What is MMI?
Maximum medical improvement, or MMI, is a medical term that is used in the treatment of an injured worker who is receiving workers' compensation benefits for their work-related injury or illness. When an injured worker reaches a point where their condition has improved the most that it will improve, they are said to have reached maximum medical improvement. This may mean that an injured worker is fully and completely recovered from their injury or illness and able to return to the job that they had before their injury or illness, if it is available. However, it may also mean that an injured worker is left with a partial or total permanent disability. This is because no additional improvement or healing is deemed possible, at this point.
Even though an injured worker has reached maximum medical improvement, that worker may still require medical care. In fact, an injured worker may require medical care for the rest of their life. If maximum medical improvement does involve either a partial or total permanent disability for an injured worker, there condition will be assessed and a rate of impairment and disability will be determined. The level and degree of the impairment and disability will determine the amount of permanent disability benefits that the injured worker will receive.
The American Medical Association’s Guides to the Evaluation of Permanent Impairment (AMA’s Guides), 4th Edition, defines impairment as “a loss, loss of use or derangement of any body part, organ system or organ function.” Furthermore, “Impairment percentages or ratings developed by medical specialists are consensus-derived estimates that reflect the severity of the medical condition and the degree to which the impairment decreases an individual’s ability to perform common Activities of Daily Living (ADL), excluding work.”
An impairment rating is to encompass each covered injury that has reached MMI according to the rating physician. MMI means the condition is unlikely to improve substantially with or without medical treatment.
An impairment evaluation performed by our qualified physician, Dr. Shellie N. Smith, is the basis for the IE’s determination of impairment benefit entitlement. Therefore, the physician’s impairment rating report is to include narrative text that clearly communicates the physician’s opinion, and that provides a convincingly descriptive rationale in support of the stated impairment rating.
We are here to help, contact us to review your case. Let us handle your impairment rating needs. We prepare Impairment Ratings for:
* Personal Injury Claims
* Work-Injury Related Claims
* Treating Physicians
The term "alternative certification" in the context of an injured worker obtaining a second opinion from an impairment rater is an impairment rating often assigned to assess the extent of a worker's permanent impairment resulting from a workplace injury. If an injured worker disagrees with the initial impairment rating provided, they may seek a second opinion from another qualified medical professional, such as a Certified Impairment Rater or another qualified physician.
The second opinion process generally involves the following steps:
Selection of Another Physician or Impairment Rater: The injured worker, with the approval of the workers' compensation system or insurance carrier, may choose another physician or impairment rater to conduct a separate evaluation.
Examination and Assessment: The selected physician or impairment rater will conduct an independent examination of the injured worker, reviewing medical records and assessing the nature and extent of the impairment.
Impairment Rating Report: Based on the examination, the second opinion provider will generate a report that includes their assessment of the impairment and a recommended impairment rating.
Dispute Resolution: If the second opinion differs from the initial rating, the parties involved (including the injured worker, employer, and insurance carrier) may engage in a dispute resolution process to resolve the disagreement. This process may involve negotiation, mediation, or, in some cases, formal hearings.
Healthcare Solutions can assist by determining your impairment rating through an impairment assessment. An impairment assessment is not a disability exam, but a reflection of how your extremity or whole body has been impaired by the covered illness. We determine the percentage of impairment as a result of your approved condition.
In Texas, an employee who sustains a work-related injury is entitled to Impairment Income Benefits (IIBs). These benefits amount to 70% of their pre-injury weekly earnings for each percentage point of their impairment rating. This compensation is provided for a duration of up to 300 weeks, with the specific duration determined by the percentage of impairment. For example, an individual with a 8% impairment rating would qualify for IIBs for a period of 24 weeks.
To receive a fair, unbiased impairment rating for your workplace injury claim, schedule a meeting with our Certified Houston Workers Compensation Doctors. Call our office at (713) 723-8300.
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