What is Maximum Medical Improvement (MMI) and impairment rating (IR) and what does it mean?

Generally, MMI is reached when you have recovered as much as you are expected to from your injury/ illness OR it is reached statutorily;  The Texas Workers' Compensation law establishes MMI is reached at 104 weeks from the date that income benefits began to accrue.

If your treating doctor is certified to perform the MMI exam he would do this when he believes you have reached MMI otherwise he can refer you to a doctor that he knows is certified to perform the exam.

If you are found to have reached MMI, the Doctor will need to determine the impairment rating. He will exam you to determine if you have any impairment as a result of the injury/illness. Once the Doctor makes his determination, he has 10 business days to complete a DWC-69 form (Report of Medical Evaluation) which notifies all parties of his determination.

Once York receives the DWC-69 form, they will accept or deny the findings by filing a PLN-3.

If you are given a percentage of impairment of 1% or above and York is not disputing, Impairment income benefits (IIBS) will begin.  The start date of IIBS will be the day following the MMI date and the amount is calculated based on three (3) weeks of IIBS for every one (1) % of IR given. Example: You are placed at MMI as of 10/13/2017 and given a 2% IR; IIBS will be paid as of 10/14/2017 and you will be due 6 weeks (3 weeks x 2% IR = 6 weeks total due). The weekly amount is based on a calculation of wage for 13/14 weeks prior to your date of injury.

IF YOU DO NOT AGREE WITH BEING PLACED AT MMI; THE DATE OF MMI OR THE PERCENTAGE GIVEN, YOU HAVE 90 DAYS TO DISPUTE ONCE THE PLN-3 IS FILED OTHERWISE ALL OF THE ABOVE WILL BE FINAL. CONTACT THE WC TEAM IF YOU NEED ADDITIONAL EXPLANATION OR IF YOU NEED ASSISTANCE.

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