Maximum medical improvement (MMI) is a term used in personal injury and workers’ compensation cases. According to the New Mexico Workers’ Compensation Administration, MMI occurs when a doctor determines that no further recovery or improvement can be reasonably expected. In other words, your doctor does not believe that further medical treatment or time will prove your condition.
Some individuals recover fully from their injuries. However, you can reach MMI without a full recovery. In those situations, your doctor or a specialist assigns an impairment rating. Your impairment rating impacts recovery for a workers’ compensation or personal injury claim.
Insurance companies often dispute impairment ratings. The insurance company downplays permanent impairments to avoid paying large claims. Working with an experienced Albuquerque workers’ compensation lawyer can help ensure you receive a fair amount for an injury claim.
How Do You Receive an Impairment Rating for a Workers’ Compensation or Personal Injury Claim?
Your doctor must determine that you have attained maximum medical improvement before assigning an impairment rating. Impairment ratings may be based on the AMA Guides for permanent impairment.
Your doctor evaluates the severity of the impairment and issues a rating between zero and 100. A zero impairment rating means you recovered fully from your injuries with no lasting impairment. An impairment rating of 100 is a total disability rating.
The insurance company may require you to submit to an independent medical examination (IME). An IME is performed by a doctor chosen by the insurance company. The doctor examines you to assess the severity of your impairment.
Independent medical examinations are intended to be impartial second opinions. However, insurance companies often use physicians who are sympathetic to employers and insurance providers. Therefore, the IME may result in a lower impairment rating.
If you are required to attend an IME, talk with an attorney. Failing to attend an IME could result in losing your benefits and compensation. However, an attorney will advise you of your legal rights and assist you in disputing the results of an IME if necessary.
How Does an Impairment Rating Impact My Personal Injury or Workers’ Compensation Claim in New Mexico?
In a personal injury case, an impairment rating impacts the amount of damages you receive. A higher impairment rating can increase future economic damages. You may receive compensation for a decrease in future earning capacity, ongoing medical expenses, and long-term nursing or personal care. An impairment may also result in increased non-economic damages for diminished quality of life and ongoing pain and suffering.
Workers’ compensation claims are handled differently. The law determines the compensation a worker receives. It depends primarily on the impairment rating and type of impairment.
If you have a scheduled injury, you receive benefits based on the specific body part that is impaired. The compensation rate depends on the percentage of your impairment. The number of weeks you receive benefits is based on the impaired body part.
Permanent total disability (PTD) results in lifetime benefits. You receive weekly benefits at your compensation rate. For PTD benefits, you must sustain a total loss of the use of two body parts (e.g., arms, legs, feet, or eyes) or a severe brain injury.
Partial permanent disability (PPD) can be confusing. If your impairment rating is less than 80 percent, the maximum duration of benefits is 500 weeks. You can receive a maximum of 700 weeks if the impairment rating exceeds 80 percent. The amount of compensation depends on several factors, including your impairment rating and how much you can earn post-recovery.
Workers’ compensation benefits may be paid in a lump sum payment. Before accepting a lump sum payment or other settlement, talk with an attorney to discuss if the amount offered is fair.
Can I File a Personal Injury and Workers’ Compensation Claim?
Generally, workers covered by workers’ compensation cannot sue their employer for damages. However, they may have a third-party claim against someone who causes their work-related injury. If so, they may file a personal injury claim to recover additional compensation. Talk with an attorney to determine all claims you might have to maximize the money you receive for a work injury.
What Should I Do if I’m Injured at Work?
The steps you take after a workplace injury can significantly impact the outcome of your workers’ compensation claim. Steps to take after a work-related injury include:
- Notify your employer within 15 days of the accident.
- Complete the Notice of Accident Form and submit it to the employer.
- Seek immediate medical treatment for your injuries. You must see an authorized healthcare provider.
- Follow your doctor’s medical treatment plan.
If your doctor says you cannot work, you should receive temporary disability benefits. The benefits are based on 2/3 of your average weekly wages. An employer or insurance provider may try to convince you to return to work before your doctor releases you to return to work. If that happens, contact an attorney immediately to discuss your legal options.
You could be entitled to compensation for accident and injury claims. Contact us at (602) 600-9000 to schedule a free consultation with an Albuquerque workers’ compensation lawyer.
