that were overlooked by your original doctor. If your employer is not willing to pay for such treatments, an attorney will help you compel them to.