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MMI and Impairment Rating Lawyers

What is MMI?

Remember those TIBS discussed before? The main reason those stop is because some doctor has declared you at maximum medical improvement, (“MMI”). Once that happens, your wage replacement ends. Ideally, you should be back at work when you get an MMI date, but this isn’t always the case. So what does MMI mean?

MMI means you are about as good as you are going to get in recovering from your injury. It does not mean you are completely healed —you may never recover completely. It just means that the doctors have done everything modern medicine can reasonably provide for your injuries.

But guess what? In all of medicine, and in workers’ compensation especially, MMI means different things to different people. If you have questions about MMI, please contact our Austin MMI attorneys. Buried in the workers’ compensation law is a very nasty rule: with a few rare exceptions, the first MMI date you get is FINAL if not properly disputed within ninety (90) days of when you receive the document declaring you at MMI.

What is an impairment rating?

Once you’re declared at MMI, you also get something called an impairment rating. In theory, you get paid for any permanent impairment you have from your injuries. After the doctor declares you are at MMI, he or she determines how permanently impaired you are by consulting the AMA Guides to The Evaluation of Permanent Impairment, 4th Edition. The previous 3rd Edition was somewhat fair in terms of awarding impairment ratings for the majority of workers’ compensation injuries—spinal injuries. However, the 4th edition is outdated and unfair. Most states using the AMA Guides are already on the improved 5th or 6th editions, but Texas continues to use the 4th edition.

How is impairment calculated?

“Impairment” is calculated as a percentage of your whole body which is impaired. The number goes from 0% to 100%. You get three weeks of checks for every 1% of whole body impairment, whether you are working or not. These are called “impairment income benefits.” Impairment income benefits are capped at a much lower rate than temporary income benefits.

Impairment Calculations in Texas

Unlike many states, with the exception of supplemental income benefits, Texas law does not take into account your prior job, or any lost earning capacity. A concert pianist who loses a finger, and a whole career, gets the same impairment rating as someone who can return to work with a missing finger. That’s it. No more checks.

At Allison & Ward, we are very familiar with the 4th edition. We often find errors the doctors have made and have handled many cases trying to correct these errors. If you believe your impairment rating is wrong, or account for all of your injuries, please give the impairment attorneys at Allison & Ward a call.

What is a designated doctor?

At the request of the insurance companies, The Texas Department of Insurance-Division of Workers’ Compensation appoints a state-approved and state-selected doctor. There are hundreds registered through the state. Most travel to different cities to examine injured workers. Not surprisingly, the quality of the opinions rendered by DD’s varies wildly. DD’s can also determine all sorts of things like MMI, IR, return to work ability and the extent of your compensable injuries. Their opinion is given presumptive weight, meaning they are presumably correct. Either side (you or the insurance company) can attack the DD’s opinion, but the attacking party has the burden to overcome that presumption with other evidence. If you think a DD has incorrectly determined anything about you, your MMI/IR, the extent of your injuries, or anything else, please give the impairment attorneys at Allison & Ward a call.

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