Jim Adler | The Tough, Smart Lawyer
By Jim Adler November 5, 2015

If you were injured on the job and it was someone else’s fault, you have a legal right to recover the costs of your medical care, lost wages and pain and suffering. But how much is your injury worth?

What is Maximum Medical Improvement?

That determination is vital in approaching and settling your work injury case as a workers compensation claim. A critical element of assessing your injury’s cost is what’s known as “maximum medical improvement.”

After your injury, you are deemed by your physician — and your physician only — to have reached your maximum medical improvement (MMI) when further meaningful improvement of your work-related illness or injury isn’t anticipated. You are then assigned an “impairment rating” (IR) by your physician as part of your claim.

Reaching MMI doesn’t mean you are fully fit and able to return to work in the same manner as before your injury. Rather, it means that your injury is not expected to improve significantly and now you must be assigned an IR by the same physician who determined you’d reached your maximum medical improvement.

In fact, MMI is especially pertinent after catastrophic injuries from which an employee may not fully recover, or from which recovery time may be substantial.

What is an Impairment Rating?

An impairment rating that’s assigned after MMI indicates the degree of permanent injury to the body of a worker who is not expected to gain full recovery.

If an IR is 15 or higher, a worker could be eligible for impairment income benefits as compensation for the damage caused to the worker’s body by a work-related injury.

Texas Law on MMI

By Texas law, if you haven’t yet reached MMI after 104 weeks (or two years) from the date benefits began, you are automatically deemed to have reached MMI, in what’s known as statutory maximum medical improvement.

When your IR rating is assigned, by Texas law an injured employee can receive three weeks of impairment income benefits for each percentage point of impairment. Thus, a 10% impairment rating would be three weeks times 10, providing 30 weeks of impairment income benefits.

As for the amount of impairment income benefits, which are paid weekly, these are determined by 70% of your average weekly wage. That is, if $1,000 was your average weekly wage, your impairment income benefits would be $700.

Impairment Rating Disputes

With this formula in mind, you may disagree with the impairment rating assigned by your doctor or the maximum improvement date. If so, you can file an impairment rating dispute.

You must file your dispute with the Texas Department of Insurance, Division of Workers’ Compensation. It’s important to contact the Office of Injured Employee Counsel as soon as you receive a Form DWC069 to assess the nature of your dispute. If you wait beyond 90 days, then the first impairment rating assigned becomes final.

Non-Work Cases of MMI

Not all MMI cases pertain to work injuries. Consider if a person was injured in a car accident and may not fully recover. That person should not file an immediate injury lawsuit, since it’s not yet clear how much his or her injury is worth. What remains to be determined is the person’s maximum medical improvement and the costs of not fully recovering.

Filing too early after an injury can reduce the amount of your claim. There may be unforeseen medical costs or work limitations that are not reflected in your lawsuit. Thus, it’s important to determine the point of MMI.

Don’t Settle for Less

The value of MMI is to alert victims that they should not settle their claim for less than it is worth. By defining the extent of an injury and its potential ongoing costs, it becomes possible to claim what an injury is worth — which may not be what an insurance company offers.

Insurance companies are in business to keep your money and make profits, not to dish out settlements freely and generously. An insurer thus will attempt to persuade a client to settle an injury claim prematurely — before the full extent of their injury is apparent.

Some persons eagerly accept such quick settlements without realizing that a more prudent course is to determine MMI and IR and to have an experienced injury lawyer on their side. They often can gain far more in a settlement by waiting to see what an injury truly is worth and then claiming that amount.

If you need help with an injury claim, notify the skilled injury lawyers and attorneys with Jim Adler & Associates. We’ll promptly provide you a free legal review of your case to help you decide what course to take.

