Understanding the Basics of Montana’s Workers’ Compensation Laws
Do you need assistance with your workers’ compensation claim?
Hiring an experienced workers’ comp attorney can help you get the benefits you deserve.Just like most states in the U.S., Montana requires most businesses to carry workers’ compensation insurance for their employees. Workers’ compensation provides money to injured workers to help pay for expenses associated with a workplace-related injury, including work-related illnesses and occupational diseases. Additionally, workers’ comp can also provide a sick or injured worker with some of the income they’d receive during their recovery.
It’s just as beneficial for a business owner to have workers’ compensation insurance as it is for an employee because if an employee is injured or sick from working, the employer generally cannot be sued by their employee in a long and drawn-out court battle.
What benefits are provided under workers’ compensation?The following workers’ compensation benefits are available to most injured workers in Montana:
- Medical treatment for work-related injuries and illnesses
- Disability benefits if an injured worker is kept from working for an extended period
- Funeral costs for employees who die in work-related accidents
- Ongoing treatment, such as physical therapy to recover from an injury
- Wage loss benefits (if an injured employee needs time off to recover)
- Travel expenses to receive medical care
- Vocational retraining costs
How to file a work injury claim in MontanaYour first step after you’ve been injured at work is to seek medical attention. Your safety is always the first priority. After ensuring that your health is taken care of, it’s important to report your injury to your employer.
In Montana, injured employees have a maximum of 30 days to report an accident to their employer. The sooner you report, the better.
After being notified, your employer must file a First Report of Injury (FROI). This report must be filed within 6 days of being notified by an injured employee. FROI forms can either be submitted to their workers’ compensation insurer or to the Montana State Fund (MSF). Forms sent to the MSF can be submitted via fax, mail, online or phone.
Online forms must include the following information:
- Montana State Fund policy number
- Worker’s first name, middle initial and last name
- Social Security number
- Mailing address
- Phone number
- Employee classification code
- Job title
- Employee type
- Date of the accident or injury
- Description of the accident or injury
- Injured part of the body
- Where accident or injury occurred
- Date the employer was notified of the injury and who was notified
- Where the injured worker received treatment (if any)
- If the injured employee worked the next scheduled shift and if not, the last date worked
- Whether the employee had to take off work more than 4 days
Once the form has been submitted, your insurer must accept or deny the claim within 30 days. Claims that are accepted will be eligible to receive compensation from the 33rd hour (5th day) of losing out on wages. Injured workers whose injuries keep them from working for 21 or more days could be retroactively paid back to their 1st day of losing out on wages.
Appeals process if workers’ comp claim is deniedUnfortunately, workers’ compensation denials happen frequently. If your claim was denied—or you have to deal with an insurance dispute—you have the right to challenge the insurance company’s decision. After the denial of a claim, you can request mediation, petition for a hearing or appeal to the Montana Department of Labor (and ultimately, the Supreme Court).
Your first step in the appeals process is to request mediation with the insurance company. This process involves 2 steps.
First, you’re required to send a letter to the insurance company in which you explain that you disagree with their denial and what you feel is the better outcome. The insurance company will either accept your request or they could deny it or fail to respond. If your request is denied (or they wait longer than 15 days to respond), you’ll move on to a mediation conference.
Mediation conferences are mandatory for most workers’ comp cases in Montana. All that’s required to request a mediation conference is to file a Petition for Mediation Conference with the Mediation Unit of the Montana Department of Labor & Industry.
During your mediation session, a mediator will hold a conference call between you and your insurance company to reach a settlement. The mediator will not be the one to make the decision but they are able to make recommendations.
Petition for workers’ comp hearing
Mediation isn’t always a success. In the event that your mediation doesn’t result in a favorable outcome, you can petition for a workers’ comp hearing. To do so, you’ll need to file a Petition for Hearing with the Montana Workers’ Compensation Court. This will need to be done within 2 years of your original workers’ comp claims denial.
After receiving your petition, your hearing will be scheduled and you’ll receive notification of the date, time and location.
Before your hearing, you’ll be given a pretrial conference in which the judge can review:
- The specifics of the case
- Evidence that will be presented
- Issues of the dispute
At your mediation hearing, both sides will be given the opportunity to present witnesses, make arguments and present documents. A judge will then review the evidence and provide you with a written decision.
Appealing to the courts
In the event that you disagree with what the Montana judge decides, you have the option to appeal to the Montana Supreme Court. When your judge gives their decision, it will include the deadline you have to appeal and the way to file. If you appeal to the Supreme Court and they accept your claim, the Court will review what the prior judge said and make a decision whether or not to uphold the judge’s decision.
As you can see, the process of filing for workers’ compensation can be difficult. The best way to ensure that you receive the compensation you need is by hiring an attorney who has experience with workers’ compensation cases.