- June 19, 2020
- Work Injury
When you’ve been injured on the job and can’t work, your medical expenses and a portion of your weekly wages are typically paid through workers’ compensation. But at some point, your doctor will examine you and decide that you have reached maximum medical improvement, or MMI. This may cause you to wonder, “What happens after I reach MMI under New York law?” How are my workers’ comp benefits affected?
Reaching MMI means that your doctor thinks you are as improved from your work-related injury or illness as you are going to get. He or she will give you a disability rating. The disability rating assigns a percentage that you are found to be permanently disabled. You might be assigned a work restriction. Or the doctor may decide that you aren’t impaired or disabled at all. You could be forced to go back to work even if you don’t feel physically able. Or the rating may mean you can work in a job that is not as strenuous as the one you left, but that doesn’t pay as well either.
What Happens to Workers’ Comp Benefits after Reaching MMI in NY?
The time it takes to reach MMI after an injury or illness varies for each individual case. It can take months but no longer than two years. After reaching MMI in NY, your temporary disability payments from workers’ comp will end. Temporary income benefits can no longer be paid once you reach maximum medical improvement. There is the scary possibility that you could be left without an income. This is also when your employers’ insurance company may try hardest to keep you from getting additional benefits.
This is why it’s so important to get help with your workers’ comp claim if your doctor thinks you are getting close to reaching MMI. A skilled New York workers’ comp attorney will work in your interests to help ensure that you don’t have a break in benefits. Additionally, in spite of what your doctor said, if you don’t feel that you are close to or at MMI, you can potentially dispute that decision with the help of a lawyer.
What Benefits Can You Get After You Reach Maximum Medical Improvement?
After you reach maximum medical improvement, you might get permanent partial disability benefits or permanent total disability benefits through workers’ comp. What you could get depends on your level of disability:
Permanent Partial Disability Benefits
If it’s determined that you are partially but permanently disabled, your cash benefits would be calculated based on two-thirds of your average weekly wage multiplied by the percentage you are disabled. So, for example, if your weekly wage is $900 and you are 50% disabled, the calculation would look like this: 2/3 x $900 x 50% = $300.00.
How long you would get cash benefits depends on the body part affected. In complex workers’ comp lingo, there are both “scheduled loss of use awards” and “non-scheduled loss of use awards.” Scheduled loss of use includes disabilities to the extremities, such as arms, fingers, legs and feet, and loss of eyesight or hearing. Non-scheduled loss of use includes injuries to the spine or pelvis or to organs such as the brain or lungs.
This area gets very complex when it comes to understanding how much money you could get and for how long. It’s best to speak with an attorney to understand what cash award you could receive. Benefits may be paid in a lump sum or in regular payments.
Permanent Total Disability Benefits
If you are permanently and 100% disabled, you will receive two-thirds of your average weekly wages, up to the current maximum. So if you earned an average of $900, you would receive a weekly benefit of $600. There’s no limit on how long you can receive these cash benefits.
After MMI, you will also continue to receive medical benefits if you are partially or totally disabled.
It is Smart to Get Legal Help When You Reach MMI
Reaching MMI is a critical point in the workers’ compensation process. It is the time when your employer’s insurance company will probably try the hardest to get you off their books. If they can find that you are not disabled at all or give you a lower disability rating than you need, it saves them money. When you reach MMI or are close to it, it’s in your interests to speak with a New York workers’ compensation attorney.
You Can Challenge the Impairment Rating the Doctor Gives You
The impairment rating you’re given has a huge impact on your workers’ comp benefits…including how much you may get or whether you’ll continue to get any at all. If you don’t agree with the rating you’re given, you have the right to challenge it. But be sure to do it quickly before it becomes part of your permanent record.
A workers’ comp attorney in New York can advise you about the process for challenging your rating. Additionally, you should know that sometimes employers’ insurance companies challenge the ratings given by doctors. In these cases, the insurance company can force injured workers to have an independent medical evaluation by a doctor of its choice. The New York Worker’s Compensation Board will then review both reports and make the final decision.
Workers’ compensation is complex, and so is the process of challenging a workers’ comp doctor’s rating. Experienced New York workers’ compensation lawyers have in-depth knowledge of the law and what it takes to successfully challenge impairment ratings. We also are well-equipped to take on big insurance companies and their attorneys.
Our New York Workers’ Comp Attorneys Will Fight for You After You Reach MMI
Big insurance companies make more profits when they can stop paying benefits to workers who have reached MMI. But when you have a workers’ comp law firm on your side that understands insurance companies and the legal intricacies of the workers’ comp system, your chance of continuing to receive adequate benefits greatly improves.
At Kaplan Lawyers PC, our workers’ compensation attorneys know New York law. We don’t want you to worry about paying the bills when you have been injured on the job. We will fight for you. Call our workers’ comp attorneys at (516) 399-2364 for a free consultation.