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Testimonials

Erick Becker
Erick Becker
01:20 06 May 17
I am a Patrol Deputy for the Sheriff Office and while working one night, a drunk driver crossed the center stripe on the highway and struck my patrol vehicle head on with his pick up truck. Needless to say we (the drunk driver and I) were both lucky to survive, as the accident occurred at highway speeds. Following my release from the hospital, I knew that I would need to have someone represent me. My employer was happy to represent me in regards to prosecuting the driver for criminal charges but, can do little in respect to the recovery of financial losses for medical bills, pain and discomfort, time lost from work etc... This is how my relationship with Jim Adler and Associates began. Yep, you probably guessed correctly when you think of what made me choose the "Texas Hammer" to represent me. Those half obnoxious, half way entertaining commercials and radio announcements most Texans have been seeing and hearing on the TV and radio for years instantly came to mind. Yes, I wanted to "hammer" this S.O.B. for trying to kill me but, more importantly I was worried about the costs associated with the life long injuries I had sustained as a result of this drunk driver's negligent behavior. I contacted Jim Adler and Associates and so began our relationship. I was immediately surprised by the prompt attention and the expression of genuine concern for my well being that I received from the employees of Jim Adler's office. Now as you can imagine, lawyers are not a breed that is held in very high regard by people in my profession but, my experiences with Jim Adler's office and his employees have forced me to amend my way of thinking, at least on the civil side of the house anyway. I have to chuckle when I say that because my experience as a client of Jim Adler's firm has been exceptionally pleasant. So before I venture down one of the stereotypical and infinite number of rabbit holes associated with the relationship between members of law enforcement and lawyers; I will do my best to stay focused on my experience with Jim Adler & Associates. Upon being informed that my case had been accepted by Jim Adler's office; I was contacted by Iris Sanchez who informed me that she was to be my case manager and any questions, comments and concerns could be directed to her. I was pleasantly surprised to receive regular calls from Iris assisting with my medical appointments and future follow up appointments. Iris had informed me that Jim Adler's son, Bill Adler would be handling my case and I was even more surprised to receive several calls from Bill to discuss my case. Now you might be thinking "what's the big deal" with the person who is representing you contacting you? In reality, you are correct in that it isn't a big deal but, what is noteworthy and what separates Jim Adler's Office from the multitude of other lawyers is the genuine expressions of concern and the desire Bill Adler conveyed to me to do their best to help me. I felt an immediate connection and instantly realized I had made the correct choice in contacting Jim Adler & Associates to handle my case. One thing I think lawyers and police officers can agree on is the proverbial wheels of justice turn very slowly. Months go by and our professional relationship is never neglected. Through the unwavering attention of Iris Sanchez and Bill Adler himself, I never felt "out of the loop" so to speak and always had a clear understanding of where my case was at in regards to the legal process. In conclusion, I know my brief description of my experiences with Bill Adler and, his assistant Iris Sanchez, cannot provide the credit they deserve. Together they have done an outstanding job representing their firm/employer. If you are seeking a great firm to represent your legal interests and, take comfort in establishing a professional relationship that feels more like a friendship than a casual business acquaintance, then I highly suggest Jim Adler & Associates.
Tierra Clark
Tierra Clark
18:52 19 May 17
My lawyer Bill Adler and case manager Iris Sanchez are amazing! They constantly call and check on you . They keep you up to date through the process. They care about you as a person and not just a client. The wreck was a life changing experience that I've never been through before. I'm just glad I had the right people like Bill Adler and Iris Sanchez to help me through it. Truly satisfied.Thanks and God bless y'all!
Lorenzo Preston
Lorenzo Preston
17:23 26 Jan 17
Jim Adler only offer nothing less than a great experience. They are a very well-established organization. They are outstanding on keeping you up to date with cases. There's no beating around the bush with this organization as they are only straight forward with the whole process. They treat their customers like family as well as go above and beyond to fight cases for you only leaving you with nothing but the best experience. Easy 5-star rated organization. I would highly recommend this one organization you not look over.
Tori Barroga
Tori Barroga
14:17 11 May 17
I was dropped from a previous law firm regarding my case before I called Jim Adler. They immediately took up my case and worked hard on it - I was always up to date with each step they took and the benefits or consequences of each. In the end, I am highly satisfied with the outcome and would not have it any other way. It took some time but I truly appreciate and want to thank everybody who helped me on this journey and worked tirelessly on it.
Bernard Orozco
Bernard Orozco
17:16 23 Feb 17
I am very happy with Jim Adler & Associates. I did not know anyone who has ever used the Law Firm before. The staff is very friendly and treated me as if I were family. At times it got very stressful being without a job. They helped me when I was confused about the process. Mrs. Theresa Rodriguez stayed in contact with me constantly. Checking on me to see how I was doing and to let me know how things were going on there end. The Attorneys that handled my case know exactly what they are doing to take good care of me. Thank You so much Attorney's Mr.Michael Gomez and Mr.Trey Smith.
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