What to expect when the doctor says you're P&S or MMI

This video reviews what to expect when either your treating doctor or a panel QME find you permanent and stationary (or at Maximal Medical Improvement). If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.

In workers’ comp cases the general goal is to get injured workers as healed as possible, or as back to baseline (pre-injury status) as possible. Once that occurs, the doctor will declare the injured worker is P&S or MMI. That generally means, per 8 CCR 9785(a)(8) that the employee's condition, "has reached maximal medical improvement, meaning his or her condition is well stabilized, and unlikely to change substantially in the next year with or without medical treatment." When that occurs, the insurance company will usually immediately cut off temporary disability, and start moving to settlement. If you disagree with that finding, you will have some work ahead of you to try to either change the doctor's mind or show that another doctor's findings are more persuasive. Check out the links below for other videos referenced.

Jeremy Lusk is a certified specialist in workers’ compensation with almost two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.

No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.

[marissabergado]

My TTD ended June 2024. My employer did not engage in the Interactive Process and so I have been beyond indigent. Not even a penny to my name now and I asked my law firm if insurance company must pay my back retro TTD. It’s honestly ridiculous how they treat injured workers forcing them to just work. They do not communicate and it’s very obvious they’re risking my health all to save money. I even have been trying to pay to see a dr out of pocket to get certified for EDD but I don’t know if this affects me legally in CA. Bottom line is the insurance does not want to pay for my income losses and my lawyer needs to stand up and fight for me. Thank you for the videos and I will keep watching! 🎉🎉🎉❤❤

[reenastephens]

Thanks this was very helpful. Dr did not mention anything about MMI when I had an appointment with him.

[saberasarmin]

Thank you so much. Very helpful video .

[reenastephens]

Yes, I saw that on my appointment yesterday. It is due on 9/30/2022. My existing lawyer is not doing much. There is no updates from them I am the only one contacting them.
It is a long story. I am not even getting 67%of my salary

[samuelphillips]

I have multiple body parts that were affected due to a spinal injury in my neck- effects are now spreading onto shoulder blades, going down upper extreminies down both arms into hands--lower back injury @l-4, l-5, s-1 to lower extreminies spreading to both legs to feet. Also had a full mouth reconstruction due to wrench slipping & hitting mouth area hitting upper & lower front teeths, send a shock killing rest of teeths-so a full mouth recon. with implants & bone grafts(20) inplants & 12 surgeries performed--- Also have a bi-laterial hearing loss in both ears --NOTE: ALL INJURIES NOTED HAVE DIFFERENT DATES OF INJURY- IN MIST OF GOING ABOUT A GLOBAL SETTLEMENT WITH WORKERS COMP W/MSA-SURGERY IS NEEDED NOW ON MY NECK(FUSION)- LOWER BACK SURGERY @L-4, L-5--NEED SUGGESTIONS-DON'T WANT TO HAVE SURGERY UNDER THE WORKERS COMP SYSTEM--(TO MANY DENIALS & HAVING TO WAIT TO GET APPROVED)COMMENTS INVITED ASAP!

[BearPapa]

If there advances then in most cases the defense has an idea of how much the case will pay out correct ? And my lawyer should know how much my case is worth ? Is this correct to assume this as a injured worker ?

[Krystaldoll]

What if you have multiple body parts that are injured and the QME calls you P&S on two of the body parts but the third body part he thinks you should still be treated and have nothing reached P&S on that body part?

[heyits]

My doctor put me on stationary permanent disability, but I’m due to have surgery next month and I have restrictions to where I can’t use my hands left no more than 2 hours per day and no use of the right hand at all should the doctor kept me on temporary disability payments until my surgery. There is no job that I will train me within one month, so how do I go back to temporary disability payments.

[ChefFlee]

What happens if WC denies your surgery 4 times and your insurance can fix it. Will I need the doctor to release me from the WC part🤷🏽‍♀️

[Ieatsouls]

It’s been like 6 months since I gotten a ttd check they cut me off due to corrupt insurance network doctors but qme find me injured because of MRI and put me on permanent disability will the insurance pay all that back pay they owe me ?

[jasonkramsey]

How common is it to have an injury claim denied before ever getting to see a doctor about the injury?

[b.]

Great video. Very informative. What happens if your treating physician has written you up as P&S, and your employer calls you saying that they received your work status from the doctors and that you’re back on full duty ? That doesn’t make sense considering the insurance requested a QME after the doctors initial P&S report.. can the the employer ask you to come back to full duty even though the doctor deemed you as P&S ? thank you for your time.

[trinepimentel]

Thanks again, great insight. What if a Qme finds you Non industrial? Does this corroborate the case?Thanks in advance.

[dreamlandautospa]

How about you have never received temporary disability from insurance and haven’t been working since filing workers comp being after denial claim

[PUT_ME_IN_COACH]

My doctor found me medically stationary on 7/6/2023
I am supposed to get biweekly time loss benefits on 7/7/2023
For the time period june 3 to june 15
So, can the claims adjuster stop payment for when i was still injured a month ago?

[lol]

Hello I was on permanent work restrictions since 8/2023 and on my last visit this month May 15 2024... for some reason my employer took me off the schedule, I guess because they have no work for me.. I never received any payments only medical treatment.. will I be getting a weekly permanent partial disability check? And how long does it take to start receiving the check...

[JonHassellProphecy]

what if they say your MMI and they dont say you have any restrictions whatsoever and that your just good to go?

[Cheezmo]

What if I’ve been put on P&S and the company has not reached out to discuss modifications at all?

[nicolerobinson]

My employer closed a month after my injury last year. I had gone to a QME earlier this year and he stated I'm not at MMI and gave a list of suggestions (physical therapy, neurology, etc) but my PTP never requested any of the QME's suggestions. My PTP put my on PnS today. Will I still lose my benefits/payments even though I have no company to go back to, and the PTP and QME disagree? Can I apply for state disability until I find a job?

[filipoinzagione]

Thank you for the video, please can you tell the impairment ratings will be if someone has two time ankle surgery have srews or plate inside the ankle and even still the ankle not really good..Thanks in advance!