Recently, Florida’s First District Court of Appeal issued an opinion addressing a claimant’s eligibility to temporary partial disability benefits after an expert medical advisor opined that he reached maximum medical improvement.
Under the Florida State Workers’ Compensation Program, employees who suffered injuries at their workplace or during the scope of their employment, have the right to recover costs associated with their medical expenses and lost wages. To collect benefits through the state’s workers’ compensation program, employees must report their injuries to their employer within 30 days of either the injury or when it was discovered to be related to work. Employees must provide as much information as possible, including details regarding the accident and the symptoms they are experiencing.
After reporting an injury, employers should contact their insurance company and send the employee to an occupational doctor of their choosing. The doctor will treat the patient until they reach “maximum medical improvement” (MMI). Under the statute, MMI is when a reasonable medical professional determines that an individual’s condition has reached a point where they should not expect any further recovery. A finding of MMI does not necessarily mean that an employee is fully recovered or that they are not experiencing functional limitations. Further, reaching MMI does not automatically terminate entitlement to treatment. However, reaching MMI is a critical point in the employee’s treatment, because once MMI is reached, an employee’s insurance carrier can reduce or terminate benefits. Issues arise because there are instances where doctors are under pressure to categorize patients as reaching MMI, even if that is not the case.