Misconceptions of MMI/IR Evaluations

We know that an MMI evaluation can be confusing to those who don't deal with these laws and calculations on a daily basis. One of the best ways to explain the underlying concepts of MMI is to cover some misconceptions:


Myth: When I obtain MMI, my Workers' Compensation case is completely over.

Fact: Not exactly. Here's an analogy to help explain: Bob has a million dollars in the bank, and that million dollars gets stolen. The police work diligently to track down Bob's million dollars, and they recover 100% of it. Two things have happened here, Bob achieved maximum financial recovery (the best the cops were able to do) and that maximum financial recovery just so happens to be all of his money. Alternatively, let's imagine Bob's millions get stolen, the police track down his money and they recover as much as they can but not all of it. They have still gotten Bob his maximum financial recovery, that is to say, they recovered the best that could be expected, but that was since the rest of it was already spent, the maximum financial recovery possible under the circumstances is less than 100% of his million dollars.


Myth: I can get a settlement based on my MMI rating.

Fact: This is wrong for two reasons. First, there is no such thing as an "MMI rating." Instead, once you reach MMI, you're issued an Impairment Rating (More information can be found here on Impairment Ratings). Based on your Impairment Rating, you do get paid additional compensation, but it's not actually a settlement. Sometimes it's paid as a lump sum payment that seems kind of like a settlement, but, legally speaking, that's its only similarity to a settlement, and it really is not a settlement.


Myth: Once I reach MMI, I can no longer receive medical attention.

Fact: No. MMI really just means you've gotten as well as you can get, it means you're not going to get any better, but it doesn't necessarily mean you won't need continuous treatment. Here's an example: Steve falls and breaks both of his legs. He also suffers nerve damage that causes severe pain. Steve undergoes surgery and lots of physical therapy, and his legs heal as well as they ever will. Meaning he can walk, but he'll always have a limp. Since he'll never get any better no matter how many extra procedures they may perform, the workers' comp carrier would determine that Steve has reached MMI. But, due to his nerve damage, he will need to take pain medicine for the next several years. Even though he's reached MMI, the insurance carrier will continue to pay for his pain medication. In a practical sense, reaching MMI means that you've probably obtained most of the medical procedures that you need, but it doesn't necessarily mean that you've obtained all of the medical treatment.


Myth: Once I reach MMI, I will no longer get paid for lost wages.

Fact: This one's a little tricky. Workers' Compensation doesn't exactly pay for lost wages. Instead, Workers' Comp provides Income Benefits, of which there are four different types. Chronologically speaking, the first type you receive are Temporary Income Benefits, and, yes, those Temporary Income Benefits do indeed stop being paid to you at the point you reach MMI. However, once you reach MMI, that opens the door for you to obtain some of the other types of Income Benefits: such as Impairment Income Benefits. You can read more about these four types of Income Benefits.