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  1. #1
    Join Date
    Nov 2009
    Posts
    60

    Default Declared at MMI Before IME

    From the great state of Idaho,
    I have continued problems from a back injury last November. I had surgery a bit more complicated than a decompression but no hardware. I ended up worse after surgery than before surgery. I had been in pain management until about a month ago. My treating doctor labled me MMI. I have pleaded this whole time, that I need help and am having great difficulties with pain and mobility. No one from work comp/doctors will allow me to have an apt with them to discuss my concern for my conditions. I have been seeing my own doctors as well for continued problems. They cut off my bi weekly checks once I was told I was MMI and started paying me for my impairment. I thought I was suppose to get paid that way until I was returned back to work or found a new job with in my restrictions-once im good enuf to work again. I was told in the mean time since right after surgery, that I would not beable to return to work due to my restrictions, but I have not been let go yet either. I am scheduled for an IME soon, I was told this is to determine what my disability will be and if any further treatment is needed. Why was I labled MMI and getting paid out for that and my IME is not scheduled for over a month later? I am working with the industrial commission for return to work, but im still getting treatment from my own doctors as im not able to do much of anything without adding pain on top of pain. Please Help Me Here

  2. #2
    Join Date
    Oct 2006
    Posts
    9,076

    Default Re: Anyone else Here

    once you are at maximum medical improvement you are expected to return to work within your restrictions and are no longer temporarily disabled.
    more info here
    http://www.iic.idaho.gov/

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,941

    Default Re: Anyone else Here

    Why was I labled MMI and getting paid out for that and my IME is not scheduled for over a month later?
    The IME is a Dr the carrier chooses to evaluate your condition, and rate to PPD.
    The insurance company can accept the opinion of any physician as long as it is reasonable. If you feel the insurance company is unreasonable, you can file a formal complaint (IC 72-706) with the Industrial Commission. The Complaint initiates the formal legal process to bring the issue to the Commission for a hearing and decision.
    You can file a form to initiate the dispute resolution process if you disagree with your Dr, or the IME. If you do not feel you are MMI, and require further treatment... you should file for a hearing.

    Because your Dr has determined you are stable/MMI at this point, your condition is not expected to change better/worse with or with out additional treatment, you are MMI. That does not mean you are not to receive additional medical care to "cure and/or relieve from the effects of your injury". That would be "future medical care".
    Is there a statute of limitation on medical benefits?
    If you have met the filing and notice requirements, there is no statue of limitations on medical benefits, unless the claim has been closed with a lump sum settlement (IC 72-706 (5)).
    But, the rules also provide...
    Can an insurance company require me to see a doctor other than my treating physician?
    The insurance company may require attendance at an Independent Medical Examination and then choose the medical opinion rendered in that report. The insurance company may also refuse to pay for future visits to your treating physician in certain circumstances.
    If I remember correctly, you are seeing your own Dr due to non industrial back/spine pain symptoms (?), not related to your work injury. It's difficult to seperate treatment where the same/similar body parts are in question.

  4. #4
    Join Date
    Nov 2009
    Posts
    60

    Default Re: Anyone else Here

    Thank You-that really does help me understand where I am at.

    No, oddly enuf I went back to my original doctor, once I was determined to be MMI, because of the amount of pain and problems. The doctor then ordered basically a full spine MRI and found another area that had problems. One of the same areas that the current work comp doctor that released me said he did not believe me when I told him I had pain and problems in the same area.

    Comp doctor has refused to let me have an apt with him, so given my situation, I can choose to go to the ER or continue to get help on my own...I have had enuf visits with the ER to know that, if im dropped to the floor with pain, they can help me for that molement, well the problems is what happens the next day and getting pumped full of drugs through an IV is not the highlight of anybodys day-that feels horrible

    One of my doctors is addressing my anxiety/panic attacks or "anxiety disorder" and another is trying to help with my spinal pain and lack of mobility-expensive-Yes-but I have dropped to the floor literally enuf times, it's motivation to seek help.

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