Getting hurt on the job can inspire a variety of complications. People usually have to miss work to obtain medical evaluation and treatment. They may be unable to return to work for some time if their injuries are significant. Their condition can quickly lead to financial hardship.
Thankfully, workers’ compensation benefits are available to help those who cannot work and who require medical care because of job-related medical issues. An on-the-job injury or a work-related medical diagnosis may qualify a professional for workers’ compensation benefits. A doctor can recommend a specific course of treatment and may also impose certain functional limitations that may allow the professional to return to work. Unfortunately, not all work injuries are as simple as a laceration or a broken bone. Employees do not always make a full recovery after initiating a worker’s compensation claim.
What happens when professionals do not respond to treatment while they are receiving workers’ compensation?
Benefits may change or end in some cases
Although medical coverage through workers’ compensation pays all the costs of necessary medical care, there are still certain limits that apply. The treatment must be necessary and effective.
The doctor overseeing a workers’ compensation claim has to follow specific standards. They must communicate with the state and provide guidance for the employer when workplace accommodations are necessary. They also need to inform involved parties when the worker no longer responds to treatment.
In such scenarios, the worker has achieved maximum medical improvement (MMI). An MMI designation has a direct impact on the benefits the worker receives. Typically, employees are no longer eligible for treatment-related medical benefits through workers’ compensation.
Instead, the only coverage they receive is for continued symptom management. A designation of MMI can also impact disability benefits. A worker who has not fully recovered but who no longer responds to treatment may have a permanent disability. They may be eligible for permanent partial disability benefits based on the impact their condition has on their ability to continue working.
Workers may need help maximizing their benefits to minimize the financial losses they suffer. Professionals navigating a claim complicated by an MMI designation may need help, especially if they question the doctor’s determination.
Retaining workers’ compensation coverage even after achieving MMI is often possible. Employees may need help negotiating permanent partial disability benefits or appealing a decision that is not in their favor, and that’s okay.
