Montana Workers’ Compensation: How Your Benefits Work

You have a right to workers’ compensation benefits if you were injured on the job in Montana. Here’s what to do.

Figuring out workers’ compensation benefits isn’t easy. Here’s a guide to Montana workers’ compensation laws and how to apply them to your injury.

Every state requires most employers to carry some form of workers' compensation insurance that covers employees who become injured on the job. Almost every business that employs one or more people is required by law to carry workers' compensation, and it protects both the employees and the employer.

Here in Big Sky Country, the Montana Department of Labor & Industry (L&I) regulates workers' compensation.

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What kinds of injuries are covered under Montana workers' compensation?

Montana workers' compensation covers both occupational illnesses and traumatic injuries caused by an accident.

Any injury that happens on the job—from a broken leg from a slip and fall to an electrocution—can be classified as a traumatic injury if it's the result of an accident.

An occupational disease or illness develops gradually over time as a result of exposure to a condition or hazard in the workplace.

For example, workers in certain industries might develop mesothelioma after being exposed to asbestos on the job. Some workers who routinely handle certain chemicals or toxins could develop industrial dermatitis (skin damage) or asthma (from airborne chemicals), along with other illnesses.

There are also occupational injuries like carpal tunnel syndrome that develop over time, often because of repetitive motion. If your job involves tasks like repetitive slicing of food, using a machine with continuous pushing or pulling, performing many hours of typing, or even many hours of driving a vehicle, you could experience strain on the muscles, ligaments, or tendons.

What to do if you're hurt on the job: the workers' compensation process

The first thing you should do is report the injury to your employer.

In order to make a claim, you need to file this report within 30 days of the injury. You can provide this written notice to your immediate supervisor, manager, human resources, or anyone else to whom you report. It's a good idea to submit your written report to your employer even if the injury is minor and you didn't receive medical treatment—that way you've covered your bases in the event the seemingly minor injury becomes more serious down the road.

Your employer is then required to report the injury to L&I within 6 days from your notice by filing a First Report of Injury (FROI) form with the Montana Department of L&I.

If you're filing a claim, you must submit it to the workers' compensation insurer within 1 year from the date when you were injured—or in the case of a gradually developing illness or injury, from the date of diagnosis.

Is your job covered under workers' compensation?

If you're an employee of a business, you're entitled to workers' compensation insurance. However, this can be trickier if you're an independent contractor or freelancer.

There are certain industries whose employers are exempt from carrying workers' compensation for employees. If you're unsure about whether your job requires coverage, consult a Montana workers' compensation attorney.

Enjuris tip: If you’re an independent contractor in Montana and you get hurt, you must either get an independent contractor exemption or self-elect coverage to receive workers’ compensation benefits. That means you either waive your rights and benefits from workers’ compensation or you carry it on your own.

What if you were injured on a lunch break... or on the way to work?

In general, workers' compensation would cover an injury that happened while you were doing something on your employer's behalf or that's related to your employment.

If you're injured away from your worksite, you'd be covered under workers' compensation if you're visiting a client or business associate or at a work-sponsored event like a holiday party or outing.

Just remember, if you're driving yourself to a client meeting, you're covered while en route to the meeting and back... but if you take a detour for your own personal errand, you're not covered during that time.

Enjuris tip: A vehicle-related injury would be covered if you were doing something connected to your job, but NOT on your commute to or from work.

So, if your boss asks you to pick up lunch for the office (and stop to get her dry cleaning on the way back), you would be covered under workers' compensation for an injury that happens at any time during this outing—even though you might be running a personal errand for your boss and using your own car.

However, if you leave work at lunchtime for your own break, you're technically “off the clock” even though it's the work day. If you're in your own car and leaving the work site for lunch, an accident that happens during that time probably wouldn't be covered under workers' compensation insurance.

What benefits does workers' compensation provide?

Workers' compensation provides reimbursement for medical treatment, wage loss, and death benefits.

Medical benefits

Once your workers' compensation claim is accepted, you will receive payment for the expense of doctors, hospital fees, prescription medications, and other medical care. You can choose a physician for the initial treatment or diagnosis. After the insurer accepts liability, it might designate a physician for you or it could approve treatment by your selected physician.

Your medical benefits will cover expenses for 60 months after the date of injury or diagnosis. You can request an extension of up to 5 years after the time frame terminates. Your travel for treatment will be covered if you cannot receive the treatment you need within 100 miles of where you live or work.

Wage loss benefits

If you're unable to return to work because of your injury or illness, you can be paid for lost wages beginning on the 33rd hour or 5th day of wage loss. If you're unable to work for more than 21 days (or if you've been permanently disabled), your insurer could pay you retroactively for the first 32 days of wage loss.

  • Temporary total disability is when you're unable to return to the same job or any job that has similar physical requirements for a period of time determined by your doctor. In that situation, you can receive two-thirds (66%) of your gross wages at the time of injury up to a certain maximum. If you're also receiving Social Security disability benefits based on the work-related injury, the workers' compensation benefit could be reduced by up to half of the social security payment.
  • Temporary partial disability benefits are paid if you can continue to work during your recovery time, but at a lower wage than your normal. This amount is the difference between pre- and post-injury wages but will not exceed the temporary total disability rate.
  • Permanent partial disability benefits are for a person who can work in some capacity. When your doctor determines that you've reached maximum medical improvement (MMI), or that you're recovered as much as you're going to be, you'll receive an impairment rating, or percentage of lost function. If your impairment is minor, you can receive permanent partial disability benefits if you've lost wages. If your impairment is more severe, you could receive benefits even if you haven't lost wages.

Death benefits

If a family member died from a work-related injury or illness, you might be able to receive survivor's benefits for up to 500 weeks. Benefits are two-thirds of the worker's gross wage up to a certain maximum. You can also receive up to $4,000 for burial and funeral expenses.

Montana workers' compensation settlements

As you go through the process of collecting workers' compensation, the insurance company is going to work with you to try to settle the claim. In other words, the insurer will urge you to accept a sum of money so that they can close your case. A “full and final” settlement means you no longer have a right to additional benefits for that injury.

Enjuris tip: Before accepting a workers' compensation settlement, have a frank discussion with your doctor about whether you might require future treatment related to the claim. Once you settle, you can't claim additional benefits—even if your condition becomes worse.

There are limited circumstances where a settlement could allow for later benefits on the same claim, but that needs to be written into the settlement agreement ahead of time.

Most settlement come in the form of a lump sum payment. Before you settle, your doctor should determine that you've reached maximum medical improvement (you've recovered as much as is expected). Before that point, it would be difficult to assess how much your medical expenses would be.

You can negotiate a settlement directly with the insurance company, but we recommend talking to a workers' compensation lawyer first to make sure you aren't being taken advantage of.

How do you file a workers' compensation claim?

If you've already reported your injury to your employer and the insurance company, you might wish to consult a lawyer before you begin negotiations. If your injury was easily treatable and there are no additional medical treatments expected, the workers' compensation claim process might be straightforward and fast. But if you're looking at ongoing treatment or a long-term condition, or if your claim was denied, it can be more complicated.

A settlement agreement often includes terms with respect to Medicare eligibility, social security, payment of outstanding bills, and other items that could be confusing. An experienced lawyer will be familiar with these terms and will make sure that you're not unknowingly giving up rights.

Ready to get started? These Montana injury attorneys can help you through the process so that you receive the compensation you need and deserve.

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