Weekly wage benefits end when you return to work full time. You don’t need “temporary total disability” checks if you’re no longer disabled and you’ve successfully returned to work. That makes sense.
What doesn’t make sense is that weekly temporary total disability checks can end before you return to work. When improvement in your medical recovery reaches “maximum medical improvement” (MMI), the law allows the workers’ compensation insurer to stop your checks.
What exactly is “maximum medical improvement”? Vermont Department of Labor Rule 2.2000 defines it as “the point at which a person has reached a substantial plateau in the medical recovery process, such that significant further improvement is not expected, regardless of treatment.” Put another way, it’s when the doctor says, “You’re as good as you’re going to get.”
You may face a financial crisis if your weekly temporary total disability checks are terminated due to reaching maximum medical improvement and you haven’t yet been able to return to suitable work. Sometimes, maximum medical improvement is declared sooner than it should have been. The insurer’s medical examiner might prematurely conclude that you have reached maximum medical improvement. If that happens, the adjuster will promptly make plans to stop your weekly temporary total disability checks.
The adjuster must file a Form 27 notice when intending to stop weekly wage benefits on grounds that you have reached maximum medical improvement. The adjuster is required to send a copy of the Form 27 notice to you or your attorney. The adjuster need give only seven days’ notice before stopping the checks.
If there is an attempt by the adjuster to cut off weekly wage benefits on grounds that you have reached maximum medical improvement, it’s important to check with your provider to see if your provider agrees or disagrees. Your provider might want to consult with an expert. You can also hire and consult with your own independent medical examiner. The insurer’s medical examiner does not necessarily have the last word.
A practical way to prevent an unnaturally early finding of “maximum medical improvement” is to be sure that (a) you fully participate in all forms of care and that (b) your provider has tried all options, including any reasonable consultations. You should not be told that you are at “maximum medical improvement” if there is a “treatment” that is reasonably expected to deliver “significant further improvement” in pain level and in functional abilities.