Greetings,

Florida has some nuances regarding Maximum Medical Improvement (MMI), so here are some reminders:

MMI is defined in the statute as 440.02(10) “Date of maximum medical improvement” means the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability.

1. A claimant can continue to treat after MMI, palliative treatment, to maintain not improve their condition.  The claimant can continue to treat as long as the doctor opines the accident remains the major contributing cause of the need for treatment, and the treatment remains medically necessary.

• If the claimant is only doing annual follow ups with the doctor to prevent the Statute of Limitations from running, you can ask the doctor if further treatment is medically necessary.  If the answer is no, then you can deny future care BUT you need to balance the costs of the treatment and the potential litigation costs.

2. A claimant is not at overall MMI until they are assigned that status for all body parts/modes of treatment (ortho, neurology, pain mgmt, etc).  Once a claimant is at overall MMI, entitlement to TTD and TPD ends.

• You do not have to start the impairment benefits until the claimant is overall MMI so you can combine the ratings. Always check the chart in the 1996 Florida Impairment Guide for the combined ratings, 2 plus 2 is not always 4.  (if you need a copy of the book, please let me know and your mailing address and we can send you one).

• Arguably, if a claimant is not at overall MMI but is at full duty you can suspend temporary benefits.  This is true even if the employer has not taken them back because the accident is not the major contributing cause of the loss of earnings.

3. A claim for Permanent Total Disability (PTD) is not ripe unless the claimant is at overall MMI…with one exception.  If the work restrictions from one body part that is at MMI are sufficient to prove PTD, they do not have to be at overall MMI.  Meaning if the work restrictions for a head injury at MMI are no work ever again, it does not matter that the claimant is not at MMI for his pinky finger.  A claimant could file for PTD in that instance.

4. A doctor is not supposed to charge the E/C for an MMI determination.  They cannot charge for completing the DWC-25.  However, some doctors will say they need an appointment to see the patient to make the determination and assign work restrictions.   Sometimes a doctor refers a claimant out for a Functional Capacity Evaluation (FCE)  to determine work restrictions for MMI, and that can delay MMI for a few weeks or longer.  In that case, it may make sense to ask the doctor to assign MMI in that last visit and then subsequently determine work restrictions in a later visit to save several weeks of indemnity.

5. A Judge will not approve a settlement of an unrepresented claimant with a compensable claim without the claimant being at MMI, and they will also want to see that an impairment benefits have been paid outside of the settlement amount.  A denied unrepresented claimant does not need MMI, and if the claimant is represented they can settle prior to MMI.

As always, please let me know if you have any questions AND:

Join me 6/25/24 for the WCCP 4 hour law and ethics webinar CEU.

And 7/26/24 in Tampa for our live CEU/Dinner.

Sincerely,

Morgan Indek | Managing Partner