Maximum Medical Improvement and Disability Impairment Ratings in S.C. Workers Compensation

Often times an injured worker will have questions about maximum medical improvement (MMI), impairment ratings, and its effect on your disability award under South Carolina Workers’ Compensation. Depending on the severity of your injury, the doctor will make a determination of maximum medical improvement and determine if you are permanently impaired and to what extent. These determinations can be very important to the evaluation of your workers’ compensation claim. This article is designed to help you understand what Maximum Medical Improvement means, what is an Impairment rating, and how it can impact your disability award.

What does Maximum Medical Improvement Mean?

Maximum medical improvement, or “MMI”, has an important meaning in South Carolina Workers’ Compensation laws.  The term “maximum medical improvement” means an injured worker has reached such a plateau that, in the physician’s opinion, no further medical care or treatment will lessen the period of impairment.  Maximum medical improvement is a factual determination by the Commission. However, the fact an injured worker has reached maximum medical improvement does not preclude a finding the claimant still may require additional medical care or treatment.  If additional medical care or treatment would tend to lessen the period of disability, then the employer maybe required to provide any treatment that would at least maintain the injured worker’s degree of physical impairment after an injured worker has reached MMI.

Maximum medical improvement is a distinctly different concept from “disability” under the Workers’ Compensation laws in South Carolina.  Once the physicians and/or the Commission agree the injured worker has reached MMI, the next step is to determine if and to what degree there is any permanent disability.  The date of maximum medical improvement signals the end of entitlement to temporary total benefits.  Post-MMI benefits may then be awarded either as a permanent total or partial disability, or as a percentage of impairment to a scheduled member.

What is an Impairment Rating, and how does it affect my Disability Award?

After reaching MMI, the treating physician will look at the American Medical Association’s Guides to the Evaluation of Permanent Impairment.  This is sometimes referred to as the “AMA Guides.”  In determining your impairment rating, the doctor will review the tables and charts that related to type of injury based your current level of medical improvement. The physician will assign an impairment rating based upon the procedure performed (surgery, injections, physical therapy, etc.) and will also consider other factors like work restrictions, decreases in range of motions and ongoing pain.  Sometimes the treating physician hired by the insurance company may not provide an injured worker with a fair impairment rating.  In those situations, this Columbia Workers’ Compensation attorney may have a third-party specialist evaluate the severity of your injury and provide an opinion on an impairment rating through an independent medical examination (IME). Getting a second opinion from a doctor who can advocate for you may significantly improve the final amount of compensation you receive from South Carolina workers’ compensation claim.

It is important to understand that the South Carolina Workers’ Compensation Commission is not bound by the physician’s impairment rating in determining the percentage of your disability award.  The physician’s impairment rating is just one of many factors used to determine disability, but a physician’s impairment rating happens to be an important factor.  Other factors that are considered in determining disability can be the injured worker’s age, education, prior work history, work restrictions, and need for future medical treatment. As a result, a “disability award” will often be a higher percentage than the initial impairment rating and may include future care such as continuing prescription medication or other procedures.  Any “prosthetic devices” implanted, such as plates, screws, rods, artificial disks or joints, are covered for the lifetime of the injured employee.

Contact A Columbia, South Carolina Workers’ Compensation Attorney Today

If you have any questions about reaching maximum medical improvement, your impairment rating, and its effect on your disability award under South Carolina Workers’ Compensation laws, please contact this Columbia Workers Compensation law firm today at (803) 350-9230 or click here to fill out an online case evaluation form.  The correct determination of MMI and your impairment rating is very important to obtaining the compensation you are entitled to under the law. There is no obligation or charge to see if we can help you with your workers’ compensation claim.