When you get hurt on the job as a first responder, one of the terms you may hear from your doctor or the insurance company is “maximum medical improvement.” Knowing what it means, and how it affects your benefits, is essential.
The Heart Bill attorneys at our law firm help injured workers understand and establish maximum medical improvement in Florida first responder claims, which will determine how long you are able to be compensated for medical care.
Maximum medical improvement (MMI) is the point at which your doctor believes you have healed as much as you are going to after your accident or illness. In other words, additional treatment is not expected to improve your condition.
Even after you are placed at MMI, you are still entitled to medical care for pain management and ongoing symptoms, including medication, injections, or therapy. The important thing is that you keep seeing your authorized doctor at least once per year. If you do not, the insurance company can try to shut down your claim.
A common worry we hear from Florida first responders is that once they have reached MMI, their case is done. This is not true! Workers’ compensation claims reaching maximum medical improvement is just a medical milestone, but is not necessarily the end of your benefits.
The focus shifts once you hit MMI. Instead of trying to make you better, the goal is to maintain your health and manage any conditions. This stage of the process can be stressful and first responders may feel pressure. It is best to have an experienced attorney who thoroughly understands how MMI works.
If you file a claim, workers’ comp can access your entire medical history. Once you put your medical condition at issue in a workers’ compensation case, the statute allows the insurance company to obtain copies of your records from all your providers.
There are limits, though. Records involving HIV status, substance abuse treatment, and certain mental health counseling have protections, but if your claim is for PTSD, then your mental health records may be accessed. Many first responders feel exposed when pursuing their claims and the uncertainty of MMI. We step in and push back where the law allows, making sure your privacy is respected.
If you are a first responder who is unhappy with the care you are getting, Florida gives you the right to an independent medical examination (IME), which can play a part in determining maximum medical improvement.
An IME means you can choose a doctor outside of the insurance company’s control to review your condition, give an opinion, and recommend treatment. MMI determinations can look different depending on whether the insurance company’s doctor or an independent doctor is making the call.
First responders often have other benefits available, such as pensions, Social Security Disability Insurance (SSDI), or even personal injury claims. Each system has its own rules and they often overlap. For example, your workers’ comp MMI status might affect your pension review or your eligibility for SSDI. Having a lawyer who understands the full scope of benefits for first responders is so important.
Reaching maximum medical improvement can feel like the end of the road for Florida first responders’ compensation, but it is not. You still have rights, and you still deserve care.
Our firm, Bichler & Longo, PLLC, is dedicated to protecting first responders. If you have been told you are at MMI or have questions about your workers’ comp benefits, we are here to explain and advocate. You have given your career to keeping others safe, so let us work to keep your rights safe.