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Requesting MMI Status From an Adjuster

Tuesday, October 20, 2009 | 0

By Robert Elliot

Follow up  and documentation are key components to managing workers' compensation costs.

If time goes by on a specific injury case, it is up to the company to find out if your employee may have healed as much as possible for a particular injury. This is called "maximum medical improvement," (MMI). 

In most cases, it is recommended to allow a period of no more than four months, or 120 days, to lapse without MMI determination.

Occasionally,  an injury will indeed be so severe the employee cannot return to his or her former duties. This is unfortunate, but still, it is critical to thoroughly document such a case.

The injury coordinator is the person responsible for the communique, which may be e-mailed. A form for your use in documenting the injury may be found at Workers' Comp Kit  (http://www.workerscompkit.com/), but if you are writing your own, here are some things to include:

  1. The claim number and name of injured employee.
  2. Send a duplicate copy the communication to your supervisor.
  3. Note the employee's injury.
  4. List the amount of time the employee has been under the care of the treating physician.
  5. Note what little progress has been made.

Explain to your  adjuster that your company needs to know if transitional duty needs to be extended, or if this employee has perhaps reached MMI and will not be able to resume the original position. If this is the case, let the adjuster know your company will transfer the issue to the human resources department to ensure compliance with legal requirements, such as the Americans With Disabilities Act.

Ask your adjuster to contact the doctor to establish:
  1. Is the employee improving?
  2. When will the injured worker be able to return to regular duties?
  3. Will the worker have permanent job restrictions?
  4. Will the worker ever be able to return to work full-time and full-capacity?
  5. Has the employee achieved MMI? (workersxzcompxzkit)

Thank your adjuster for being helpful and request a phone call in response.

Editing Note:  Remember to use gender neutral descriptions.  Say: "Will the employee, injured worker, worker..."  instead of:  "Will he/she . . ." or worse, using the plural "they" as in: "He/she . . . and "they."

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Robert Elliott is executive vice president of Amaxx Risk Solutions Inc. in Mansfield Center, Conn. Copyright by Amaxx Risk Solutions Inc. and www.ReduceYourWorkersComp.com.® Reprinted with permission.
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