Maximum Medical Improvement in Oregon

Maximum Medical Improvement

The law in Oregon provides workers’ compensation rights to every employee. The workers’ compensation is applicable in cases where an employee gets injured at the workplace.

It entails immediate medical benefits as well as wage loss compensation, depending on the circumstances.

A worker is not required to file a personal injury claim to receive compensation for their injuries at work, thereby ensuring quick delivery of relief. Under Oregon law, the benefits of worker’s compensation must be provided irrespective of who is responsible for the injury.

The Workers’ Compensation Division of the Department of Consumer Business Services (DCBS) in Oregon administers the workers’ compensation.

The Difference Between First Party And Third Party Insurance Claims in Oregon

Maximum Medical Treatment (MMI)

MMI is one of the most contested terms related to workers’ compensation in Oregon. In a situation where an injured worker has to pay their medical bills through worker’s compensation insurance, determining the right MMI increases the victim’s burden even more.

What Does Maximum Medical Improvement Mean?

Maximum Medical Improvement (MMI) refers to the medical condition of an injured worker beyond which further improvement in their injuries is not possible.

MMI is determined by a doctor after putting to use all possible treatments available. It does not, however, mean that the patient has necessarily recovered fully – it only refers to the fact that the patient has reached the point of maximum recovery possible.

The doctor provides a disability rating to the injured worker. The worker or their attorney should obtain a written statement from the physician indicating the disability rating.

The doctor also informs the employer about the physical work restrictions that the patient would face while doing the job at the workplace going forward. These are commonly termed as “Work Restrictions”.

The issue might appear to be simple, but it has certain grey areas. Complications arise especially when the worker faces restrictions in performing some tasks, but not others. For example, a spinal injury may disallow a worker to stand for extended periods, while they may still be able to work while sitting.

The employer may choose to place the worker in a different job which is commensurate with their work restrictions. However, sometimes the employer may not have such options. An example would be an assembly line where all the work has to be performed in a standing position.

Reaching a Fair MMI Settlement

In case of MMI, determining a fair compensation is another area of conflict. The injured worker is potentially compelled to choose between the following two options:

  • A final lump settlement
  • Receiving benefits to pay for the medical care and other financial needs.

The first option absolves the employer and the insurance company of all future liabilities.

MMI settlement is complex and workers and doctors may not always be knowledgeable enough about all aspects of the injury to make a sound decision.

Physicians may sometimes mistakenly believe that they should not continue to pursue other avenues of treatment and may declare that the worker has reached the condition of MMI.

Who Determines MMI?

It is the legal duty of the physician to determine the MMI of an injured worker. The insurance company providing the workers’ compensation can request for an independent medical assessment to verify the MMI status.

The independent examiners will prepare a report, copies of which are submitted to the patient, the employer, the physician, and the insurance carrier.

If the physician agrees with the independent examiner’s medical report, the worker’s compensation is terminated on either the date on which the physical examination was conducted or on the date of physician’s approval.

In cases where the physician does not agree with the independent report, the claim is forwarded either to the Industrial Commission or a workers’ compensation judge. The judge is the final authority in determining whether the injured worker has reached MMI or not.

In some cases, MMI may mean full recovery with absolutely no work restrictions at all. However, in most of the cases, the future of patient cannot be guaranteed to be the same and their medical condition may sometimes take a turn for the worse.

What Happens if the Injury Worsens after the MMI is Determined?

MMI has a pivotal role in determining the compensation and benefits to be awarded to an injured employee. The disability or the impairment rating is assigned only at this point. This rating is an indicator of the limitations and restrictions placed on the victims for the rest of their lives.

While the MMI means that no further recovery is possible, it does not guarantee that the injury or symptoms will not worsen. If such a situation occurs, the physician needs to evaluate the patient and determine whether the workplace injury has caused the appearance of new symptoms and whether further treatment is required.

If the worker is not satisfied with the physician’s evaluation of MMI, they have a right to explore alternative forms of treatment.

Personal Injury and Maximum Medical Improvement

MMI clearly plays a vital role in workers’ compensation claims of injured employees in Oregon. However, it also has a role to play in some forms of personal injury claims. A common example of such claims pertains to the injuries occurring in a car accident.

When injuries are sustained in an accident due to the fault of another driver, the victim can file a personal injury claim for compensation. This compensation is generally paid by the car insurance company of the at-fault driver.

In personal injury cases, settlement is usually the preferred option for both the parties involved. Hence, most of such cases are settled before they reach court.

To receive a fair compensation that covers all the expenses and losses borne by the victim, it is a sagacious idea to hire the services of a dependable Oregon attorney with deep knowledge of personal injury laws.

It must be noted that injuries sustained in car accidents may sometimes worsen over time. Therefore, before accepting a settlement, the victim of should wait until they reach the point of Maximum Medical Improvement or MMI.

Settling early absolves the at-fault party of all future liabilities. By making a settlement, the victim relinquishes all the rights to ask for compensation later on. Maximum Medical Improvement (MMI) does not mean that the costs of medical treatment will never be incurred in future for that same injury.

In light of these facts, it is absolutely essential for both the victims of personal injury as well as work related injuries to acquire the best possible legal representation.

Contact a Reputable and Experienced MMI Lawyer in Oregon

Dwyer Williams Cherkoss is a law firm in Oregon specializing in workers’ compensation and personal injury cases. The prudent and caring lawyers at Dwyer Williams Cherkoss fully understand the potential implications of Maximum Medical Improvement on the life of a victim.

The firm’s attorneys can help you understand your legal rights and provide the best legal advice and defense through all stages of the compensation process. Call 1-800-285-8678 today to schedule a consultation.