GQ Corner
Q. I had a DD completed on 9/18/20 to address MMI/IR. Claimant was not placed at MMI. A post DDRME was completed 2/2/21 and post has MMI date of 8/31/20. What are my options in this situation?
A. You should request a Benefit Review Conference on the issues of MMI and IR. You should not pay TIBs pursuant to the RME since that MMI date pre-dates the DD examination date where the claimant was found to not be at MMI; however, send a copy of the certification to the claimant by verifiable means for purposes of the 90-day finality rule.
Q. I have a claim from 1999. She indicated that at that time, when her claim was completed, they told her that she would have medical for life, and if she did not accept the money, she would also get future indemnity benefits. I know that for injuries now, this is not an appropriate statement, but not sure if this would have been something that was accurate 20 years ago? Have there been any law changes? Injured employee was at MMI on 10/20/2000 and 13% rating, which was paid in full.
A. The “new law” became effective in 1991, so that statement relating to settlement would be inaccurate. The claimant was paid income benefits. She is entitled to medical benefits too, but only if they are medically necessary and related to her compensable injury.
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