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WC says Maximum Medical Improvement, Back not healed

AnonymousUserAAnonymousUser Posts: 49,082
edited 06/11/2012 - 8:22 AM in Health Insurance Issues
HELP!!! I have been off work for 10 months enduring constant pain after herniations abutting nerves with Left leg weakness, sciatica and much more. I have only had about 5 weeks of Physical Therapy in that time but then WC doctor says I am ready to go back to a physical job lifting up to and over 100 lbs 70% of my day. At this point I can hardly push a cart through WalMart without pain. Attorney says if WC says I have met MMI they are the final say. If I go back to work and can't do it(which I have no doubt) what will happen then as far as another claim, payments, etc? How can they go by what a doctor paid by WC says?


  • Get a doctor of your own, ask friends or family for referrals to ones they have seen. You need to have an exam by a doc who will be un biased and objective.

    I was wc, and hired an attorney after 6 mos of work comp docs saying i just needed some PT and time to recover because I was 47 and "older" it will take longer. HOOEY =; I was in fantastic physical shape and very healthy.

    Your number 1 thing is to find help, treatment, validation, and support. My personal experience is no one will hand it you , fight for it with everything you can...even though it will add to your pain.
  • First off, sorry to hear you have to fight another difficult battle with so many opinionated people in your life. I hope things turn around for you soon.

    MMI means just that - maximum medical improvement. In your defense, MMI does not mean you are all better.... It just means you CAN'T get any better at this time...

    Be sure and spin it that way!

    Good luck!

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  • Hopeful, So sorry you are going through the WC runaround. I am also in their snare so can truley relate. 4 weeks before my surgery WC IME said I could return to work, my surgery was already scheduled, had to go to court 2 weeks before surgery and fortunately judge ruled in my favor. The IME never looked at the MRI.
    I agree with Gemini, go to your own doctor and don't go by what WC doctor says especialy if it is IME, they are hired by the company. I wish you best of luck as I know the frustration of the politics does not help stress level which in turn does not help your pain. My thoughts and prayers are with you.
  • Thanks so much for caring and your replys. I have an attorney and he has written a letter to my doctor,(the surgeon that says I do not need surgery at this time) requesting an impairment rating. That might get me a little money for the time being but as we all know, what I am worried about is my future medical. What if I go back to work (since WC says they won't pay my wages or anything else since I am MM now) and they close the case out and I can't perform my job? Then what? If the case is closed, can WC reopen for the same injury. My attorney is in mediations today and I am frantic
  • Hopeful, Seeking and Gemini:

    I just read my response to this thread. I feel like I used a poor choice of words "... spin it that way".

    Actually, what I mean to say was to explain it in a way to make those bozos understand that the phrase MMI can be misleading in that it leads some to assume the patient is all better, when in fact, that is not necessarily so. MMI just means that the patient is as good as he/she is going to get at this point in time.

    Hope I did not insult/offend anyone. If I did, I am deeply sorry.

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  • Hopeful, In my case I have been in and out of work several times. I have never had a "settlement" but get weekly payments from WC when I have been out of work In 2004-2005 I was out of work for 8 months. Then returned part time and then full time continuing to follow up with doctor at least in 6 month intervals depending on pain level and need for injections etc. Went back out for 3weeks in Aug 2007 that was covered WC again, and now most recent have been out since Dec 2007 and this time had PLIF 2 level fusion, all of this is still considered the same claim. Hope this helps.
  • That's what I needed to hear. I don't mind trying to go back. It is welcome but I don't see making it very long. I was worried I would be out in the cold and my case would be over with no recourse. My attorney has not filed a case but he is asking the MD for an impairment rating on my injury. If I take any money will that settle it and no more payments. I know it will happen again. It is not healed so I don't think a few thousand dollars can replace my salary payments should my back go out again. What do you think? I love this board. You are all so knowledgeable.
  • WC stated that they would not pay for any more diagnostic or treatments. So how do you go to the doctor for more injections if needed or go to the doctor every 6 months? Can they really just cut you off or are they just blowing smoke. I am still in alot of pain. They are covering my scripts and pain meds. I don't like the idea of working while on pain med, myself. Thanks again and no one here has ever offended me! I like the bluntness.
  • Hopeful, It sounds as if your lawyer is on the right track, they will probobaly have another hearing. Make sure he is well aware that you are NOT fine, and he knows your concerns about going back to work. As I said I did not recieve any settlement, and I am not an expert but my understanding is if you settle it closes your claim. Good questions to ask the lawyer. Good Luck at work, I know how difficult it is and am hoping to return to a wonderful job of my own soon.
  • Just came across this thread and thought i would offer up what i know and some of what been through. Most important get to know the laws of your state. Go to their website and learn as much as you can. Has work comp put you through a IME (independent medical exam). If it where me there is noway i would settle that case for a few thousand dollars. You could be doing well for awhile and everything going well and then bam out of nowhere it flares up again maybe not at your work or maybe. The problem is then you have a pre-existing condition which will cause more problems. Tell your attorney you want to see another doctor and they can contact work comp for you or as in my case my attorney paid for me to see another surgeon and a neologist. I was made MMI and have since had another surgery to correct the problems. The other question i have is are the going to send you back first for some light duty work and why have they not put you in a work hardening program. In the state that i live my employer has the final say so with work comp and forced them to put me in a therapy program last year. If your attorney is looking for a rating it sounds as though he is looking at settle your case and is not looking to get you medical help. Also not sure what type of business your in but that rating is available to future employers as well. I do hope things work out for you and that someone is more concerned about your medical condition and not just worried about how to close the claim.
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