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Workers Compensation in Montana

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Jason Metz

Montana requires all businesses to have workers comp for employees, with only a few exceptions.

Workers comp insurance can pay a portion of a worker's lost income and their medical bills if they are hurt while doing a work-related task. Work injuries that can be covered by workers comp range from foot joint pain to breathing problems to broken bones.

Montana workers compensation law defines who can be exempt from coverage, who is required to be covered and the limits of workers comp payments. Below are many of the specifics contained in the workers comp law in Montana. The Montana Department of Labor & Industry also has a page with helpful information for employers.

Who has to be covered by Montana workers compensation?


Can any employees opt out of Montana workers compensation with a waiver?

No


Is self-insurance for workers comp allowed in Montana?

Yes, for individual employers, groups of employers and political subdivisions. Political subdivisions in Montana are typically the state or a city, county, special district, school district or public agency.

By self-insuring, a business assumes responsibility for paying their own workers comp claims. A self-insured company typically hires a claims service company to handle claims administration and other services.


Are there exclusions for:

Small employers? No.

Agricultural employers? Yes, agricultural employers are not required to cover employees who are performing temporary agricultural work for an employer (if the person performing the work is otherwise exempt from the coverage requirement).

Domestic employers? Yes.

Independent contractors? Yes.

Casual employees? Yes.

Volunteers? Yes.

Professional athletes? Yes.

Montana workers comp medical benefits


Is there a Montana workers comp fee schedule?

Yes.

Fee schedules define payments for surgery, radiology, hospital services, chiropractic care, ambulance service, prescription drugs and other medical services for an injured worker.


Are there limits on medical treatment?

Yes, after initial visit to hospital emergency room, there is a $25 co-payment for each subsequent visit to an emergency room unless requested by the insurer.

Palliative care is also limited. Palliative care may not be payable after medical stability unless the worker is permanent total disability (PTD), it is necessary to monitor a prosthetic device, or it enables the worker to continue employment or is necessary to return the worker to work. Medical benefits terminate if not used for 60 consecutive months.


Who makes the initial choice of treating physician?

The employee. Any time after the insurer accepts liability for the claim, the insurer may designate the treating physician and transfer care to the designated treating physician.

Disability payments for workers compensation insurance in Montana

Workers comp generally pays a worker a portion of their income when they cannot work because of a work-related injury. Based on both permanent and temporary disability, state laws outline the disability payment amounts and length.


How are temporary total disability (TTD) payments calculated?

66 2/3% of the employee's pre-injury wage, subject to a maximum.

Weekly minimum: None.

Weekly maximum: $733

Maximum length of TDD benefits: For the duration of temporary total disability.

How are permanent total disability (PTD) payments calculated?

66 ⅔% of the employee's pre-injury wage, subject to a maximum.

Weekly minimum: None.

Weekly maximum: May not exceed the state's average weekly wage (AWW) at time of injury.

Are there cost of living increases for PTD payments? Yes, after 104 weeks paid benefits; increases each year the same percentage as the increase in the statewide average weekly wage (SAWW).

Maximum length of PTD benefits: Payable until retirement.

How are permanent partial disability (PPD) payments calculated?

66 ⅔% of the employee's pre-injury wage, subject to a maximum.

Weekly minimum: None.

Weekly maximum: $366.50

Fatality benefits under Montana workers compensation law

Maximum burial benefit: $4,000

Dependency benefits, weekly minimum: 50% of statewide average weekly wage (SAWW).

Dependency benefits, weekly maximum: May not exceed the state's average weekly wage at time of injury (AWW).

When do children's dependency benefits end? At age 18; age 22 if the child is a student; benefits can continue for life if child is disabled.

Other injuries covered by Montana workers compensation

Mental stress with no physical injury? No.

Cumulative trauma (such as injuries caused by repeated exposure or repetitive motion)? Yes.

Occupational hearing loss? Yes.

Disfigurement? Yes.

Source: Workers Compensation Research Institute, May 2016 report