Court: Temporary Total Disability Payments Must Stop When Worker Achieves Maximum Medical Improvement
Maximum medical improvement is an important concept in workers' compensation cases. Maximum medical improvement (MMI) occurs when an injured employee has reached the maximum benefit that can be obtained from medical care. At that point, a doctor can evaluate any lingering impairment to determine the extent of the permanent injury to the employee's body.
An injured worker's recent attempt to change longstanding workers' compensation laws to allow her to continue to receive temporary total disability benefits after achieving MMI has been rejected by Maryland's Court of Special Appeals.
Phuonglan Ngo fell on ice while working as a pharmacist at a CVS store in Hyattsville, Maryland. She suffered an injury to her back as a result of the slip and fall. Ngo began receiving temporary total disability (TTD) payments through CVS's insurer, American International South Insurance Company the day after her fall. Temporary total disability is a disability that is 100 percent in extent but temporary in duration. TTD is one of four categories of disability benefits.
Ngo started medical treatment shortly after the accident and eventually saw a neurosurgeon. The doctor believed that she might benefit from surgery to repair the fracture. When the insurer found out that Ngo had refused surgery, it stopped making TTD payments.
Ngo filed issues with the Maryland Workers' Compensation Commission (Commission) and asked the Commission to order vocational rehabilitation and to reinstate temporary total disability payments. After a hearing, the commission found that Ngo had reached MMI and it refused to reinstate her TTD payments but did authorize a 60-day vocational rehabilitation program for job placement. The Commission also determined that Ngo should be paid compensation for vocational rehabilitation benefits at the TTD rate during the period of vocational rehabilitation
One of the doctors who examined Ngo determined that she was unable to return to work full-time; but, that she was capable of working four hours a day, providing that her job was sedentary. The doctor also determined that she had reached MMI as of the day she decided against the surgery.
Ngo then asked the Circuit Court for Prince George's County to review the Commission's decision. At trial, Ngo testified that she had applied for 50 jobs that met the criteria suggested by the doctor and that after, having applied for 50 jobs, she was still unemployed. The jury found that Ngo had reached MMI, that she was temporarily and totally disabled from performing any work for several months after the on-the-job accident and that she continued to be temporarily and totally disabled until she found a job. However, the court set aside the jury's finding that she was "temporarily and totally disabled . . . continuing until she finds a job." The court also vacated the Commission's order. Ngo appealed.
The appeals court observed that Ngo contended that Maryland case law supported her position that temporary total disability payments could continue even after a worker reaches maximum medical improvement, so long as the claimant remains wholly disabled. Reaching back into Maryland case law, Ngo cited a 1940 case, relying upon language that said that a period of temporary total disability is "the healing period or the time during which the workman is wholly disabled and unable by reason of his injury to work. It is, therefore, a separate and unitary period of compensation, and as such is distinguished from a permanent partial disability."
Ngo argued that the rule should be that even though the healing period had ended because she reached MMI, she could still receive temporary total disability payments if she remained wholly disabled and unable, by reason of injury, to work.
The appeals court disagreed, explaining that to read the case the way Ngo did would blur the distinction between permanent disability - either partial or total - and temporary disability.
In Ngo's case, the court said the language supported the employer/insurer's position over the meaning of the word "temporary." An injury cannot be considered "temporary" once the healing period has ended, i.e., once the injured worker is as far restored as the permanent character of the injuries will permit. Once the healing period has expired, to obtain further workers' compensation benefits, the worker is required to apply for either permanent partial disability or permanent total disability.
The court also noted that, contrary to Ngo's contention, the test of whether a claimant's disability is permanent is not whether the claimant is able to convince an employer to hire her. Instead, the court said, the test for permanent partial disability is whether, at the time a claimant reaches maximum medical improvement, there exists a job for which a reasonable stable market exists. If, due to her work-related injury, Ngo cannot perform services for which a reasonable stable market exists, but has reached MMI, she would be eligible for permanent total disability payments.
As a result, the appeals court affirmed the trial court and concluded that a claimant cannot receive temporary total disability after he or she has reached MMI.
Baltimore, Maryland-based Belsky, Weinberg & Horowitz has represented consumers in workers' compensation cases for many years. Call our attorneys at 410-234-0100 or email us for a free consultation.