Key Takeaways:
- Reaching maximum medical improvement (MMI) does not mean you have fully recovered.
- You may be eligible to receive temporary or permanent disability benefits after reaching your MMI.
- You can dispute an MMI determination if you believe it is inaccurate.
- A workers’ compensation attorney in South Dakota can help you support your claim and fight for your right to receive benefits.
After suffering a workplace injury, many people wonder how long it will be before they can go back to the way they were prior to the accident. Unfortunately, some injuries do not ever fully improve, and people have to adjust to their new normal. When it comes to workers’ compensation, maximum medical improvement (MMI) can affect benefits a person receives once their condition no longer responds to medical treatment.
At Alvine Law Firm, our Sioux Falls, SD, workers’ compensation attorneys can help you navigate the process of filing for benefits and contesting any decision to revoke or discontinue them.
In this post, we will explain how maximum medical improvement impacts workers’ comp cases and your rights when seeking benefits for a workplace injury in South Dakota.
Disclaimer: This article is intended for educational purposes online. Please consult an attorney for legal advice.
What Is Maximum Medical Improvement (MMI)?
South Dakota will allow workers’ compensation benefits until an employee returns to their job or until they reach maximum improvement [1]. If an employee reaches a point of maximum improvement but can’t resume their previous level of work, then they may qualify for disability benefits.
Definition: Medical maximum improvement is the highest level of recovery a person can reach after an injury; this may be when they are fully healed or if they have recovered as much as they can with appropriate medical treatment.
If someone returns to their pre-injured state, then they can resume working as they used to and no longer require workers’ comp to cover their lost wages. If they are permanently partially or fully disabled, then they can pursue temporary or full-time disability benefits.
There are several key concepts to maximum medical improvement:
- Stabilization: The condition has improved as much as it can, even if the person still experiences symptoms or is not at their pre-injury state.
- Medically Determined: MMI can only be determined by a physician tending to the patient or an independent medical examiner; it is not the employee’s or employer’s judgement.
- Not Fully Healed: MMI does not mean a person is fully healed; many people who reach MMI are permanently disabled or impaired in some way.
How Does a Doctor Determine Maximum Medical Improvement?
A medical evaluation is required to determine if someone has reached MMI in a workers’ comp case. This evaluation will consider the patients’ medical history, their pre-injury abilities and post-injury abilities, and their response to medical treatment for their work-related injury.
The physical examination will test the workers’ mobility and physical capabilities; they will also review diagnostics tests, such as X-rays or MRIs, to track progress and note change over time.
Most importantly, the physician or medical examiner will look for a plateau in progress, which indicates that the patient’s condition is no longer benefiting from additional treatment.
Understanding IMEs (Independent Medical Examinations)
An insurance provider or the workers’ compensation board can request an IME from an independent medical examiner who does not have any prior history with the patient or employer.
IMEs can be used to provide a second opinion if the patient’s doctor’s MMI diagnosis is contested. Disagreements between the patient’s doctor and an IME can lead to legal disputes, which is where an attorney can help.
We help South Dakota employees protect their rights through unwavering defense and legal representation. Learn more about ourworkers’ compensation services.
How Maximum Medical Improvement Affects Workers’ Compensation Benefits
When a worker is deemed to have reached their MMI but is unable to work as they did before their injury, they can explore disability benefits. An employee can seek temporary, permanent partial, or permanent total disability benefits.
Temporary disability benefits offer wage replacement until the employee can return to work. Permanent disability covers an employee indefinitely.
Permanent partial disability benefits are calculated as a percentage of the employee’s impairment rating determined by a doctor. The impairment rating represents the patient’s level of functional loss, which refers to their ability to perform daily activities or work-related tasks.
Full disability benefits cover an employee who is unable to acquire gainful employment after their injury. They may not be physically capable of doing a job and supporting themselves or their families after their accident, and they need full-time benefits to replace the wages they have lost.
How much money can I receive in disability benefits?
The amount of money an injured employee receives depends on the severity of their injury and impairment. It is important to note that workers’ comp benefits are not the same as Social Security Disability Insurance (SSDI), which has its own eligibility criteria.
Compensation is two-thirds of the employees’ weekly pay, including overtime.Currently, workers’ compensation benefits in South Dakota are capped at a maximum of $1,066 per week and a minimum of $543 per week through June 30, 2025 [1].
You may seek additional compensation if you feel you have been wrongfully denied coverage, or if you intend to recover damages from an employer through a personal injury lawsuit.
Discuss your options with a dedicated attorney at Alvine Law Firm — call 605-275-0808 to book your free call.
What Happens After You Reach MMI?
After MMI, there are several possible avenues:
- Full-Duty: You return to work fully recovered
- Modified Duty: You return to your previous job with modification s
- Alternative Duty: You may take a different job that you can perform with your current abilities.
- Vocational Rehabilitation: If you are unable to return to your previous job, you may qualify for new job training or job placement assistance.
If you are unclear about next steps, consider consulting with an attorney. Our workers’ compensation attorneys in South Dakota can help you explore your options and ensure you receive the compensation you deserve.
Understanding Your Rights
You are allowed to challenge the declaration of MMI by your treating physician. Every employee who was injured in South Dakota has a right to a second opinion, and they can also dispute the MMI determination if they do not believe it is accurate.
If disputes arise, an attorney can help you navigate the process and build a strong case that supports your claim. You deserve to be compensated for your injuries and feel secure financially.
Our team will work with you and fight for you. Contact Alvine Law Firm today to schedule a call with one of our attorneys.
Sources
[1] Summary of Workers’ Compensation Law | South Dakota Department of Labor and Regulations